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Ambigapathy R, Ramachandram S, Rahim FF. Referral patterns and outcomes of children who failed Modified Checklist for Autism in Toddlers screening during routine health screening at maternal and child health clinics in the northeast district of Penang: A retrospective cohort study. Malays Fam Physician 2024; 19:9. [PMID: 38496769 PMCID: PMC10944646 DOI: 10.51866/oa.378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
Introduction Autism spectrum disorder (ASD) is a developmental disability that causes significant social, communication and behavioural challenges. The Modified Checklist for Autism in Toddlers (M-CHAT) is a parent-administered screening questionnaire for ASD used at 18 and 36 months of age. This study aimed to determine the outcomes of children who failed M-CHAT screening during routine health screening at maternal and child health clinics in northeast district, Penang and the prevalence of ASD among those with a final diagnosis. Methods This retrospective cohort study was conducted at 12 maternal and child health clinics. All children who failed M-CHAT screening at 18 and 36 months from January 2017 to December 2021 and received a final diagnosis before 31 March 2022 were recruited. All information required was recorded in a data collection form and analysed using SPSS. Multiple logistic regression was performed to assess the association between the factors and ASD status. Results Eighty-two children failed M-CHAT screening. Fifty children did not receive a final diagnosis. Among 32 children who received a final diagnosis, 25 were diagnosed with ASD (78.1%). Among the children who underwent M-CHAT screening, the odds of having ASD increased by a factor of 1.2 for every 1-unit increase in age at final diagnosis. Conclusion In northeast district, Penang, more than half of children who fail M-CHAT screening have no final diagnosis. The specificity of the M-CHAT is 78.1% among children with a final diagnosis of ASD. The age at final diagnosis is positively associated with the diagnosis of ASD.
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Affiliation(s)
- Ranjini Ambigapathy
- MBBS, M.MED (FAM MED), Klinik Kesihatan Sungai Dua (Timur Laut), Lot 2544, Mukim 13, Gelugor, Pulau Pinang, Malaysia.
| | - Sathyabama Ramachandram
- MBBS, MRCPCH, FRCPCH, Department of Paediatrics, Penang General Hospital, Jalan Residensi Georgetown Penang, Malaysia
| | - Fairuz Fadzilah Rahim
- BScBiomed, MScMedStats, Department of Public Health Medicine, RCSI & UCD Malaysia Campus 4, Sepoy Lines Road, George Town, Penang, Malaysia
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Kueh MTW, Rahim FF, Rashid A. Development and validation of the health belief model questionnaire to promote smoking cessation for nasopharyngeal cancer prevention: a cross-sectional study. BMJ Open 2022; 12:e057552. [PMID: 36104123 PMCID: PMC9476129 DOI: 10.1136/bmjopen-2021-057552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
OBJECTIVE Lifestyle-induced nasopharyngeal carcinoma is a serious but preventable risk factor. This study serves to develop and validate a questionnaire that aims to predict the health behavioural intention on smoking cessation in Sarawak, Malaysia using the Health Belief Model (HBM). DESIGN A cross-sectional study. SETTING Urban and suburban areas in Sarawak, Malaysia. PARTICIPANTS The preliminary items of the instrument were developed after extensive literature review. The instrument was translated into the Malay language using the forward-backwards method before commencing with the content validity by a panel of 10 experts. Face validity was done both quantitatively and qualitatively by 10 smokers. The construct validity of the instrument was evaluated through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). A total of 100 smokers participated in phase 1 for EFA, while 171 smokers participated in phase 2 for CFA. Internal consistency was measured using Cronbach's alpha coefficients to evaluate the reliability. RESULTS In the exploratory stage, the factor loading of each item remained within the acceptable threshold. The final revised CFA yielded appropriate fit of the seven-factor model with the following model fit indices: χ2=641.705; df=500; p<0.001; comparative fit index=0.953; Tucker-Lewis Index=0.948; root mean square error of approximation=0.041. Satisfactory convergent validity and divergent validity were shown, with the exception of one pairwise construct. The internal reliability of these scales was above the desirable threshold, with Cronbach's alpha coefficients ranging from 0.705 to 0.864 and 0.838 to 0.889 in phases 1 and 2, respectively. CONCLUSIONS The study substantiated the instrument to be valid and reliable for predicting smokers' health behavioural intention to reduce cancer risk. The instrument is made up of 34 items, categorised into two sections, six HBM constructs and health behavioural intention. The instrument can be utilised for other smoking cessation-related cancers in different at-risk populations.
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Affiliation(s)
- Martin Tze Wah Kueh
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus, Georgetown, Malaysia
| | - Fairuz Fadzilah Rahim
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus, Georgetown, Malaysia
| | - Abdul Rashid
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus, Georgetown, Malaysia
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Foong WC, Chean KY, Rahim FF, Goh AS, Yeoh SL, Yeoh AAC. Quality of life and challenges experienced by the surviving adults with transfusion dependent thalassaemia in Malaysia: a cross sectional study. Health Qual Life Outcomes 2022; 20:2. [PMID: 34998406 PMCID: PMC8742937 DOI: 10.1186/s12955-021-01897-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/25/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Improvement in medical management has enabled transfusion dependent thalassaemia (TDT) patients to survive beyond childhood, building families, and contributing to the labour force and society. Knowledge about their adult life would provide guidance on how to support their needs. This study aims to explore the general well-being of adults with TDT, their employment status and challenges. METHODS This study recruited 450 people with TDT, aged 18 and above, of both genders through all regional Thalassaemia societies in Malaysia and from the two participating hospitals, over five months in year 2016. A self-administered questionnaire including 'Healthy Days Core Module', WHOQOL-BREF and employment measurements was used. Multiple linear regression models were fitted with associations adjusted for several potential confounders. RESULTS A total of 196 adults with TDT responded to the survey (43.6% response rate). Almost half (45%) had comorbidities and 9% suffered multiple complications: bone-related (13%), hormonal (12%), cardiac (3%) and infections (2%), resulting in 23% seeking treatment more than twice monthly. Within a month, they suffered from at least three days with poor physical and or mental health and their normal daily activities were disrupted up to three days. 36% were jobless and 38% of those with a job were receiving salaries below RM1000. The mean WHOQOL-BREF score (mean (SD)) was: physical health 62.6 (15.5), psychological health 64.7 (15.7), social relationship 64 (15.9), environmental health 60.8 (16.7). Having days with mental issues, financial status, education level, ethnic and marital status were main factors affecting QOL scores. Open questions showed dissatisfaction with health service provision, conflicting judgement in prioritising between health and job, and poor public empathy. CONCLUSION The adults with TDT perceived their health as good and had less unhealthy days when compared with people with other chronic diseases. However, some perceived themselves to be facing more life disruption in a rather non-supportive community and that health services do not meet their needs. Future qualitative studies are needed to focus on their perceived needs and to look for more tailored supportive approaches.
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Affiliation(s)
- Wai Cheng Foong
- Department of Paediatrics, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4, Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia.
| | - Kooi Yau Chean
- Department of Family Medicine, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4, Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Fairuz Fadzilah Rahim
- Department of Public Health, RCSI & UCD Malaysia Campus (formerly Penang Medical College), 4, Jalan Sepoy Lines, 10450, George Town, Penang, Malaysia
| | - Ai Sim Goh
- Haematology Unit, Hospital Pulau Pinang, Ministry of Health Malaysia, Jalan Residensi, 10990, George Town, Penang, Malaysia
| | - Seoh Leng Yeoh
- Department of Paediatrics, Hospital Pulau Pinang, Ministry of Health Malaysia, Jalan Residensi, 10990, George Town, Penang, Malaysia
| | - Angeline Aing Chiee Yeoh
- Department of Paediatrics, Hospital Seberang Jaya, Ministry of Health Malaysia, Jalan Tun Hussein Onn, 13700, Seberang Jaya, Penang, Malaysia
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Foong SC, Tan ML, Foong WC, Ho JJ, Rahim FF. Comparing breastfeeding experiences between mothers spending the traditional Chinese confinement period in a confinement centre and those staying at home: a cohort study. Int Breastfeed J 2021; 16:4. [PMID: 33407645 PMCID: PMC7789407 DOI: 10.1186/s13006-020-00353-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 12/10/2020] [Indexed: 12/05/2022] Open
Abstract
Background Ethnic Chinese mothers in Malaysia adhere to 30 days of traditional postpartum practices (the “confinement period”) aimed at recuperation after delivery. Recently there has been an emergence of confinement centres (CCs) where mothers stay and receive traditional confinement care. Ethnic Chinese mothers have low breastfeeding rates. There are concerns that practices in CCs could contribute to this but no data exists. We described mothers’ breastfeeding experiences at CCs and identified areas for potential improvement in breastfeeding support. Methods Ethnic Chinese mothers intending to breastfeed their healthy infants were recruited post-delivery between August and October 2017 then, at 1 and 6 months, they were telephone interviewed about their experience. For every participant going to a CC after the birth, another mother going home (“home”) for her confinement was recruited. Chi-square test was used to compare groups and multiple logistic regression was used to assess the effect of confinement place on exclusive breastfeeding. Results Of 187 mothers, 88 (47%) went to CCs. Significantly more were primipara and fewer had previous breastfeeding experience. Response rates for the 1- and 6- month interviews were 88% (CC) versus 97% (home); and 77% (CC) versus 87% (home) respectively. Exclusive breastfeeding rates were similar between the groups: 62% (CC) versus 56% (home) at 1 month (p = 0.4); and 37% (CC) versus 42% (home) at 6 months (p = 0.5). Multiple logistic regression did not show that CCs were a factor affecting exclusive breastfeeding rates at 1 month, (adjusted odds ratio [aOR] 1.7, 95% confidence interval [CI] 0.9, 3.3), or 6 months (aOR 0.9, 95% CI 0.4, 1.7). However, significantly more CC participants only fed expressed breast milk. Despite 66% of CC participants reporting that their centre supported breastfeeding, only 6 (8%) CC participants compared to 66 (69%) of home participants roomed-in with their baby (p < 0.001). The proportion encountering breastfeeding difficulties were similar between groups. CC participants sought help for breastfeeding problems mainly from CC staff and support groups while home participants obtained help from friends and healthcare professionals. Conclusions Breastfeeding rates appeared to be similar at CCs and at home during the confinement period, but there were gaps in how CCs supported breastfeeding. Targeted training to CC staff to support breastfeeding may result in better outcomes for mothers staying in CCs.
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Affiliation(s)
- Siew Cheng Foong
- RCSI & UCD Malaysia Campus, 4 Jalan Sepoy Lines, George Town, Penang, Malaysia.
| | - May Loong Tan
- RCSI & UCD Malaysia Campus, 4 Jalan Sepoy Lines, George Town, Penang, Malaysia
| | - Wai Cheng Foong
- RCSI & UCD Malaysia Campus, 4 Jalan Sepoy Lines, George Town, Penang, Malaysia
| | - Jacqueline J Ho
- RCSI & UCD Malaysia Campus, 4 Jalan Sepoy Lines, George Town, Penang, Malaysia
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Kader Maideen SF, Rahim FF, Rashid A, Abdulrahman S. Seroprevalence of Hepatitis B Among Municipal Waste Collectors in Penang Island, Malaysia and Their Knowledge, Attitude and Practice Towards the Prevention of Hepatitis B. Glob J Health Sci 2020. [DOI: 10.5539/gjhs.v12n7p20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
While there are many risks that increase an individuals’ exposure to infectious diseases such as Hepatitis B, occupational exposure increases one’s risk to acquire such infections. The objective of this study was to determine the prevalence of Hepatitis B among municipal solid waste collectors and their knowledge, attitude and practice towards the prevention of Hepatitis B. An analytical cross-sectional study was carried out among solid waste collectors in Penang Island from November 2017 to Mei 2018. The inclusion criteria of this study were solid waste collectors who have been working for at least 6 months and able to understand either Malay or English language. Those who did not turn up during the data collection period and who were unable to give their blood sample were excluded from the study. Participants’ blood were tested for Hepatitis B surface antigen (HBsAg) and Hepatitis B surface antibody (HBsAb) using Elisa. The waste collectors were then interviewed using a structured questionnaire. Ethical approval was obtained from the Institutional Research Ethics Committee, PMC RC-14. A total of 184 out of 221 eligible waste handlers participated in the study, giving a response rate of 83.3%. The prevalence of Hepatitis B in this study was 1.6%. Significant correlation was observed between attitude and practice scores (r=0.203, p=0.006). The prevalence of Hepatitis B among municipal waste collectors was low in this study. Most had poor knowledge in regards to Hepatitis B. Empowering workers by providing them adequate information is essential to reduce the risk of contracting the disease.
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Rahim FF, Abdulrahman SA, Kader Maideen SF, Rashid A. Prevalence and factors associated with prediabetes and diabetes in fishing communities in penang, Malaysia: A cross-sectional study. PLoS One 2020; 15:e0228570. [PMID: 32040497 PMCID: PMC7010272 DOI: 10.1371/journal.pone.0228570] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 01/17/2020] [Indexed: 12/23/2022] Open
Abstract
Background Diabetes is a metabolic disorder, characterized by hyperglycemic state of the body. A silent killer, which can take the lives of victims if undiagnosed at the earliest stage. Prediabetes has become an important health concern across countries due to its huge potential for the development of diabetes and other complications. The objectives of this study were to determine the prevalence of prediabetes and diabetes and its associated factors among rural fishing communities in Penang, Malaysia. Methods A cross-sectional study was conducted among fishing communities in Southwest District of Penang, Malaysia from August to November 2017. Blood sample (finger prick test) and physical examination were performed on sample of 168 participants consented in this study. Pre-validated Malay versions of International Physical Activity 7 (IPAQ-7) and Perceived Stress Scale (PSS) questionnaires were used to assess the level of physical activity and stress levels of the participants. Multinomial logistic regression models were fitted to identify factors associated with prediabetes and diabetes. Results The prevalence of diabetes and prediabetes were 19.6% (95% CI: 14.3, 26.4) and 10.12% (95% CI: 6.4, 15.7) respectively. The median physical activity (interquartile range) in MET-minutes per week for those with diabetes (1071.0 (2120.0)) and prediabetes (1314.0 (1710.0)) was generally lower as compared to non-diabetes. Majority reported moderate stress (57.3%) from PSS system. Abdominal obesity, family history of diabetes and being hypertensive were significant factors associated with diabetes; while older age, bigger waist circumference and self-perceived poor routine diet were factors associated with prediabetes. Conclusions The screening for prediabetes in this population gives the opportunity to implement lifestyle interventions at the earliest possible, which could prevent the development of diabetes. The identification of diabetic individuals provides an opportunity to conduct health promotion and education to ensure good metabolic control and hence reduce the risks of complications.
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Affiliation(s)
- Fairuz Fadzilah Rahim
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
- * E-mail:
| | | | - Siti Fatimah Kader Maideen
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
| | - Abdul Rashid
- Department of Public Health Medicine, RCSI & UCD Malaysia Campus (formerly Penang Medical College), George Town, Penang, Malaysia
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Yau CK, Rahim FF, Sheng CJ, Ling CX, Weng LK, Chia TC, Chye TK, Ting OS, Jin TH, Ali IAH. Assessing Airflow Limitation among Smokers in a Primary Care Setting. Malays J Med Sci 2019; 25:78-87. [PMID: 30899189 PMCID: PMC6422560 DOI: 10.21315/mjms2018.25.3.8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Accepted: 04/24/2018] [Indexed: 10/28/2022] Open
Abstract
Background Many smokers have undiagnosed chronic obstructive pulmonary disease (COPD), and yet screening for COPD is not recommended. Smokers who know that they have airflow limitation are more likely to quit smoking. This study aims to identify the prevalence and predictors of airflow limitation among smokers in primary care. Methods Current smokers ≥ 40 years old who were asymptomatic clinic attendees in a primary care setting were recruited consecutively for two months. We used a two-step strategy. Step 1: participants filled in a questionnaire. Step 2: Assessment of airflow limitation using a pocket spirometer. Multiple logistic regression was utilised to determine the best risk predictors for airflow limitation. Results Three hundred participants were recruited. Mean age was 58.35 (SD 10.30) years old and mean smoking history was 34.56 pack-years (SD 25.23). One in two smokers were found to have airflow limitation; the predictors were Indian ethnicity, prolonged smoking pack-year history and Lung Function Questionnaire score ≤ 18. Readiness to quit smoking and the awareness of COPD were low. Conclusions The high prevalence of airflow limitation and low readiness to quit smoking imply urgency with helping smokers to quit smoking. Identifying airflow limitation as an additional motivator for smoking cessation intervention may be considered. A two-step case-finding method is potentially feasible.
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Affiliation(s)
- Chean Kooi Yau
- Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Fairuz Fadzilah Rahim
- Department of Public Health, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Chin Jiunn Sheng
- Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Choi Xin Ling
- Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Liew Kah Weng
- Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Tan Chia Chia
- Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Tan Kean Chye
- Department of Family Medicine, Penang Medical College, 4, Jalan Sepoy Lines, 10450 Pulau Pinang, Malaysia
| | - Ooi Siew Ting
- Trinity College Dublin, School of Medicine, Dublin 2, Ireland
| | - Tan Hong Jin
- Department of Primary Care, Penang General Hospital, Jalan Residensi, 10450 Pulau Pinang, Malaysia
| | - Irfhan Ali Hyder Ali
- Department of Respiratory Medicine, Penang General Hospital, Jalan Residensi, 10450 Pulau Pinang, Malaysia
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Karunakaran R, Tay ST, Rahim FF, Lim BB, Puthucheary SD. Molecular Analysis of Ciprofloxacin Resistance among Non-Typhoidal Salmonella with Reduced Susceptibility to Ciprofloxacin Isolated from Patients at a Tertiary Care Hospital in Kuala Lumpur, Malaysia. Jpn J Infect Dis 2014; 67:157-62. [DOI: 10.7883/yoken.67.157] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Rina Karunakaran
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya
| | - Sun Tee Tay
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya
| | | | - Bee Bee Lim
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya
| | - Savithri D. Puthucheary
- Medical Education, Research and Evaluation Department, Duke-NUS Graduate Medical School Singapore
- Department of Medical Microbiology, Faculty of Medicine, University of Malaya
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Karunakaran R, Tay ST, Rahim FF, Lim BB, Sam IC, Kahar-Bador M, Hassan H, Puthucheary SD. Ceftriaxone resistance and genes encoding extended-spectrum β-lactamase among non-typhoidal Salmonella species from a tertiary care hospital in Kuala Lumpur, Malaysia. Jpn J Infect Dis 2012; 65:433-435. [PMID: 22996219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The prevalence of ceftriaxone resistance and the associated genes encoding extended-spectrum β-lactamase (ESBL) was determined in 149 non-duplicate non-typhoidal Salmonella isolated in 2008-2009 from patients in a tertiary care hospital in Kuala Lumpur, Malaysia. The resistance rate to ceftriaxone was 2.7% (2/74) in 2008, 4.0% (3/75) in 2009, and 3.4% (5/149) overall. CTX-M ESBL genes were detected in 2 of the 5 ceftriaxone-resistant isolates. The prevalence of ceftriaxone resistance, although low, is a concern because it limits therapeutic options. Continued surveillance of ceftriaxone resistance is important to monitor its trends.
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Affiliation(s)
- Rina Karunakaran
- Department of Medical Microbiology, University of Malaya, Kuala Lumpur, Malaysia. rina@ummc.edu.my
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Karunakaran R, Tay ST, Rahim FF, Lim BB, Sam IC, Kahar-Bador M, Hassan H, Puthucheary SD. Ceftriaxone Resistance and Genes Encoding Extended-Spectrum ^|^beta;-Lactamase among Non-Typhoidal Salmonella Species from a Tertiary Care Hospital in Kuala Lumpur, Malaysia. Jpn J Infect Dis 2012. [DOI: 10.7883/yoken.65.433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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