OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer. METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review. RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19). CONCLUSIONS: Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.
Brain ; Case-Control Studies ; Delivery of Health Care ; Folic Acid ; Health Education ; Health Promotion ; Odds Ratio ; Pregnancy

OBJECTIVES: Maternal folic acid supplementation is considered mandatory in almost every country in the world to prevent congenital malformations. However, little is known about the association of maternal folic acid intake with the occurrence of childhood cancer. Hence, this study aimed to determine the effects of maternal folic acid consumption on the risk of childhood cancer. METHODS: A total of 158 related articles were obtained from PubMed, Google Scholar, Scopus, and ProQuest using standardized keywords, of which 17 were included in the final review. RESULTS: Eleven of the 17 articles showed a significant protective association between maternal folic acid supplementation and childhood cancer. Using a random-effects model, pooled odds ratios (ORs) showed a protective association between maternal folic acid supplementation and childhood acute lymphoblastic leukaemia (OR, 0.75; 95% confidence interval [CI], 0.66 to 0.86). However, there was no significant association between maternal folic acid supplementation and acute myeloid leukaemia (OR, 0.70; 95% CI, 0.46 to 1.06) or childhood brain tumours (OR, 1.02; 95% CI, 0.88 to 1.19). CONCLUSIONS Maternal folic acid supplementation was found to have a protective effect against childhood acute lymphoblastic leukaemia. Thus, healthcare professionals are recommended to provide regular health education and health promotion to the community on the benefits of folic acid supplementation during pregnancy.

Introduction: Measles outbreaks are endemic in Southeast Asia. A possible reason for such outbreaks is low vaccine coverage. In Malaysia, there is a lack of studies on measles outbreaks. The urban district of Petaling in Selangor, Peninsular Malaysia, reported a high number of outbreaks in 2014–2018. Thus, we analysed the trend of measles outbreaks and identify the common characteristics of measles cases in Petaling District. Methods: This was a cross-sectional study using secondary data from the Petaling District Health Office online surveillance system. Data from 2014 until 2018 from the e-Measles and eWabak systems were extracted, and the trend and common characteristics of measles cases were analysed. Results: A total of 48 outbreaks involving 124 cases were reported during the period investigated. The outbreaks showed an increasing trend from 2.1% in 2014 to 37.5% in 2016, and decreased slightly from 29.2% in 2017 to 27.1% in 2018. The common characteristics were age 1 to <7 years (50.8%), female sex (55.6%), Malay ethnicity (89.5%), Malaysian citizenship (95.2%) and being unvaccinated (55.6%). Of the cases, 63.7% were admitted to hospital, and siblings were the common source of infection (75.8%). Most cases occurred at home (75.8%). Most of the children who were infected at home were unvaccinated (60.6%). Conclusion: Unvaccinated children aged 1 to <7 years are at highest risk of contracting measles and spreading it to their siblings. Thus, awareness of the importance of vaccination needs to be emphasized to their parents to prevent related issues such as vaccine hesitancy.

Introduction: Dengue fever is caused by the dengue virus that is transmitted via Aedes mosquitoes. The lifecycle of Aedes mosquitoes is affected by the local climate (rainfall) which influences dengue transmission. Sabah is one of the states that is laden with a high incidence rate of dengue in Malaysia and the condition seems to have worsened with sudden, multiple outbreaks occurring in the year 2016. Methods: An ecological analysis was conducted in Keningau, Sabah to analyse dengue case patterns and distribution over a 5-year period and to exhibit the correlation between rainfall, larval indices, dengue incidences, and outbreaks. Results: Significant cross-correlation analysis (CCF) was discovered between rainfall and Aedes index at lag number 5 with a correlation coefficient of 0.151 (±0.063) as well as between rainfall and Breteau Index at lag number 5 with a correlation coefficient of 0.143 (±0.063). However, no significant cross-correlation analysis was found between Aedes index and dengue incidences. Associations were also seen between larval indices and outbreak cases. Conclusion: This study showed an increase of Aedes and Breteau Indices to susceptibility level five weeks after rainfall which increases the risk of dengue transmission.