As critically ill COVID-19 patients are prone to infections by other respiratory pathogens, this study aimed to investigate the detection of respiratory co-pathogens in such patients, by employing a multiplex respiratory molecular panel. Conducted at Universiti Sains Malaysia Specialist Hospital (HPUSM) from November 1, 2021, to November 1, 2022, this retrospective cross-sectional study analysed adults admitted with confirmed COVID-19. Oropharyngeal/ nasopharyngeal swabs collected upon admission were tested using the Fast Track Diagnostic (FTD®) Respiratory Pathogens 33 multiplex kit to detect other respiratory pathogens. Within 48 hours of admission, the presence and type of organisms were determined to assess community co-infections. Among 48 critically ill COVID-19 patients (26 male; mean age, 62.2 years), clinically significant organisms were found in 32 patients (67%). Bacterial co-infections or co-colonization were detected in 91% (29/32) of these patients, with Klebsiella pneumoniae (40%) and Staphylococcus aureus (23%) were the most common, followed by Streptococcus pneumoniae (11%), Moraxella catarrhalis (4%), and Haemophilus influenzae (2%). Fungal (6%) and viral (2%) co-infections were less frequent. The use of syndromic respiratory panel in critically ill COVID-19 patients offers the advantage of being highly sensitive, rapid, and able to detect multiple pathogens. However, detection of multiple respiratory pathogens needs to be interpreted with caution, taking into consideration patient’s clinical and radiological findings, as well as quantitative molecular data.

Introduction: The Asthma Knowledge Questionnaire developed by C. Rodriguez Martinez in 2005 was proved to be a valid instrument for asthma knowledge assessment for parents of children with asthma. 17 items were included in the questionnaire including their myths and beliefs, knowledge, and associated aspects. The objective of this study is to analyse the validity and reliability of the Malay version of the questionnaire. Methods: Forward-Backward translation method was used by language experts to obtain the Malay version of the questionnaire. The questionnaire was then given to twenty respondents at the Paediatric Institute Hospital Kuala Lumpur to ensure the clarity and relevance of the questionnaire as a pilot study. Subsequently, 60 respondents who fulfilled the inclusion and exclusion criteria were selected to proceed with the reliability test of the Malay version questionnaire. The results were analysed with SPSS version 26.0. The reliability and internal consistency were confirmed by intra-class correlation and Cronbach’s alpha coefficient. Results: There were 60 respondents to the questionnaire consisting of parents and caretaker who has child with asthma at the Institute of Paediatric Hospital Kuala Lumpur. The mean age of respondents was 34 ± 7.5year old. 91.7% of the respondents were female. The overall Cronbach’s alpha coefficient of the questionnaire was 0.84. Conclusion: The Malay version of the Asthma Knowledge Questionnaire has a good degree of validity, reliability and is culturally acceptable equivalent to the original version.

Objective: The study was designed to determine the risk perception of the public population in Kota Kinabalu towards childhood immunisation. Methodology: This was a cross-sectional study where self-administered questionnaires were distributed to the public in Kota Kinabalu. The respondents who consented were 18 years old and older. The illiterate persons and the foreigners were excluded. The calculated sample size was 400. Only 313 samples collected were suitable for analysis using SPSS21.0. Results: Fever, pain swelling and allergic reaction were correctly identified as risks of immunisation. Autism, mental retardation and even death could also result from vaccination. Of the total respondents, 76.7% agreed with the practice of childhood vaccination, 70.0% thought that childhood vaccinations were safe and effective and 58.1% felt that its benefit outweighed the risk. Other than that, 32.0% refused childhood vaccination from fear of its risks, and this fear was the main reason for the refusal of childhood vaccination. Age, marital status, race and income were the factors which influenced parental willingness to vaccinate their children (p<0.05). Conclusions: Most participants understood the risks of childhood vaccination, but few agreed to the practice of childhood immunisation for herd immunity. Public health campaigns are needed, to increase the understanding and acceptance of childhood vaccination especially in the rural community.

Introduction: Infant feeding choices made by mothers in the context of HIV infection depend on a number of factors. In our environment, the relative contribution of some of these factors is not known. Methods: The infant feeding practices of HIV positive mothers seen over a decade (July 2004 and December 2015) at a large HIV treatment centre in Lagos, South-western Nigeria were reviewed. Information on maternal socio-economic characteristics, obstetric, HIV treatment history and infant feeding choices were extracted from the program data base for analysis with SPSS version 20. Results: Exclusive formula feeding (EFF) was the most common feeding practice of the mothers ( 86.4%). However, it decreased from 95.3 % before 2010 to 79.5% after 2010. Exclusive breastfeeding (EBF) was practised by only 9.0% of the mothers. Mixed breastfeeding practice increased from 1.1% pre-2010 to 4.1% post-2010. The provision of free infant formula was found not to influence significantly the EFF or EBF rates but the MBF rate. MBF rate decreased from 3.0% pre-free formula to 1.7% after the introduction of free infant formula. Conclusion: Exclusive formula feeding was the most practised infant feeding method in this study (86.4%). Change in infant feeding guidelines was found to influence the infant feeding choice of HIV positive mothers. Health workers implementing PMTCT programs in our setting should be made aware of the risk of mixed breastfeeding with the new guidelines and educate mothers on its dangers at every contact with the health system.

An antiplasmodial screening of Phyllanthus debilis and Phyllanthus urinaria was carried out. The medicinal plants were extracted and evaluated for in vitro antiplasmodial activity against D10 (chloroquine-sensitive, CQS) and Gombak A (chloroquine-resistant, CQR) strains of Plasmodium falciparum. The methanolic crudes from the soxhlet extraction were active against both strains however, P. urinaria (IC50 8.9 μg/ml with CQR strain) exhibited better anti-malarial activity compared to P. debilis (IC50 12.2 μg/ml with CQR strain). Furthermore, the methanolic crude of P. urinaria obtained by the cold extraction has good anti-malarial activity towards CQS (IC50 4.1 μg/ml). The concentration of macronutrients (calcium and magnesium) and trace metals (copper, manganese, iron and zinc) from three Phyllanthus species i.e. P. debilis Klein ex Wild., Phyllanthus niruri L., P. urinaria L. and Alpinia conchigera Griff. were determined using microwave digestion method and analyzed by Flame Atomic Absorption Spectroscopy. Standard Reference Material 1547 (peach leaves) was used to validate the method throughout this study. The recovery values were in the range of 80% to 120% which were in very good agreement with the certified values. The three Phyllanthus species and leaves of A. conchigera showed the highest concentration of calcium compared to other metals and macronutrients studied. The significant presence of all the important macronutrients and trace metals which are essential for human health and wellbeing substantiate their use medicinally in traditional practices.

Nosocomial blood stream infection (or nosocomial bacteremia) is a common problem in hospitals worldwide, including Malaysia. A three-year prospective cohort study (October 2003-March 2007) of the incidences, risk factors, and patterns of the microorganisms causing bacteremia was conducted using a validated surveillance form in three intensive care units (ICUs) in Malaysia. Center for Disease Control criteria were used to diagnose bacteremia. Patients were monitored from admission until the end point of study, which was the first detection of bacteremia in the blood in each patient. The frequency of occurrence of bacteremia with clinical symptoms was 10.7% (n = 23). Bacteremia was observed to occur within a mean length of stay of 10 days in ICU. The rate of device-related infection was 10.4% per device utilization days with a device utilization rate of 95.9%/1000 patient days. The total number of patient days was 2309 and the period of device utilization was 2211 days. The common bacteria detected were extended-spectrum beta-lactamases (ESBLs) Klebsiella pneumoniae (n = 6); Pseudomonas aeruginosa (n = 6); Acinetobacter species (n = 5); Methicillin-resistant Staphylococcus aureus (MRSA)(n = 3); and (non- ESBL) Klebsiella pneumoniae (n = 2). Multivariable analysis using Cox Proportional Hazard Model showed that the predictors for developing bacteremia were cancer, MRSA carriage, duration of central venous catheter (CVC) infusion, frequency change of CVC, and the administration of hydrocortisone drugs. These results indicate that a combination of nursing and medical interventions as well as patients' severity of illness could lead to bacteremia in ICU. Strategic implementation of quality assurance measures in ICUs could help to control this problem.