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 The increased risk of loss to follow-up among TB smokers raises concern over the secondary spread within the community. This study aimed to determine the factors associated with loss to follow-up among TB patients who smoke. Methods All registered TB patients who smoke in the state of Selangor between 2013 and 2017 via the Malaysian Tuberculosis Information System (MyTB) database were included for analysis. TB patients who smoke were considered those who are “current smoker” during the notification, while loss to follow-up was defined as a TB patient who had interrupted treatment for 2 months or longer. There were 3 main variable domains included for analysis: sociodemographic profiles, disease profiles, and comorbidities. Logistic regression analysis was used to identify determinants of loss to follow-up among TB patients who smoke. Results A total of 14.1% (N = 813) of TB patients who smoke loss to follow-up. The determinants of loss to follow-up among TB smokers were working age population aged 32-41 and 42-53 years old (AOR 1.08; 95%CI 1.23,2.08) and (AOR 1.44; 95%CI 1.11,1.87) respectively, Malaysian nationality (AOR 2.34; 95%CI 1.66,3.30), patients staying in urban area (AOR 1.55; 95% CI 1.23,1.97), income level less than RM2160 (AOR 1.59; 95% CI 1.14,2.20), un-employed (AOR 1.30; 95%CI 1.09-1.55), have low education level i.e., secondary school education, primary school education and no formal education (AOR 1.60; 95%CI 1.22,2.10), (AOR 1.73; 95%CI 1.16,2.57) and (AOR 2.29; 95% CI 1.57,3.33) respectively, previously treated TB cases (AOR 2.19; 95% CI 1.71,2.81), active TB case detection methods (AOR 2.06; 95%CI 1.40,3.02), moderate lesion x-ray (AOR 1.60; 95%CI 1.13,2.27) and HIV positive (AOR 1.36; 95%CI 1.02,1.82). All the significant factors gave rise to the final model of determinants, with a predictability of 67.2% (95% CI 65.0,69.3). Conclusions The high proportion of loss to follow-up among TB patients who smoke highlight the importance of providing early risk detection that examines the three main domains of risk factors such as socioeconomic, disease profiles and comorbidities. Potential integrated intervention should aim to reduce the proportion of smoking among TB patients through the stop smoking programme together with directly observed therapy (DOT).

Alzheimer’s disease (AD) is a progressive and relentless debilitating neurodegenerative disease. A post-mortem microscopic neuropathological examination of the brain revealed the existence of extracellular β-amyloid plaques and intracellular neurofibrillary tangles. An accurate early diagnosis of AD is difficult because various disorders share the initial symptoms of the disease. Based on system biology, the multi-omics approach captures and integrates information from genomics, transcriptomics, proteomics, cytokinomics, and metabolomics. This study developed an AD prediction model based on the integrated blood-based multi-omics dataset involving 32 AD patients and 15 non-AD subjects. The integrated multi-omics dataset consists of 16 transcript genes, 14 metabolites, and nine cytokines. Due to the complete separation and multicollinearity issues, Firth’s logistic regression model was then developed to predict AD using the principal components. The model revealed 18 potential biomarkers of AD, consisting of seven metabolites, two transcriptomes, and nine cytokines. These potential biomarkers show an upregulated risk in the AD group compared to the non-AD subjects. The possibility of using these biomarkers as early predictors of AD is discussed.

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