Hafizah Pasi

Background: Questionnaire has long been one of the acceptable form of data collection tools for medical and health sciences. It is convenient and reliable when used and psychometrically tested to the intended populations. This study aims to evaluate the principal factor and reliability analysis of the Malay versions of DASS21, CBI and Brief-COPE questionnaire among Malaysian OSH competent person. Methods: A total of 40 OSH competent persons participated in the study. IBM SPSS Statistics for Windows, Version 26.0 software was used for statistical analysis. Principal Factor Analysis was computed to assess factor analysis, while Cronbach's alpha and the intraclass correlation coefficient for individual items were used to measure the internal consistency and reliability of the questionnaires. Results: Principal Factor Analysis revealed that the number of components and items in each questionnaire aligned with the original versions, and the Kaiser’s criterion along with Cattell’s rule supported the appropriate number of factors to be retained for each questionnaire. Reliability testing indicated that all questionnaires demonstrated high internal consistency and exhibited good to excellent reliability, with Cronbach’s alpha values ranging from 0.900 to 0.951 and intraclass correlation coefficient values ranging from 0.895 to 0.946. Conclusion: This study showed that the Malay versions of DASS21, CBI and Brief-COPE questionnaires are validated tools for use among Malaysian OSH competent persons.

Amidst the COVID-19 pandemic, mental health challenges have emerged, highlighting the need to identify psychological distress and coping strategies, particularly among occupational safety and health (OSH) competent persons. This is a cross-sectional study measuring stress, anxiety, and depression levels while exploring coping mechanisms among OSH professionals in Malaysia during the COVID-19 recovery phase, using DASS-21 and Brief-COPE questionnaires. The findings indicate that chronic illness increases the risk of depression (p=0.005) and stress (p=0.047). Higher income is associated with greater risks of depression (p<0.001) and stress (p<0.001). Monthly expenses exceeding budget limits heighten the risk of depression (p<0.001) and anxiety (p=0.024). Conversely, older age decreases the risk of both depression (p<0.001) and stress (p=0.001). Caring for family members affected by COVID-19 reduces depression (p<0.001) and stress (p<0.001). Having more monthly savings decreases the risk of depression (p<0.001) and anxiety (p=0.017). The study reveals that stress individuals prefer emotional focus coping (p=0.006). Addressing these factors is crucial for mitigating psychological distress among OSH professionals.

The uncertainties surrounding P. knowlesi’s ability to be zoonotic have caused it to be “left out”. Highlighting the individual, host-vector interactions and environmental risk factors for this disease were consequential towards more focused and effective prevention and control strategies. This study aims to identify the individual, host-vector interactions, and environmental risk factors for P. knowlesi malaria among at-risk communities in Peninsular Malaysia. A case-control study was conducted involving laboratory-confirmed cases of Plasmodium knowlesi malaria, registered and notified to the online vector disease reporting system, Vekpro Online System, and primarily resided in the study areas for a minimum of three weeks. A locality-matched individual with no history of fever and tested negative for malaria through blood slide and polymerase chain reaction, PCR of the same duration was taken as control. Univariate and multiple logistic regression was applied to evaluate the potential individual, host-vector interactions, and environmental risk factors for knowlesi malaria among respondents using the IBM SPSS Statistics for Windows, Version 26.0. Results showed notably higher cases among males as compared to females (76.1% versus 23.9%). Multiple logistics regression analysis showed being male is 3.51 higher risk (p values < 0.001) to become a case. Respondents whose place of work or study is near the forest edge have 44.0% lower risk (p = 0.030), while those living in the Orang Asli village was 56.0% lower risk as compared to the organized village to become a case (p-value 0.035). These findings demonstrated that gender emerges as an independent individual risk factor, while residing near a forest edge, living in an Orang Asli village, or occupying a brick or wooden workers' longhouse situated in hilly areas reduces the interactions between hosts and vectors, thereby lowering the environmental risk. These attested to different views and approaches aimed at mitigating the risk of knowlesi malaria within this specific population. Thus, all relevant agencies must consider alternative directions in addressing the known risk factors associated with this type of malaria by acknowledging that a one-size-fits-all approach cannot be universally applied, but rather the design of prevention and control programs should be tailored to the unique characteristics of each population.

This study explores at-risk communities’ attitudes toward Plasmodium knowlesi (P. knowlesi) malaria prevention behaviours using the Integrated Behavioural Model (IBM) as a guiding framework. This study also presents efforts and challenges faced by district health officers in Peninsular Malaysia in their role as the health authority for mitigating the disease. Seventeen informants were selected from at-risk areas in three states with high cases of P. knowlesi in 2019 (Johor, Pahang, Kelantan) to be interviewed. Semi-structured interview questions were developed guided by the IBM framework. Three district health officers who were involved in malaria prevention efforts in the selected states were also interviewed. Qualitative data analysis using Atlas.ti 8 software was used to facilitate thematic coding. Five prevention behaviours were found to be prevalent among the informants and are hypothesised to be suited for behavioural improvement intervention among at-risk communities. The prevention behaviours identified are: consuming prophylaxis, wearing long sleeves, using bed nets, mosquito coils and insect repellent. Current efforts by health district officers for P. knowlesi malaria prevention include erecting warning signs, community education programmes, and empowering community influencers. Challenges faced by the health district officers include difficulty accessing remote locations, limited facilities, and military-specific issues. This study suggests that future prevention efforts focused on behavioural improvement among at-risk communities in Malaysia should concentrate on the five prevention efforts most prevalent among these communities. Keywords: P. knowlesi malaria, attitude, prevention challenges, prevention efforts, peninsular Malaysia.

Antepartum depressive and anxiety symptoms (ADS and AAS) are prevalent in Malaysia. Prior evidence linking maternal ADS and AAS with adverse birth outcomes and caesarean section (CS) or instrumental delivery is conflicting. There is no research in Malaysia on the association between maternal mental disorders and adverse birth outcomes and mode of delivery. This study aims to investigate the independent effect of maternal ADS and AAS on low birth weight (LBW), preterm birth (PTB) and CS or instrumental delivery among women in east and west coasts of Malaysia. We used data from a prospective cohort study of 799 pregnant women from health clinics of two states in east and west coasts of Malaysia. Baseline data were measured at the third trimester of pregnancy on ADS, AAS, socioeconomic condition, anthropometric status, reproductive history and intimate partner violence. Birth outcomes and mode of delivery were determined at the time of delivery. Univariate and multiple Cox’s regressions were applied to assess the association between ADS and AAS and LBW, PTB and CS or instrumental delivery. ADS was significantly associated with an increased risk of giving birth to LBW babies in both east coast (RR = 3.64; 95% CI 1.79–7.40) and west coast (RR = 3.82; 95% CI 1.86–7.84), but not with PTB. AAS was associated with increased risk of both LBW (RR = 2.47; 95% CI 1.39–4.38) and PTB (RR = 2.49; 95% CI 1.16–5.36) in the east coast, but not in west coast. The risk of CS or instrumental delivery was evident among women with ADS (RR = 2.44; 95% CI 1.48–4.03) in west coast only. ADS predicts LBW in both coasts, AAS predicts LBW and PTB in east coast, and ADS predicts CS or instrumental delivery in west coast. Policies aimed at detection and management of ADS and AAS during antenatal check-up in health clinics may help improve birth outcomes and reduce obstetric interventions.

Introduction: Caregiving for stroke patients is a challenging task both emotionally and physically. Studies have shown that caregiving can affect caregivers’ wellbeing that could lead to depression. Objective: This study was carried out to determine the prevalence and associated risk factors of depression amongst caregivers of stroke patients attending Hospital Universiti Sains Malaysia (HUSM) in Kelantan over a 6 month period. Methodology: This is a cross sectional study at the primary care clinic in HUSM over a period of 6 months. A total of 116 caregivers of medically documented stroke patients who fulfilled the inclusion and exclusion criteria were recruited via convenience sampling. The brief patient health questionnaire (PHQ-9) were used to assess their depression. Descriptive statistics and bivariable analysis was used using SPSS version 23.Results: 63.8% of the caregivers of stroke patients are depressed. Caregiver’s burden, ethnicity and patient’s ethnicity were found to be significant associated risk factors for depression.Conclusion: Screening for depression in caregivers especially those with risk factors must be carried out in the clinic in order to detect and intervene early. Coping mechanisms especially in the religious aspect should be elicited in future studies.