1.Treatment Outcomes of Patients with Multidrug-Resistant Tuberculosis (MDR- TB) Compared with Non-MDR-TB Infections in Peninsular Malaysia
Omar Salad Elmi ; Habsah Hasan ; Sarimah Abdullah ; Mat Zuki Mat Jeab ; Zilfalil Ba ; Nyi Nyi Naing
Malaysian Journal of Medical Sciences 2016;23(4):17-25
Background: Treating patients with multidrug-resistant tuberculosis (MDR-TB) strains is
more complicated, complex, toxic, expensive, than treating patients with susceptible TB strains. This
study aims to compare the treatment outcomes and potential factors associated between patients
with MDR-TB and non MDR TB infections in peninsular Malaysia.
Methods: This study was a retrospective cohort study. Data were collected from the medical
records of all registered MDR-TB patients and Non-MDR-TB patients at five TB hospitals in peninsular
Malaysia from January 2010 to January 2014.
Results: A total of 314 subjects were studied, including 105 MDR-TB cases and 209 non-MDRTB.
After TB treatment, 24.8% of the MDR-TB patients and 17.7% of non MDR TB relapsed; 17.1% of
the MDR-TB patients and 16.3% of non MDR TB defaulted from TB treatment. A significant difference
seen in treatment success rate 17.1% for MDR-TB; 63.1% for non MDR TB (P < 0.001)). Mortality rate
were 8.9% for MDR-TB; 13.2% for non MDR TB. Multivariable analysis showed the potential factors
associated with poor treatment outcomes were presence of HIV infection (AOR, 1.09; 95%CI: 1.05,
1.75; P = 0.001) and previous TB treatment (AOR, 4.87; 95%CI: 2.84, 8.38; P = 0.001).
Conclusion: This study revealed that the treatment success rate in patients with non MDR TB
infection was higher than MDR-TB. Unsuccessful treatment was seen in MDR-TB associated with
potential factors such as history of TB treatment, and presence of HIV infection.
2.Molecular detection of selected zoonotic respiratory pathogens and the presence of virulence and antibiotic resistance genes via PCR among Kelantan Hajj pilgrims
Ilia Eleena Mohd Baharin ; Habsah Hasan ; Nik Zuraina Nik Mohd Noor ; Maizan Mohamed
Malaysian Journal of Microbiology 2021;17(3):254-265
Aims:
Respiratory tract infections (RTIs) among Malaysian pilgrims are caused by exposure to zoonotic-potential
respiratory pathogens, symptomatically and asymptomatically affected by rigorous pilgrimage rituals, overcrowding and
other stressors. This study aimed to determine the prevalence, virulence and antibiotic resistance genes of selected
zoonotic respiratory pathogens using polymerase chain reaction (PCR) assays among Hajj pilgrims from Kelantan state,
Malaysia.
Methodology and results:
Throat swab specimens were obtained from 189 Kelantan Hajj pilgrims in 2016 and
examined by PCR for the identification of respiratory pathogens. Thirteen samples (6.88%) were positive for
Streptococcus pneumoniae and four (2.11%) were positive for Klebsiella pneumoniae. All the samples were negative for
Influenza A virus, MERS-CoV and Mycobacterium bovis. One sample was positive for S. pneumoniae virulence lytA
gene. One sample was positive for K. pneumoniae virulence magA and K2A genes respectively, and three samples
were positive for K. pneumoniae rmpA genes. Ten and seven samples were positive for S. pneumoniae mefA and pbpA
antibiotic resistance genes respectively. Two samples were positive for K. pneumoniae blaKPC and blaOXA-48 antibiotic
resistance genes.
Conclusion, significance and impact of study
This work provided insight into the existence of zoonotic respiratory
pathogens inducing Hajj RTIs in Kelantan pilgrims. It showed promising findings for zoonotic studies in Hajj settings. The
findings could be relevant in potential control measures for the management of zoonotic infections among Hajj pilgrims.
Respiratory Tract Infections
;
Polymerase Chain Reaction
;
Bacterial Zoonoses
3.Epidemiology and Determinants of Serologically Diagnosed HIV-1 and HIV-1&2 in Tertiary Hospitals of Eastern Peninsular Malaysia
Siti Aishah Muhadi ; Habsah Hasan ; Nurahan Maning ; Nik Rosmawati Nik Husain ; Fatimah Haslina Abdullah
Malaysian Journal of Medicine and Health Sciences 2020;16(SP 1, September):9-15
Introduction: HIV is the leading cause of mortality and morbidity worldwide. There are two types of HIV, HIV-1, and HIV-2, which are geographically different in epidemiology and determinants.
Objective: To determine the epidemiology and determinants of HIV-1 and HIV-1&2 in the three tertiary
hospitals of Eastern Peninsular Malaysia. Method: A cross-sectional study of confirmed serologically
HIV-1 and HIV-1&2 from January 2016 until December 2018. SPSS analysed all collected
data, descriptive statistics for sociodemographic data and Pearson chi-square for the association
between type of HIV with HCV, HBV, syphilis, and tuberculosis. In identifying the risk factor associated with HIV-1&2, several variables were tested by the Multiple Logistic Regression Model.
A P-value of <0.05 was considered statistically significant. Results: Out of 519 serologically diagnosed
HIV, 344 (66.28%) were HIV-1, and 175 (33.72%) were HIV-1&2. HIV positive were highly distributed
in Malay male in both groups. Most HIV-1 patients were single, unemployed, and presented with tuberculosis.
HIV-1&2 were single and employed, mostly asymptomatic at diagnosis. The commonest mode of
transmission for HIV-1 was by sexual contact (31.87%), whereas IVDU (13.63%) in HIV-1&2.
Co-infection with tuberculosis (P=0.005) and HCV (P<0.001) were significantly higher in HIV-1 as
compared to HIV-1&2. IVDU was a significant determinant to develop HIV-1&2
(Adjusted OR: 3.5, 95% CI=1.875-5.227, P<0.001). Conclusion: HIV-1&2 was high in this study.
Patients with HIV-1&2 present in less severe symptoms compared to the patient with HIV-1. A further molecular
diagnostic study should be tested to confirm the type of HIV.
4.Effectiveness Of Community-Based Health Education On Preparedness For Flood-Related Communicable Diseases In Kelantan
Wan Mohd Zahiruddin Wan Mohammad ; Wan Nor Arifin Wan Mansor ; Noor Aman A Hamid ; Surianti Sukeri ; Habsah Hasan ; Lee Yeong Yeh ; Alwi Muhd Besari ; Nani Draman ; Rosnani Zakaria ; Zeehaida Mohamed
Malaysian Journal of Public Health Medicine 2020;20(3):117-124
The flood disaster in Kelantan in 2014 had resulted in substantial health implications including increased cases of communicable diseases. There was a lack of community preparedness including customized health educations in the prevention and control of flood-related communicable diseases in the affected areas. The research was aimed to evaluate the effectiveness of community-based health education modules on flood-related communicable diseases among communities in Kelantan. Health education modules focusing on major food-related diseases were developed. A non-randomized community-controlled trial using the modules were conducted. Outcomes were assessed on knowledge, attitude and preventive practice scores to flood-related communicable diseases using a pre-validated questionnaire. Independent t test was used to compare mean scores between the intervention community (Tumpat) and the control community (Bachok) at 1-month post intervention. One-way independent ANOVA test was done to compare score differences at baseline (pre), post 1-month and post 2-month from repeated surveys among random samples within the intervention community. There were significant improvements in all knowledge components from 9.4% to 52.6% with 10% increment in attitude scores toward preventing behaviours on flood-related communicable diseases. When compared against the control community at one-month post-intervention, there were significantly higher knowledge on types of diseases, symptoms and risk factors as well as practice scores of drinking safe water and protective habits. This research demonstrated that community-based health education is effective in improving relevant knowledge, attitude and preventive practices among affected communities as part of their preparedness toward communicable diseases related to flood.