CHARACTERISTICS OF SMEAR-POSITIVE PULMONARY TUBERCULOSIS WITH NORMAL CHEST RADIOGRAPHIC FINDINGS DURING A TUBERCULOSIS OUTBREAK IN NORTHEAST MALAYSIA: A CROSS-SECTIONAL STUDY Introduction: Tuberculosis (TB) remains a highly prevalent disease in Malaysia. Early identification using cost-effective methods such as chest radiography can reduce the health burden of a TB epidemic. However, normal chest radiographic findings are common. This study aimed to evaluate the characteristics of smear-positive pulmonary TB with normal chest radiographic findings during an outbreak. Methods: A cross-sectional study was conducted by reviewing the medical records of 56 pulmonary TB cases registered at Kodiang Health Clinic from April to October 2022. Smear-negative and extrapulmonary TB cases were excluded. Relevant information was extracted from the medical records and recorded in a case report form for data management and analysis. Results: Approximately 60.7% of the cases had symptoms lasting >2 weeks, and 89.3% showed abnormal findings upon clinical examination. Additionally, 73.2% had sputum acid-fast bacilli counts of ≥1+, and the sputum Mycobacterium tuberculosis culture and sensitivity test findings were positive in 82.1% of the cases. The proportion of smear-positive pulmonary TB with normal chest radiographic findings was 42.9%. The factors associated with smear-positive pulmonary TB with normal chest radiographic findings included being under 18 years old (P=0.021), being a student (P=0.010), being single (P=0.012) and being asymptomatic (P=0.04). Conclusion: Normal chest radiographic findings may lead to a misdiagnosis of smear-positive pulmonary TB, especially during an outbreak. Therefore, active case detection among close contacts with risk factors for normal radiographic findings should consider additional supportive tests.

Introduction: This study aimed to determine the risk factors of CHD among the Malaysian adult population. Methods: Using a cross- sectional observational study design, this study involved 365 adult patients aged between 30-64 years, attending clinics from eight government hospitals and four health clinics in Terengganu, Pahang, Selangor, Putrajaya, Penang, Kedah, Johor and Sabah from February 2018 until September 2020. Sociodemographic characteristics, clinical and dietary data, physical activity and stress level were recorded using a structured questionnaire. Multiple logistic regression was used to analyse CHD risk factors. Results: The overall response rate was 99.2%. The adjusted odds ratio of CHD was greater for age (AOR; [%95 CI]) (1.043;[ 1.009,1.078]); waist circumference (1.033;[1.009, 1.057]); total fat intake (1.035;[1.021, 1.050]); full cream dairy products intake (1.004;[1.001, 1.008]); smokers vs non-smokers (4.691;[2.399, 9.176]); individual with family history of CHD vs without family history (2.705;[ 1.496, 4.891]); married vs single (0.434;[ 0.217,0.867]); and lower for HDL cholesterol (0.185;[0.052, 0.662]); Chinese vs Malays (10.619;[ 2.255, 49.995]); and third lowest income (0.197;[ 0.073, 0.532]) and forth lowest income (0.167;[ 0.056, 0.499]) vs lowest income. Conclusion: Age, race, income, smoking and marital status, family history of CHD, waist circumference, HDL cholesterol, total fat intake, full cream dairy products intake were significantly associated with CHD among this population. This finding is particularly important to the primary health carers to identify at-risk CHD individuals thus appropriate intervention could be provided.