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Nipah virus (NiV), a bat-borne paramyxovirus, has caused outbreaks of human disease with high mortality rates in Malaysia, Singapore, India, and Bangladesh. Two divergent NiV strains (NiV-Malaysia and NiV-Bangladesh) share [...]

This paper considers the subject of managed care in Malaysia, providing a questionnaire-based analysis of the position adopted by private medical practitioners. Managed care is now seen as the dominant health care system in the United States, with many other countries around the world including Malaysia beginning to selectively use component parts to tackle particular health care problems. In this survey it was found that three out of four respondents have concerns regarding the implementation of managed care. The survey was used to identify and categorise these concerns. At the same time, three out of four respondents held the opinion that principles of managed care were already a reality or would be in the next 5 years. This group expressed an eagerness to be trained in managed care principles and be given the opportunity to be part of managed care organisations. It is argued that clinicians' knowledge and interest perceptions are an important influence on the implementation of managed care based systems. The survey-based evidence presented in this article is intended as a measure of current understandings and beliefs, in relation to clinical micro-management process associated with managed care. Keywords: Health care system; Managed care; Doctors; Malaysia

I assess the population health effects in Malaysia of air pollution from a widespread series of fires that occurred in Indonesia between April and November of 1997. I describe how the fires occurred and why the associated air pollution was so widespread and long lasting. The main objective is to uncover any mortality effects and to assess how large and important they were. I also investigate whether the mortality effects were persistent or whether they represented a short-term, mortality-harvesting effect. The results show that the smoke haze from the fires had a deleterious effect on the health of the population in Malaysia.

Researchers describe an outbreak of encephalitis in Malaysia caused by a previously unknown virus. Encephalitis is an infection of the brain. Of 94 patients examined, 93% reported contact with pigs a few weeks before the illness. Over half the patients had symptoms of brain stem dysfunction. Other symptoms suggested the virus attacked the brain, brain stem and upper spinal cord. Thirty patients died, 50 completely recovered, and 14 had persistent neurological symptoms. The virus was named Nipah virus, and belongs to the class of viruses called paramyxoviruses.

Although the majority of studies have found that the incidence of eating disorders (eg. anorexia and bulimia nervosa) has increased over the last few decades (Lucas et al. 1991), there is as yet no evidence to differentiate as to whether it is a true increase or whether it is due to improved detection and increased referral rates. The eating disorders have a prevalence of about 1-2% in adolescent girls and young women. It is also reported that it has a higher prevalence in certain groups like ballet dancers and models. The prevailing social values and social desirability of 'slimness' is as widespread in Malaysia as in Western countries. The EAT, which is a 40-item, 6-point, forced choice self report format was administered to all the students in the Fifth Form of a secondary school in an affluent part of Kuala Lumpur, the capital city of Malaysia. This South East Asian country of about 19 million people is made up of 62% Malays and Malay-related races, 29% Chinese, 8% Indians and less than 1% other ethnic groups (NST, 1994). The percentages of population by religious denomination are: Muslim, 53%; Buddhist, 17.3%; Confucianist, Taoist and ancestor worship, 11.6%; Christian, 8.6%; Hindu, 7.5%; tribal religion, 1.5%, Sikh, 0.5% (Hatta, 1993). All the 140 students who were present willingly answered the questionnaire with no difficulties. However eight questionnaires were excluded because of incomplete scoring. Demographic characteristics like age, race and occupation of fathers were also recorded., Female students of a secondary school in Malaysia were asked to accomplish the EAT questionnaire to determine their eating habits and attitudes. Results indicated that culture and family attitudes influence the Malaysian girls' eating habits. The results also showed that, unlike their Western counterparts, Malaysian girls do not ascribe too much importance to thinness. Moreover, family and culture should be considered when applying the EAT questionnaire.

The patterns of health care seeking behavior of 1061 schizophrenics and the factors that affect the determination of the patterns were studied in 6 areas of 5 nations in east Asia: Hunan and Sichuan Provinces in China, Japan, Korea, Malaysia and the Philippines. The information was gathered through a structured questionnaire developed by the authors. The subjects generally favored psychiatry-oriented health care, but with frequent interruptions or combination with other types of managements. Most Japanese subjects sought care in western medicine, while subjects from Hunan, Sichuan and Korea alternated between western medicine and magicoreligious therapies or traditional herbal medicine. In the Philippines and Malaysia, the majority of the subjects sought magicoreligious therapies first, then later sought western psychiatric care. The choice of western psychiatric care was mostly influenced by the decision maker's knowledge and interpretation of the patient's illness. In determining the choice of management among various types of non-psychiatric management, cost, location, and societal attitudes played substantial roles as well as knowledge and interpretation. Suggestions and opinions were discussed to improve health care services for schizophrenic patients in each community.

Information on the relationship between prenatal health care utilization and infant and child mortality rate in Malaysia is offered. Additional information on models studying the relationship between infant and child mortality, prenatal health services and institutional delivery in Malaysia is included.

To the Editor: Since 2007, a new cardiovirus, named Saffold virus (SAFV), has been isolated from human specimens in the United States, Canada, the Netherlands, and People's Republic of China [...]

A study was conducted of the growth patterns of 32 infants from Kuala Lumpur, Malaysia. Girls were found to have slightly lower birth weights and lengths than boys. In the first six months, girls experienced a more rapid weight gain than boys, but the boys height increased more rapidly than the girls. During the second six months all rates slowed. The manner in which the infants were fed were uncontrolled combinations of breast-feeding of varied durations and solid foods. Data analysis showed that the pattern of growth was close to the Malaysian growth percentile, and that manner of feeding may cause variations.

Due to the increasingly documented prevalence of diarrhoeal diseases in Malaysia, a number of water-related programmes have been implemented in an attempt to improve health status through the reduction of incidence of waterbone communicable diseases associated with poor public water supplies. The implicit assumption underlying these projects is that the enhancement of the physical infrastructure, and subsequent improvements in the quality of the water supply, will substantially reduce water-related disease. The present study questions this hypothesis and uses a socio-ecological model as a framework to assess risk factors associated with the increased probability of waterbone disease. Research is centred on Port Dickson, a district which typifies existing water and sanitation conditions in much of semi-rural Malaysia. Health services utilization data and a 268-household diarrhoeal morbidity survey were used to measure the burden of illness of waterbone disease within the district and to identify predictors of morbidity. It was concluded that although treatment facilities will reduce the health burden in the region, a number of behavioural and sanitation factors may be more important and could act to minimize the potential impacts of improved water quality.

The study employs classification and regression trees (CART) for analyzing the relationships between growth and energy expenditure and economic status among Malian adolescent girls. High-risk subgroups for stunting are identified.

Chlamydial serology is of value in defining the epidemiology of chlamydial infections and, especially, asymptomatic disease. Prevalence data is notably lacking in developing countries. The extent of exposure to chlamydial agents in Malaysia is reported. A total of 794 serum samples were collected over a one-year period, from August 1988 to July 1989. The study population was largely urban Chinese, from Kuala Lumpur and surrounding regions. The sera were tested by indirect fluorescent antibody staining techniques. Subject ages ranged from infancy to over 50 years, and both sexes were represented in approximately equal proportion. Seropositivity increased with age and sexual activity in both males and females. The sera of 94 percent of the prostitutes were positive for chlamydia antibody. Over 70 percent of adult males attending clinics for sexually transmitted diseases tested positive. The prevalence of chlamydia antibody in other males was 43.4 percent; in adolescent females and pregnant women it was 24.8 percent and 34.7 percent, respectively. Rates for children under 10 years ranged from 10 to 16 percent. Six infants under six months were positive for chlamydia antibody. (Consumer Summary produced by Reliance Medical Information, Inc.)

This paper covers preliminary findings from a participatory action research (PAR) project into dengue prevention in Sarawak, Malaysia, which formed one part of a national, multisite study. The objectives of the project in Sarawak were to reduce a high Aedes mosquito index and associated risk of dengue in two coastal Malay villages, using behavior modification strategies through a community participatory approach. The approach has achieved a reduced Aedes index as well as both material and nontangible benefits for the communities under study. These benefits may be calculated in terms of reduction of identified health risks and physical well-being of the community as well as in terms of more effective networking and self-advocacy with government agencies and the wider community. Key words: dengue, participatory action research, Sarawak

Department of Human Services and Professional Leadership, College of Education and Human Services, University of Wisconsin Oshkosh, Oshkosh WI 5490108666 University Kebangsaan, Malaysia Michigan State University Journal of Asian and [...]

Despite a strong commitment, for both ideological and pragmatic reasons, to the privatization of state enterprises and services, and pronouncements that public health care services would be privatized, the Malaysian [...]

Voir page 192 le resume en francais. En la pagina 193 figura un resumen en espanol. A confidential system of enquiry into maternal mortality, based on that used in England [...], A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.

In Malaysia, because of an alarming increase in the number of intravenous drug users, the government has started a harm reduction program in which methadone is used as a drug [...]