Treating tuberculosis (TB) remains a public health challenge in many developing countries. Treatment success rate in Malaysia is on declining pattern from 78% in 2000 to 48% in 2006. This study will determine factors associated with unsuccessful treatment among pulmonary TB patients. A retrospective cohort study was conducted on notified and treated pulmonary TB cases in Kota Bharu district Kelantan between January 2006 and December 2007. To identify the associated factors, univariate comparison and multiple logistic regressions were performed. Among the 765 patients identified, 472 (61.7%) cases fulfilled the criteria and were analyzed. There were 316 males and 156 females and their mean (SD) age was 45 (17.9) years. In univariable analysis, age, gender, educational level, employment status, family incomes as well as co-existence of extra-pulmonary TB, smoking, co-morbid disease (diabetes mellitus), HIV status, sputum cultures, chest X-ray findings and duration of delay for diagnosis were all found to have significant relationship with unsuccessful pulmonary TB treatment outcome. After adjusted for the confounders, the significant predictors for unsuccessful tuberculosis treatment were age (Adj. OR 1.09; 95% CI: 1.03-1.15), HIV positive (Adj. OR 23.04; 95% CI: 3.01-176.22) and advanced chest X-ray findings (Adj. OR 6.51; 95% CI: 1.50-28.23). A large proportion of unsuccessfully treated cases could be identified at entry by screening for age, chest X-rays and HIV status and specially targeted measures could be taken. The use of directly observed treatment short-course (DOTS) should be given more focus and priority among this high risk group of patients.

Background: School children are at great risk of nutrition-related chronic diseases. Their eating pattern in school is influenced by the availability of food served within the school environment. The purpose of this paper was to determine the effectiveness of a canteen-based food nutrition intervention, designed according to the theory of planned behaviour, on the knowledge, perception and choices of healthy food among primary schoolchildren. Methods: This was a prospective intervention study using a two-group design. Six school canteens from the ninety-eight primary schools were randomly allocated to an intervention group or a control group. All the food handlers in the intervention group were given a twelve-week training course in food nutrition. On the completion of the course, 293 Standard Six students from these schools, were interviewed with a nutritional questionnaire on food in their school canteens. The training programme for the intervention group and the questionnaire for the students were developed and validated for the study, and a power calculation made for the sample size of students.Results: The students in both groups were homogeneous in gender and body mass. The mean body mass index (BMI) was 19.26 (SD: 0.38) and 19.47 (SD: 0.39) for the intervention and the control group respectively. There were more schoolchildren in the intervention group who purchased foods in school canteens (p 0.0036)of milk and milk products (p 0.034), and white rice (p<0.001). Fewer purchased fast food (p<0.001), and more had a better perception towards serving of healthy food (p 0.001). There were no significant differences in the knowledge level (p 0.095) and purchased fruit (p 0.557) between the groups. Conclusion: A school-based nutrition programme was associated with significant improvement in the perception of students towards foods served in school canteens and in their choices of healthy food. The study provided a framework for the design and implementation of future food nutrition intervention in school canteens.