COVID-19 Cluster in School: A Study on Epidemiology and Clinical Manifestations among Cases from Rengas Cluster in Perak, Malaysia

Background: A COVID-19 cluster named as Rengas Cluster was declared on 6th November 2020 after nine students from a boarding school in Padang Rengas, Perak diagnosed as positive COVID-19. Risk assessment was conducted and Targeted Enhanced Movement Control Order (TEMCO) was enforced at the school to contain the viral transmission. An investigation was carried out to analyze epidemiological data, clinical manifestations among cases and effect of TEMCO on this cluster. Methods: A retrospective cross-sectional study was conducted from 2nd August 2021 until 3rd September 2021 using data that obtained from Kuala Kangsar District Health Office Crisis Preparedness and Response Centre (CPRC) Surveillance System through e-COVID notification system. The variables used in this current study include socio-demographic and clinical characteristics that include age group, gender, occupation, co-morbidities, symptoms and signs. Results: There were 132 cases out of 324 exposed populations whereby most cases were students (87.9%) and aged between 11 and 20 years old (84.8%). More than half of cases were female (57.6%) with only one case had existing co-morbidity. Majority of cases were asymptomatic (64.4%). Those symptomatic mainly presented with cough (66%) and the strongest significant positive correlation were observed between anosmia and ageusia (r = 0.807, n = 47, p < 0.001). There was no significant association between age group and development of symptoms [χ2 (6, N = 132) = 6.014, p > 0.05]. An abrupt decline in number of cases was observed following TEMCO enforcement. Conclusion: COVID-19 cases in Rengas Cluster were mostly among young students, asymptomatic and mildly symptomatic. This cluster was timely and effectively controlled by TEMCO enforcement which contributed towards early diagnosis, isolation and treatment for more effective control and preventive measures.

The Public Health Intervention for International Students at Universiti Malaysia Sabah, Malaysia

Background: COVID-19 pandemic that started in Wuhan, Hubei Province, China, has spread globally, and Sabah is one of the states in Malaysia that is affected by it. The outburst in social media on discrimination against the people from China impacted the international students from China. Thus, University Malaysia Sabah (UMS) had to play a role in mitigating the COVID-19 pandemic and protecting its students. This article aimed to describe the actions taken by UMS for its international student from China during the early phase of the COVID-19 pandemic. Methods: This study used a cross-sectional design where all 379 students from China in UMS were screened from February 2020 until March 2020 during the early phase of COVID 19. Results: During this study period, 0.5% of the students were classified as Persons under Investigation (PUI), while 99.5% were classified as Person under Surveillance (PUS). Conclusion: The public health interventions included surveillance, contact tracing, monitoring, quarantine, isolation, social distancing, mental health support, and mental health intervention activities. These actions to control the pandemic reduce the state health department's health burden and help the students in need.

Use of Effect Size Measures along with p-Value in Scientific Publications

Background: To describe various measures for estimation of effect size, how it can be calculated and the scenarios in which each measures of effect size can be applied. Methods: The researchers can display the effect size measures in research articles which evaluate the difference between the means of continuous variables in different groups or the difference in proportions of outcomes in different groups of individuals. When p-value alone is displayed in a research article, without mentioning the effect size, reader may not get the correct pictures regarding the effect or role of independent variable on the outcome variable. Results: Effect size is a statistical concept that measures the actual difference between the groups or the strength of the relationship between two variables on a numeric scale. Conclusion: Effect size measures in scientific publications can communicate the actual difference between groups or the estimate of association between the variables, not just if the association or difference is statistically significant. The researchers can make their findings more interpretable, by displaying a suitable measure of effect size. Effect size measure can help the researchers to do meta-analysis by combining the data from multiple research articles.

Mentor-Mentee Program with Medical Students: A Successful Program with Ethical Considerations

Background: Mentoring is the relationship of a guide or a teacher with another person/student augmenting his/her carrier growth, knowledge, skills, and experiences implemented by caring, sharing and helping hands. The aim of this paper is to highlight the mentoring, type of mentoring, how important of matching and consideration of ethical issue in mentoring program. Not missing these significant points, mentoring program could be successful in universities including medical faculty. Methods: The SMART principles of specific, measurable, attainable, relevant, and time-bound are essential to structure the matching between mentor and mentee. The rule of etiquette and ethical issues are crucial and beneficial for mentor mentee relationship. Clinical mentoring programs help to develop students’ clinical skills and can increase interest in under-subscribed specialties. Positive mentoring plays a part in reversing the decline of academic medicine, by sparking interest through early research experiences. Results: There is the short term goal which is to introduce an immediate support network for incoming students and the long term goal is to cultivate a mentoring culture to engage all strata of medical students and every faculty member. Medical students expressed that mentoring program is to provide counselling, develop professionalism, increase students' interest in research, and support them in their personal growth. Conclusion: The goal of mentorship is to provide additional support to student or mentee by steering of the academic needs or social prerequisites to accelerate the personal and professional development of mentee with advice, guide and feed backs from the mentor.

Public Health Informatics in Global Health Surveillance: A Review

Background: Surveillance is the backbone for effective public health practice. Traditionally, surveillance system relies on the collection of information regarding health-related events through healthcare facilities, disease notification system from the physician, syndromic notification networks, selected sentinel healthcare facilities, or by event-based data. However, there are several limitations in using conventional surveillance. Methods: With the advancement of technology and computer science, overcoming those limitations and complementing the traditional method has been recommended. Three leading emerging technologies are applied in public health surveillance: the internet of things, artificial intelligence, and blockchain. Results: Application of informatics in public health surveillance could raise several issues including accessibility and affordability of innovations; public health informatics’ experts, law, and regulation to protect patients’ information; social and ethical considerations, norms, and standards of implementing new technologies; data ownership; privacy and sharing of information; biosecurity; biosafety; and cybersecurity. Conclusion: This article aimed to review several applications of informatics system in public health surveillance practice and its several issues related to the use of technology. Several applications of informatics could be useful for incoming challenges in public health. However, application of informatics can pose significant issues and must be taken into consideration in public health practice.

Impact of COVID-19 Lockdown on Medical Education in India and its Scope on Distance Learning

The year 2020 was frightened with the fight against unprecedented Coronavirus Disease-19 (COVID-19) pandemic situations which impacted extreme changes in everyone’s lives. Particularly healthcare system was not ready to tackle public health emergencies on immediate declaration of COVID-19 outbreak by World Health Organization (WHO), later the lockdown situations have helped a lot to tackle the situations worldwide. Coming to the medical education in India, there are 272 government medical colleges with teaching hospitals and 260 private medical colleges including deemed universities in India, a good asset to India. Total of 76,928 of Bachelor of Medicine, Bachelor of Surgery (MBBS) students were getting admitted in to the colleges every year with an average intake of 150-250 students per college and per year. The COVID-19 pandemic has strengthened distance & e-Learning worldwide. Distance & e-Learning is defined as application of computer technology to deliver training, including technology-supported learning either online, offline, or both. This technology has also helped a lot to the medical education across the world including India.

Post-COVID-19 among Iraqi Population: Symptoms and Duration

Background: Earlier studies focused on description of clinical presentations of patients in the acute phase of Coronavirus disease 2019 (COVID-19). Recently, records have emerged that some patients continue to suffer from symptoms related to COVID-19 after the acute phase of infection. Yet, there is no clear definition for this condition, and different terminology has encompassed such as “post-acute COVID-19 syndrome”, “post-COVID syndrome” and “long COVID”. This study aimed to identify the prevalence of Post-COVID-19 symptoms among the adult population in Baghdad city. Methods: A cross-sectional study was conducted among 341 Iraqi adults during the period from January to February 2021. All participants are confirmed and recovered cases of COVID-19. An online self-administered questionnaire was used for data collection. The questionnaire includes information about socio-demographic characteristics, presence of co-existing conditions, details about COVID-19 infection, in addition to frequency, type, and duration of symptoms. Results: The results showed that the mean age of the participants was 30.41 years old and females represented about 65.1% of them. They suffer more frequently from symptoms of depression (6.7%), anxiety (6.2%), and peripheral neuropathy (6.2%) after 12 weeks after the acute phase. Feeling of fatigability was the most frequent symptom mentioned by (12.3%) of the patients that persist for more than 3-4 weeks beyond recovery followed by cognitive impairment in (11.7%) and loss of taste and/or smell in about (11.4%) of them. Conclusion: The majority of the patients suffered from persistent symptoms of COVID-19 following recovery, some of these symptoms continue for more than 3-4 weeks whereas others persist for longer than 12 weeks.

Factors associated with Hospitalization among COVID-19 Home Quarantine Patients in Melaka Tengah District, Melaka, Malaysia

Background: COVID-19 is an emerging new disease, recognized in late 2019, has since caused public health pandemic worldwide. Since the establishment of the COVID-19 Assessment Centre (CAC), cases were staged in terms of the severity. The mild cases were allowed for home quarantine and the severe cases were hospitalized. This study will assist healthcare providers to identify the high-risk patients and anticipate proactively, reducing morbidity and mortality. The study aimed to determine the incidence rate of hospitalization among home quarantined patients and its associated factors. Methods: A case-control study design was conducted from 16th August until 30th September 2021 involving newly diagnosed COVID-19 patients under the CAC Melaka Tengah monitoring. A case was defined as home quarantined patient whom later required hospitalization, while a control was defined as home quarantined patient throughout the period. Analysis using Chi-square and Multiple Logistic Regression were done to determine the significant associated factors. Results: There were 13,748 COVID-19 patients; with 8,237 were home quarantined and 82 required hospitalization later (1.0%). A total of 164 patients were included (82 cases and 82 controls). Among the hospitalized, 30.5% were aged 60 and above, 39.0% with comorbidity, 70.7% were symptomatic, and 40.2% were fully vaccinated. From the analysis, the only significant factor associated with hospitalization was age > 60 years old (p<0.05). Conclusion: There were home quarantined patients that required hospitalization later, especially the elderly patients. Thus, the CAC team should give priority for hospital admission to these cases instead of home quarantine order.

Pandemic Fatigue: A Challenge in Combatting against COVID-19

The COVID -19 pandemic has hit the world for a period of a year and a half; it has been a triple crisis, with medical, economic, and psychological consequences. After 18 months of going through a pandemic, this includes not only facing the transmission of SARS CoV-2 virus but also restricted movements. Communities are now facing pandemic fatigue starting as early as the third wave of increased cases in September 2020. Pandemic fatigue is the stage when the initial enthusiasm and eagerness to tackle the crisis is replaced by feelings of exhaustion. In a simple definition, pandemic fatigue is understood as demotivation to follow recommended protective behaviours. It is a natural and expected reaction to sustained and unresolved adversity in people’s lives, evolving gradually over time and affected by several emotions, experiences, and perceptions as well as the cultural, social, structural, and legislative environment.

A Report on a Visit to the School of Tropical Medicine and Global Health, Nagasaki University

Introduction: In August 2018, three Master of Public Health (MPH) students from the Faculty of Medicine and Health Sciences, University Malaysia Sabah visited the School of Tropical Medicine and Global Health (TMGH), Nagasaki University in Japan. Methods: They were joined by a faculty lecturer from the Community and Family Medicine Department. The objective of the ten-day educational trip was to attend the short course on Spatial Eco-Epidemiology Technologies at Public Health at Nagasaki University, School of TMGH. Results: The trip provided students with practical and theoretical experience of the latest technologies in the field of spatial eco-epidemiology. It also provided an opportunity to learn from the Japanese culture and gave them a well-rounded foundation upon which to build their knowledge for future careers in public health. Conclusion: This fantastic opportunity would not have been possible without the generous support and funding provided by UMS Student Mobility Programme.