Working as a marble artisan exposes individuals to marble dust, which often contains high levels of silica. This study looks at how breathing in marble dust affects marble workers in Tulungagung. It focuses on respiratory problems and higher IL-8 levels in their blood, aiming to understand how much silica in the dust relates to these health issues. This cross-sectional observational study involved 30 artisans, assessing silica dust levels using personal dust samplers and IL-8 levels via ELISA. In Tulungagung, many marble artisans, mostly over 45 years old with over 5 years of experience, work 8 hours daily using cloth masks for protection. The finishing unit had the highest dust exposure, with levels far above safe limits: dust measured 37.1203 mg/m³ (TLV is 10 mg/m³), and silica concentration was 0.1114 mg/L (TLV is 0.0250 mg/L). The study found a clear relationship between using PPE, exposure to silica, reports of shortness of breath, and higher IL-8 levels in the blood (p < 0.05). The study showed that higher silica in marble dust is tied to increased IL-8 levels in the blood of marble artisans in Tulungagung. However, there was no clear link found between breathable dust levels and IL-8 in their blood.
Leprosy is a contagious infectious disease that still causes high morbidity and mortality rates in the world. Uncontrolled risk factors can increase the transmission and cause permanent damage to nerves and human body tissue. The aim of the study was to determine the risk factors of leprosy. The study used a case control design with 42 respondents consisting of 12 leprosy cases and 24 neighbors of cases who did not have leprosy (1:2). Cases were patients confirmed bacteriologically at the community health center. Multivariate analysis by logistic regression was carried out to determine the most risk factors of the incidence of leprosy, using the P-Value < 0.05 and Odds Ratio (OR). People who had close contact (P-Value= 0.035; OR= 10.8; 95%CI= 1.07-108.62), did not get BCG vaccination (P-Value= 0.023; OR= 5.67; 95%CI= 1.28-25.02), low monthly income (P-Value= 0.031; OR= 9.75; 95%CI= 1.12-85.16), poor water resources (P-Value= 0.036; OR= 8.41; 95%CI= 0.96-73.73), and low level of knowledge (P-Value= 0.009; OR= 6.60; 95%CI= 1.48-29.36) were related to the incidence of leprosy. The most risk factors of the leprosy are did not get BCG vaccination (P-Value= 0.015; OR= 45.81; 95%CI= 2.08-10.96) and low level of knowledge (P-Value= 0.029;OR= 25.64; 95%CI= 1.39-473.13). People who did not receive BCG vaccination and had low knowledge were the main risk factors of leprosy in Pidie Jaya Regency. Close contact with leprosy patients and poor water sources also increased the risk through prolonged exposure and poor hygiene. Strengthening BCG coverage and public education is recommended
Typhoid fever remains a public health concern in Malaysia, particularly among food and beverage (F&B) workers who play a critical role in food safety. Vaccination is a key preventive strategy; however, knowledge gaps may limit its effectiveness. This cross-sectional study assessed knowledge of the typhoid vaccine and its association with sociodemographic factors among 157 F&B workers in Cyberjaya. Data were collected using a structured questionnaire and analyzed using descriptive statistics and Chi-square tests. Overall, 45.2% of participants demonstrated good knowledge of the typhoid vaccine. Approximately 64.3% reported having received typhoid vaccination, although gaps in understanding regarding vaccine purpose and prevention remained. Higher knowledge levels were significantly associated with female gender, younger age, Malaysian nationality, higher education level, student status, and employment in fast food chains (p < 0.05). Despite moderate vaccination coverage, knowledge gaps were evident, particularly among males, older workers, non-Malaysians, and those working in informal food outlets. Targeted educational interventions integrated into routine food handler training are recommended to strengthen vaccine literacy and support typhoid prevention efforts.
Postpartum depression (PPD) is a common and often underdiagnosed mental health condition that affects women worldwide and poses significant challenges to both maternal well-being and child development. In Malaysia, there are still many studies conducted about PPD among women, but fewer for the population of men. This study assessed knowledge and attitudes toward postpartum depression (PPD) and examined their association with sociodemographic factors. A cross-sectional study using the convenience sampling method was conducted among 267 adults in Kuantan. SPSS version 30 was used to analyze the data. The results showed that the level of knowledge among adults was poor, with a mean (SD) score of 31.00 (5.034) %. Meanwhile, the level of attitude was moderate among the adults in Kuantan, with a mean (SD) score of 42.15 (6.733). Significant associations revealed that females, non-smokers, individuals with higher education, and those working in the private sector had significantly higher knowledge about PPD (p<0.05). Additionally, higher scores on attitude were observed among females, smokers, younger adults (18–25 years), those from higher-income groups (M40), and those with higher education (degree holders), as well as students (p<0.05). There is no correlation between the level of knowledge and attitude toward PPD among adults (r=0.088, p=0.146). Overall, this study highlights that the relationship between knowledge and attitudes toward PPD is multifaceted. Thus, efforts to enhance knowledge should concurrently target stigma and misconceptions to foster positive attitudes.
Stunting is a severe consequence of intrauterine and early childhood malnutrition. Children who suffer from stunting fail to reach their full height potential, and their brains do not develop to their total cognitive capacity. This study aims to explore environmental factors associated with stunting in children under five years old in Indonesia. Systematic review study was conducted using the PubMed, Science Direct, BMC, and Google Scholar databases to identify eligible articles published between 2018 to 2022. Studies conducted in Indonesia were reviewed using The Joanna Briggs Institute (JBI) Critical Appraisal Tools. 6,049 articles from the databases, and ten studies met the inclusion criteria, which—the most consistent factor associated with stunting was access to an unimproved latrines. Additional factors included poor hand-washing practices, use of unimproved water sources, consumption of unsafe drinking water, and smoking habits. Various environmental factors are associated with stunting. Addressing these issues through improved access to latrines, better water quality, and enhanced hand hygiene is crucial.
Healthcare worker motivation is essential for job satisfaction, engagement, and the effective operation of healthcare systems. In Malaysia, challenges such as workforce shortages, public-private disparities, and brain drain significantly impact motivation and retention. This systematic review identifies the key determinants of healthcare worker motivation in Malaysia. A systematic search was conducted across several databases up till December 2024. Keywords included terms related to healthcare workers, motivation, and the Malaysian healthcare context. Data extraction followed a standardized protocol, and the methodological quality of studies was assessed using the Mixed Methods Appraisal Tool (MMAT), and data synthesis followed a convergent integrated design. Intrinsic motivators such as personal beliefs, task significance, and growth opportunities were critical in influencing motivation. Group-level factors, including teamwork, supervisor support was highly valued, reflecting Malaysia’s collectivist cultural values. Organizational barriers such as staffing shortages, high workloads, and public-private pay disparities posed significant challenges to motivation. Financial incentives were acknowledged, where dissatisfaction with salary increment were prevalent. Motivated healthcare workers exhibited higher job satisfaction, organizational commitment, and engagement, contributing to better patient care and retention. This review underscores the need for structured career pathways, equitable remuneration, and supportive work environments to address motivational challenges. Team-building activities, professional development opportunities, and community recognition were recommended to enhance both individual and group motivation. Future research should explore culturally specific motivational factors using mixed method and longitudinal designs to develop sustainable workforce resilience. Enhancing healthcare worker motivation is critical for overcoming workforce challenges and ensuring high-quality, sustainable care in Malaysia.
Antineoplastic drugs (AD), essential in chemotherapy for cancer treatment, pose significant occupational health risks to healthcare workers, particularly nurses involved in drug preparation, administration, and disposal. Repeated exposure, inadequate adherence to safety standards, and the absence of comprehensive local guidelines further compound these risks. A cross-sectional analytical study was conducted among 166 nurses from the National Cancer Institute of Malaysia (NCI). Participants were selected using proportionate stratified random sampling based on their work units, and data were collected through a validated self-administered questionnaire. Analyses included chi-square, Fisher’s exact tests, and simple logistic regression to assess associations, followed by multiple logistic regression to identify predictors. Factors studied included sociodemographic (age, gender, marital status, education level), employment (work experience, work unit, training), knowledge and attitude on AD handling practices, and organisational (workload, workplace safety climate). The response rate was 96.9%, and 66.3% of participants demonstrated good AD handling practices. Three factors were associated with good practices: workload (average number of patients per workday, and per workday involving AD) and attitude level. Multivariable analysis identified workload as the sole significant predictor (AOR = 0.825, 95% CI = [0.718, 0.947], p = 0.006). The study recommends adopting acuity-based staffing models that align nurse workload with patient complexity in oncology settings. The Ministry of Health (MOH) should also consider implementing nurse-to-patient ratio guidelines specific to cancer centres and incorporating workload thresholds into occupational safety audits, as addressing workload is essential to improving AD handling practices and ensuring both healthcare worker safety and quality patient care.
Tobacco smoking is a major public health concern because it is a contributing risk factor of non-communicable diseases. Smoking cessation clinics are an intervention provided by the Ministry of Health Malaysia to help smokers quit smoking. We investigated the characteristics of the attendees of these clinics and the factors contributing to failure to quit smoking among the attendees in a primary health care setting in Malaysia. This was a cross-sectional study using retrospective secondary data from 245 attendees of smoking cessation clinics in the district of Hulu Langat, Malaysia from 2016 to 2017. Purposive sampling was used, and data were analysed using SPSS 22.0. Failure to quit smoking was defined as failure to abstain from tobacco smoking after at least 6 months’ attendance at the smoking cessation clinic. The majority of attendees were middle-aged, male, Malay, had at least secondary school education and were married. The quit smoking failure rate was 61.2%. The factors associated with failure to quit smoking were the clinic attended, being non-Malay, smoking more cigarettes per day, fewer attempts to quit, fewer visits and higher addiction level. The logistic regression model showed that non-Malays and those with higher modified FTND (Fagerström Test for Nicotine Dependence) scores were 49.6 times and 16.2 times more likely to fail, respectively, while smoking for >15 years had a lower failure rate. Emphasis should be placed on non-Malay smokers and smokers with higher FTND scores for better quit smoking outcomes.
With the phenomenal development and advancement of technology, coupled with the current concerns about effective consumer engagement in health information-seeking (HIS), e-health systems in healthcare are gaining the attention of more and more people. Past literature reviews on HIS show limited discussion on the dimensions that motivate HIS among consumers. This study’s main objective is to comprehensively validate twelve (12) dimensions of consumer online HIS using the Exploratory Factor Analysis (EFA) procedure. A cross-sectional research design was implemented to establish reliable measures in the online HIS construct. The questionnaire items were modified from 16 studies and adapted for this study. Consumers were selected based on simple random sampling from hospitals and universities in Kuala Lumpur and Selangor. Within three weeks, 120 participants completed the questionnaire. Initially, 76 items were formed to assess the online HIS construct. After conducting the EFA procedure, 13 items with a factor loading below the cut-off point of 0.60 were deleted, and 63 items with a factor loading above the cut-off point of 0.60 were retained and considered suitable for measuring the construct. This study has established the development of a reliable and valid instrument to assess the quality of the consumer online HIS construct.
Bakumpai Dayak people, residing along the fast-flowing Barito River, have long been engaged in the practice of defecating in the river. Despite the efforts of the government to combat open defecation, this behavior has remained persistent in the community. Therefore, this study aims to explore the causes of the non-use of toilets by Bakumpai Dayak people. This was an ethnographic study, and data were collected from 11 respondents using participant observations, as well as in-depth and group interviews. The observation revealed that the community already had knowledge about hygienic toilets, but could not stop the practice of open defecation. In the area, the floating latrines employed were of various types, which were tailored to suit the specific geographical conditions of the village. Bakumpai Dayak people had a high water demand to meet their defecation, bathing, and washing needs. Furthermore, the respondents believed that floating latrines had several advantages over conventional toilets, such as the central concept of invisible stool in defecation. Based on these findings, open defecation-free status could only be achieved by implementing sanitation interventions that considered the long-standing social culture and habits of the community
Children with disabilities are dependent on caregivers. With various clinical and feeding issues with susceptibility to malnutrition, more strength, motivation and attention are required in their parenthood journey. Such special challenges may disrupt the life of the caregivers which can consequently affect their overall quality of life (QOL). This paper evaluates the association between sociodemographic factors, child’s clinical and feeding characteristics with the caregivers’ QOL. A total of 174 caregivers were involved in this cross-sectional study which was conducted in 46 community-based rehabilitation centres (CBR) across Terengganu state. The validated Malay Version World Health Organization Quality of Life-BREF (WHOQOL-BREF) questionnaire was used to assess the QOL based on four principle domains. General linear regression was applied to analyse the association between QOL impact score and study factors. The lowest QOL median score obtained was for environmental support domain 64.61 (12.26) followed by physical health domain 65.04 (12.72), psychological wellbeing domain 68.98 (13.01) and social relationship domain 75.15 (14.82). Caregivers with lower income, having children with other diseases despite current disability, experience with child seizure’s episodes and child unable to tolerate family meals had significantly lowered the caregiver’s QOL score. Both caregivers and children’s characteristics contributed to the negatively affected QOL score that consequently will contribute to the increased in the prevalence of malnutrition among disabled children.
The proportion of sexual intercourse among girls aged 15-19 years is 0.9%, and 2.6% for aged 20-24 years, while boys aged 15-19 years is 3.6%, and 14% for aged 20-24 years old. The enabling factor related to behavior is the information media. This study aims to prove the relationship between exposure to reproductive health information and adolescent sexual intercourse with a cross-sectional approach using the 2017 IDHS data. Data analysis used Mantel Haenszel Stratification and Logistics Regression statistical test. A total of 23,351 respondents were exposed to television (97.2%), print media (56.1%), and radio (50.1%). The most exposures to reproductive health information were HIV, AIDS, STIs, condom advertisements, and information on all three materials. As many as 6.6% have had sexual intercourse. The results of logistic regression were found on print media (p-value 0.001; POR 0.6), radio (p-value 0.001; POR 0.460), and television (p-value 0.001; POR 0.767). Gender became the interaction variable on print media (POR 15.784 on girls; POR 1.822 on boys) and radio (POR 48.72 on girls; POR 1.584 on boys). The government suggests providing the boys with material on the impact of sexual intercourse based on a boys’ perspective. It is expected to be more effective in preventing sexual intercourse and to reach expanding reproductive health information from the mass media multi-sectoral collaboration. The government or academics can formulate longitudinal research on adolescent health and examine the effects of media on changes in social behavior using the Use and Gratifications Theory of media effects.
Ceftriaxone is one of the most prescribed antibiotics in hospitalized patients in Gaza. This study aimed to screen the antimicrobial resistance profile of ceftriaxone in the Gaza Strip (GS) in the State of Palestine. This study was cross-sectional, hospital-based, and was conducted in governmental hospitals across GS. The study started in November 2017 and continued till December 2018. Clinical samples such as pus, urine, sputum, blood, cerebrospinal fluid (CSF), and others were collected from hospitalized patients and outpatient clinics attendants. After identification of the bacterial isolates, a standard disc diffusion technique for drug susceptibility test was performed. Totally, 4397 bacterial isolates were obtained. Escherichia coli isolates were 38.3%, Klebsiella species were 16.4%, Pseudomonas species were 11.7%, and Staphylococcus aureus isolates were 11.5%. These mentioned organisms were the predominant organisms isolated from the study subjects. Additionally, 51.1% of the clinical isolates were found to be resistant to ceftriaxone. Also, 4.9% and 44.0% of the isolates remain intermediate and susceptible to ceftriaxone. E coli showed 50.0% (841/1683) resistance, while Klebsiella species showed 69.7% (502/720) resistance. Pseudomonas species showed 57.0% (294/516) resistance and S aureus showed 37.8% (191/505) resistance to ceftriaxone. Acinetobacter species showed 87.3% (96/110) resistance. Clinical isolates showed differences in their resistance to ceftriaxone during the study period, in different age categories, genders, and specimen types. The present study demonstrated an increase in the microbial resistance to ceftriaxone. It is very important to establish efficient strategies, updated prescribing guidelines and stewardship programs to preserve the efficiency of the antibiotics
In the last decade, in Iraq, an unexpectedly high prevalence of vitamin D deficiency among diabetic and non-diabetic adult patients started to markedly appear, especially among females. Vitamin D deficiency in type 2 diabetic (T2DM) females is expected to add more burden to their complaints. To study the impact of vitamin D deficiency on diabetic females in regard to total serum calcium, phosphate, parathyroid hormone, and bone mineral density this study was conducted. The study was achieved in Mosul at a Clinic of Endocrinology and Diabetes. It is a case-control observational study that enrolled 54 non-diabetic (non-DM) and 49 type 2 diabetic adult females with vitamin D deficiency who were age-matched. After measuring serum vitamin D and electing the patients, serum concentrations of parathyroid hormone, total calcium, phosphate and alkaline phosphatase of the enrolled patients were measured, in addition to bone mineral density assessment by dual-energy X-ray absorptiometry. The results were statistically analyzed, examined and compared. There were no significant differences between vitamin D deficient non-DM and T2DM females in regard to proportions of hypocalcemia, hypophosphatemia and secondary hyperparathyroidism. However, vitamin D deficient T2DM females showed as twice preponderance to have hypophosphatemia as non-DM female patients (odds ratio: 2.37). Lumbar vertebral and femoral neck osteopenia or osteoporosis affected 75.47% of non-DM vitamin D deficient patients and 76.59% vitamin D deficient T2DM female patients. Femoral neck osteoporosis was significantly more prevalent among vitamin D deficient T2DM female patients (p 0.01). The proportion of osteopenia and osteoporosis of lumbar vertebrae were comparable among vitamin D deficient, diabetic and non-diabetic females. However femoral neck osteoporosis is significantly more prevalent among vitamin D deficient T2DM females than among non-DM females. These findings call for an active workup and care to prevent potential adverse complications in the femoral neck of T2DM patients.
Adenomyosis is the existence of ectopic endometrial glands and stroma within the myometrium with myometrial hypertrophy and hyperplasia. The aims of the study are, first, to determine the prevalence of adenomyosis among hysterectomy specimens. Second, to assess the clinical presentation of those patients and other pathologies coexistent in the same uterus. This is a cross-sectional study which was conducted among women, who underwent hysterectomy for various indications in a referral governmental hospital in Sana'a-Yemen. The diagnosis of adenomyosis was confirmed by postoperative histopathological assessment. Out of 73 patients who underwent a total hysterectomy, histopathological results were available for only 50 respondents. Among these patients, 52% were confirmed with a postoperative diagnosis of adenomyosis. At the time of the hysterectomy, 96.15% of patients were aged between 40-50 years old. Adenomyosis was found in 84.62% of grand multiparous women and 57.69% of patients had a history of miscarriages, 88.46% had heavy menstrual bleeding, 61.54% had dysmenorrhea and those with chronic pelvic pain were 61.54%. Based on histopathological findings, uterine leiomyoma and endometrial hyperplasia were 26.92% each and those with endometrial inflammation and cervical ectropion were 34.62% and 30.77% respectively. Although the preoperative diagnosis of adenomyosis was rare among our candidates, more than half of them had the disease in the hysterectomy specimen. The common clinical features of adenomyosis and the presence of other pathologies in the same uterus can conceal its diagnosis. Through this study, we want to bring awareness of the high prevalence of adenomyosis in this region.
Rheumatic Heart Disease (RHD) is a preventable chronic heart disease caused by rheumatic fever. RHD can result in complications and can even conclude in unexpected death at a young age. This study aimed to estimate the prevalence of RHD among the school-going age group in the Northern and Southern regions of Sarawak. This research was conducted as a cross-sectional study in Samarahan and Kuching of the Southern Region and Miri of the Northern Region of Sarawak. The study population comprised school-going children within the divisions. The data on sociodemographic characteristics were collected through a questionnaire. At the same time, echocardiographic parameters were collected through a portable echocardiographic device. Cardiologists confirmed the abnormal cardiac findings. The overall prevalence of RHD was 14 per 1000 persons or 1.4%. Borderline RHD prevalence was 9 per 1000 persons or 0.9%, while the Definite RHD prevalence was 5 per 1000 persons or 0.5 %. With the prevalence obtained, more attention should be given to preventing this silent disease.
Deaths in Indonesia are mostly caused by diabetes mellitus, a non-communicable disease due to a person's unhealthy lifestyle. The number of health facilities increases annually with the high prevalence of diabetes cases in Indonesia. This study aims to analyze factors affecting the utilization of health services among diabetic people in Indonesia. It was a quantitative study with a cross sectional design, using secondary data of IFLS-5. The theory used was the Andersen's health service utilization model. A multistage random sampling was used to obtain 534 user data that matched the inclusion and exclusion criteria. Data were analyzed using the chi-square analysis and logistic regression. The results showed that the number of respondents who used inpatient services was 16.9%, and that who used outpatient was 44.4%. The variables that were significantly related to the utilization of inpatient and outpatient health services in diabetic people were socio demographic caracteristic, ownership of health insurance, perception of health status, suffering from chronic diseases and daily activities. It is important for policymakers in the health sector must improve financial or economic access to health services, as well as health service equity in all regions.
This cross-sectional study aimed to assess the mental health awareness and communication with parents among healthcare students (Medicine, Dentistry and Health Sciences) across three private universities in Selangor, Malaysia. The study hypothesized that healthcare students would have good mental health awareness and positive communication with parents about mental health. An online survey composed of 38 items was developed and distributed among the selected students. Results showed that 418 out of 575 participants completed the survey with an 85.7% response rate. The survey questions had high reliability (a Cronbach’s alpha of 0.876), and the factor analysis showed that the survey examined one construct. The findings revealed that there were no significant differences in mental health awareness among students with respect to gender, nationality, and year group, but significant differences were observed between religious groups (p=0.017) and only-child in the family (p=0.026). Male Malaysian students showed a significantly positive parent-student communication score compared to female students (p=0.004) and international students (p=0.040). This study shows positive growth in mental health awareness among students in health-related courses. Although parents’ communication about mental health is affected by factors such as gender and religion; students perceived their parents are supportive regarding mental health issues. Further studies are recommended to explore deep the factors that impact mental health communications.
The trend of Human Immonodeficiency Virus/Acquired Immonodeficiency syndrome has become a significant health problem in Indonesia. One of the primary factors contributing to the high transmission of the virus among the HIV-positive population, particularly men who have sex with men (MSM), is their practice of risky behavior. To address this issue, it is crucial to optimize social capital, including both structural and cognitive dimensions, to prevent the transmission of the disease and its progression to the advanced stage (AIDS). Therefore, this study aimed to explain the impact of social capital on in the prevention of HIV transmission among the MSM population with HIV-positive. This qualitative study was conducted in Jember, Indonesia, using a grounded theory approach between April and September 2021. Data were collected using in-depth interviews with 12 HIV-positive MSM obtained using purposive sampling. This study found that social networks were formed through community activities and associations built from participation in social activities, focused on improving the structural dimension of social capital. In the cognitive dimension, trust among HIV-positive peers was related to adherence to ARV treatment, including prevention and transmission. By providing information through both structural and cognitive dimensions, social capital can effectively prevent HIV transmission among MSM HIV-positive and serve as a behavior model in the prevention of the progression to AIDS. Therefore, the education of peers can be developed based on this social capital, providing a basis for effective interventions.
The population of immigrants in Malaysia has increased from 1.4 million back in 2000 to 5.3 million in 2018 besides the undocumented workers who are at high risk of poor physical, interaction problems and lack of health protection. This research has been carried out to study the immigrant populations awareness, accessibility and utilization of healthcare services based on Anderson’s Behavioural model among immigrants in Selangor, Malaysia. A cross sectional sampling technique involving immigrants at Selangor was carried out where a total of 271 respondents were assessed for their awareness regarding the availability, utilization and perception of the quality of healthcare services. Almost all of the immigrants reported being ted aware on the health services that are offered to immigrants although 47.2% of them expressed communication and language barriers to get the service. The majority of the immigrants can access to health service and 64.6% of the immigrants have sufficient information regarding healthcare services in Selangor, Malaysia. There is a relationship between the demographic data regarding their awareness and their perception regarding the service. Conclusion: Most of immigrants in Selangor, Malaysia has high level of awareness of the healthcare services and has good usage of the healthcare services. The limited access of the healthcare services is mostly among those with lower income (39.1%) or inadequate knowledge about healthcare (64.6%). Besides, nationalities of immigrants also one of the factors that contribute to usage of healthcare services and it low in Asia immigrants (86.3%).
