Introduction: The trends of tuberculosis (TB) treatment success rate among children in Malaysia plateaued at 90% from 2014 to 2017. Malaysia sets a higher treatment success target of 95% to be achieved in line with an affordable, accessible, and holistic approach in managing TB among children.Objective: This study aims to explore the parents' experiences and perspectives toward achieving treatment success among children who were diagnosed with TB in two districts in Selangor state, Malaysia.Methods: The study was conducted using phenomenology study design via an in-depth interview of 15 mothers who were purposively sampled from the list of pediatric TB cases in the MyTB version 2.1 database in Klang and Petaling Districts of Selangor state. The R-based qualitative data analysis package of R version 0.2-8 was used to perform the thematic analysis.Results: Two main themes were identified from this study. The first theme was trust toward the healthcare services with the subthemes of acceptance, self-efficacy, holistic care, and perceived benefits. The second theme was the motivation to take or continue medication. The subthemes were support from family, healthcare workers' (HCWs') support, the convenience of healthcare services, community support, personal strength, and child's character.Conclusion: TB treatment success for children can be achieved when parents develop trust in healthcare services and have strong motivational factors to remain steadfast in achieving a successful treatment goal. Psychosocial support should be provided to the primary caregiver who faced any difficulty, while good relationships between parents and HCWs should be maintained. These results will inform the TB program managers to strengthen the holistic approach and identify the motivational factors among parents of children with TB disease.
Introduction: Parents play an essential role in the success of their children’s tuberculosis (TB) treatment. They faced many challenges from the initial children’s health status changes until completing the TB treatment. The challenges were also described as perceived barriers, according to the Health Belief Model (HBM). This study aims to explore parents’ experiences on the challenges in achieving a successful TB treatment for their child in two districts of Selangor, Malaysia. Methods: The research was carried out using the phenomenology study design. In-depth interviews were conducted among purposely sample primary caregivers of children with TB disease who have completed TB treatment or still under treatment. MyTB version 2.1 data were sought from TB Unit, Selangor Health State Department for Klang and Petaling districts. The participants were selected based on the registration year of 2017 to 2019. The collected data was considered as achieving its saturation level if no new themes arise from the latest interviews session. The R-based Qualitative Data Analysis (RQDA) package version 0.2-8 was used for thematic data analysis. Results: The total number of participants in this study was fifteen mothers of children with TB disease. There were six main themes identified from this study, which were health symptoms challenges, TB investigation challenges, personal challenges, healthcare facilities challenges, administration medication challenges, and community challenges. Conclusions: Understanding the challenges faced by parents of children with TB disease is vital for improving the TB services and providing the required psychosocial support to the children’s family.
Background Tuberculosis (TB) among children remains a significant public health problem in many parts of the world. The objective of this study was to describe the characteristics of TB patients and to determine the predictors of treatment success among children in Malaysia. Methods Secondary data from MyTB version 2.1, a national database, were analysed using R version 3.6.1. Descriptive analysis and multivariable logistic regression were conducted to identify treatment success and its determinants. Results In total, 3630 cases of TB cases were registered among children in Malaysia between 2013 and 2017. The overall treatment success rate was 87.1% in 2013 and plateaued between 90.1 and 91.4% from 2014 to 2017. TB treatment success was positively associated with being a Malaysian citizen (aOR = 3.43; 95% CI = 2.47, 4.75), being a child with BCG scars (aOR = 1.93; 95% CI = 1.39, 2.68), and being in the older age group (aOR = 1.06; 95% CI = 1.03, 1.09). Having HIV co-infection (aOR = 0.31; 95% CI = 0.16, 0.63), undergoing treatment in public hospitals (aOR = 0.38; 95% CI =0.25, 0.58), having chest X-ray findings of advanced lesion (aOR = 0.48; 95% CI = 0.33, 0.69), having EPTB (aOR = 0.58; 95% CI = 0.41, 0.82) and having sputum-positive PTB (aOR = 0.58; 95% CI = 0.43, 0.79) were negatively associated with TB treatment success among children. Conclusions The overall success rate of treatment among children with TB in Malaysia has achieved the target of 90% since 2014 and remained plateaued until 2017. The socio-demographic characteristics of children, place of treatment, and TB disease profile were associated with the likelihood of TB treatment success among children. The treatment success rate can be increased by strengthening contact tracing activities and promoting early identification targeting the youngest children and non-Malaysian children.
Objective: Aged-care facilities are high-risk settings for coronavirus disease 2019 (COVID-19) outbreaks because residents have risk factors such as advanced age and multiple comorbidities. This report details a COVID-19 outbreak at an aged-care facility in Selangor, Malaysia during March–April 2020. Methods: Epidemiological and environmental data were gathered via telephone interviews and field investigations. Swab samples were taken from all residents and staff for laboratory investigation. Possible contributing factors to the outbreak were explored. Results: There were a total of 18 individuals at the institution: nine elderly residents and nine staff. The attack rate was 66.67% (6/9) among the elderly residents and 55.56% (5/9) among the staff. The most common symptoms reported were fever, cough, shortness of breath and diarrhoea. The fatality rate among COVID-19 cases was 18.18% (2/11). Both fatal cases occurred in people of advanced age (86 and 92 years old), who had comorbidities and had fever at presentation. The factors contributing to the outbreak included a delay in isolating symptomatic residents, the use of common facilities, caregivers providing support to more than one resident and a lack of natural ventilation. Discussion: Prevention and control measures must be aggressively implemented in high-risk sites to significantly reduce the risk of morbidity and mortality during COVID-19 outbreaks. Specific guidelines should be developed detailing the management of outbreaks in institutions such as aged-care facilities.
Public health activities under district health offices (DHOs) play a major role in Malaysia’s fight against COVID-19. This article aims to describe and illustrate the public health activity pathway in combating the COVID-19 pandemic, and a team of public health workers who are familiar with DHO work settings was created in April 2020 for that purpose. Review of documents and the Ministry of Health’s updates was carried out, followed by a series of discussions with stakeholders. Based on the steps in the outbreak investigation tasks, the flow of activities from January to May 2020 was listed in line with the phases of the country’s National Movement Control Order 2020. Results show that the activities can be classified into three different sections—namely, the main action areas, category of cases, and level of care. The main process flow of activities comprised the case management and support activities. Case management flow was split into tasks for patients under investigation and persons under surveillance, while the support services existed throughout the phases. The pathways illustrate that the progression of the pandemic translated directly to changes in the pattern of activities, with additional subgroups of activities in accordance with all imposed guidelines.
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