Materia Medica Malaysiana

June 30, 2006

HIV: The Rising Fear Factor

Filed under: Uncategorized — malaysianmedicine @ 9:50 am

NST: PUTRAJAYA: It is scary. People who know full well that they are HIV-positive are donating blood. Last year, 124 blood donors were found to be infected with the HIV virus.
And the Government, worried by a projection that there will be 300,000 HIV/AIDS-positive Malaysians by 2015, wants to put a stop to this.
It is proposing mandatory jail for anyone who donates blood knowing he or she has HIV/AIDS.
This is one of the basket of measures the Government plans to introduce to fight the scourge. Another is to make it compulsory for Muslim couples to undergo an AIDS test before being allowed to marry.
Deputy Prime Minister Datuk Seri Najib Razak said yesterday the Prevention and Control of Infectious Diseases Act 1988 would be amended to provide for fines and a jail term.
Saying the number of HIV-positive people who donated blood rose from 107 in 2004 to 124 last year, Najib added: “It must be made a crime as there is a prevalence of such incidences. If you knowingly donate blood when you are HIV-positive, you could cause the death of other people. That’s why we are taking it seriously.”
He said this after chairing the first meeting of the Cabinet Committee on HIV/AIDS here. Also present was Health Minister Datuk Dr Chua Soi Lek.
Dr Chua said his ministry would push for a mandatory jail term for the offence.
“Blood donated to hospitals is used to save lives. There are people who know they are HIV-positive and yet they purposely donate their blood.
“There are cases where they cheat while filling forms, saying they are negative. But when we run checks, their record shows that they are HIV carriers. They do it deliberately despite knowing their status,” Dr Chua said, adding that in many countries this had been criminalised.
He said some donors failed to inform the authorities despite being told that they had newly contracted the disease.

Najib also said the Health Ministry and the World Health Organisation had projected that there would be over 300,000 Malaysians with HIV/AIDS by 2015. Currently, the figure stands at 71,676.
He said it was expected that over 6,000 would be infected with AIDS a year, unless effective measures were taken to address the problem.
The Cabinet Committee, he said, decided on several steps to curtail the spread of HIV/AIDS.
They include compelling Muslim couples to undergo HIV/AIDS screening prior to marriage.
The Islamic Development Department, Najib said, would be directed to discuss with the state governments on introducing this ruling.
He said initiatives to increase awareness of the disease, including through “shocking messages” were in the pipeline, as were talks to captive audiences such as National Service participants and Friday prayer congregations at mosques.

The government is also working to free drug users of their addiction through better implementation of the methadone substitution therapy.
He said it cost the Government RM5 for every 40 milligramme of methadone. It was now looking at sharing the resources of countries such as Hong Kong, Thailand and Germany which sourced their supply for between RM0.45 and RM2.60.
The methadone substitution therapy, he said, had proven effective. Ninety per cent of 1,200 pilot users of this method were no longer drug dependent, he added.
Najib also said while statistics showed that 70 per cent of HIV/AIDS patients were drug addicts, there was also an alarming increase (22 per cent) in the number of those who contracted the virus through sexual intercourse.
The number of women with HIV/AIDS had grown from 1.2 per cent of the total figure in 1990 to 12 per cent, he said.

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HIV has found its place among the ‘straight’

Filed under: Uncategorized — malaysianmedicine @ 9:49 am

NST: KUALA LUMPUR: HIV can no longer be referred to as a “gay disease” or a disease that involves injecting drug users as it has found its place among “straight” men and women.
A total of 1,218 heterosexuals were infected with the virus in 2002. This increased to 1,307 the following year. In 2004, the number dropped to 1,271 but is on the rise again.
The number of homosexuals and bisexuals who became HIV-positive in 2002 was 51, rising to 151 the following year and to 222 in 2004. The 2004 report by the Ministry of Health’s AIDS/STD section said there had been a steady increase in the reported number of cases among homosexuals and bisexuals since 2000. Cases were concentrated in Selangor and Kuala Lumpur.
An infectious diseases expert said: “The gap is narrowing between the number of homosexuals and heterosexuals becoming infected with HIV.”

Fighting AIDS: Blood test for couples poser

Filed under: Uncategorized — malaysianmedicine @ 9:48 am

NST: KUALA LUMPUR: Should couples who want to get married take a blood test to determine whether they are HIV-positive?
The Department of Islamic Development Malaysia (Jakim) is all for it, but the Malaysian AIDS Council (MAC) has reservations. The Malaysian Hindu Sangam is considering whether such a law should cover Hindus as well.
Jakim director-general Datuk Mustafa Abdul Rahman said compulsory testing for Muslim couples was being carried out in seven States: Johor, Kelantan, Terengganu, Selangor, Perak, Perlis and Malacca.
He was commenting on a proposal yesterday by the Cabinet Committee on HIV/AIDS to make it compulsory for Muslim couples to undergo such a test before being allowed to marry.
“Jakim and state Islamic affairs departments have agreed that couples about to get married must be tested and now, following the decision by the Cabinet Committee, we will expand this to the other States,” he said when contacted.
He said he would meet state department officials to discuss plans to implement this as soon as possible.

MAC, meanwhile, feels that compulsory testing could compromise confidentiality and the quality of counselling.
“MAC has always been very, very uncomfortable with this,” council president Dr Adeeba Kamarulzaman said.
“While we encourage people to come forward for testing, especially with the treatment available, there should be adequate dissemination of knowledge and counselling, especially if they are HIV-positive.”
UNAIDS and the World Health Organisation recommend that testing be voluntary and confidential, accompanied by counselling and conducted only with informed consent, meaning that it is both informed and voluntary.
Both bodies support mandatory screening for HIV only if blood is destined for transfusion or for manufacturing blood products.
Dr Adeeba said a one-off test would not help if people were not aware of what HIV was all about.
(The blood result of someone who is HIV-positive may show that he or she is free of the virus if they have taken the test during the window period when the virus is not yet present in the body. This requires a second test. First tests may show a false positive, which means a second, and sometimes third, test is required.)
“Everyone should come in for testing but it should not be forced upon them,” Dr Adeeba said.
“We have compulsory testing in prisons and drug rehabilitation centres and we are not seeing it as being really effective.”
She said testing would not make a difference if it did not lead to behavioural changes.
“Yes, people need to know their status, but they also need to know how to handle it,” she said.

Catholic priest and moral theologian Rev Dr Clarence Devadass said there should be a law to make it compulsory for a HIV-positive person to tell his or her partner and their family of their status, but agreed that voluntary testing was acceptable.
“We encourage couples to do blood tests. It is for your own general health,” he said.
He said if an individual knew that he or she was HIV-positive and refused to tell their partner or potential spouse, society had a responsibility to inform the uninfected partner.
“That’s the principle of justice, which outweighs the principle of confidentiality,” he said.
Devadass also welcomed the idea of promoting HIV/AIDS awareness to captive audiences, saying the Catholic stand was abstinence.
He said the Catholic church did not condone the needle-exchange programme, the distribution of condoms or methadone substitution therapy.

The Hindu Sangam will consider whether HIV testing should be made compulsory for Hindus, said its president, Datuk A. Vaithilingam.
“I am not saying we are formaking it compulsory at the moment because we have to consider all angles first. We have to be very careful,” he said.
The Hindu Sangam will next month call for a meeting of national Hindu organisations and spiritual leaders to discuss the matter.
Asked whether he was for compulsory testing, Vaithilingam, who is also the vice-president of the Malaysian AIDS Council, said: “Not yet. We want to go through everything very carefully.”

Noodles high in boric acid

Filed under: Uncategorized — malaysianmedicine @ 9:47 am

Star: BALIK PULAU: Noodles in Penang and Selangor have high content of hazardous boric acid, Health Minister Datuk Dr Chua Soi Lek warned.
A random survey carried out in April showed that Selangor topped the list with 19% of samples containing dangerously high levels of boric acid, followed by Penang (16%), he said.
Dr Chua said hokkien mee contained 33% boric acid, wantan mee (18%) and yellow mee (6%).
Stressing that high boric acid content in food could cause nausea and lead to death and kidney failure, he warned that stern action would be taken against noodle manufacturers who flout the regulation.
Under the Food Act, those liable can be fined up to RM20,000 and be jailed two years.
“We are taking stern action. We have seized the products containing excessive boric acid and initiated court action,” he said after visiting Balik Pulau Hospital here yesterday.
“The highest cases were found in Klang, Selangor, and in Kepala Batas, Sungai Dua and Butterworth in Penang.”
Dr Chua announced that he would approve RM600,000 for the hospital to purchase additional facilities such as haemodialysis and X-ray machines.

He said the Cabinet had directed his ministry and the Higher Education Ministry to form a committee to improve the Teaching Hospital programme to reduce cost of training medical students overseas.
“We want to include all 131 hospitals in the programme. Now only 98 hospitals are involved,” he said.
“The committee will look into how to make full use of local specialists and experts to train medical students.
“The Government spends RM330mil a year to train medical students overseas. It costs a student about RM1mil to study medicine in Ireland, and RM700,000 in Australia.”

Register only for genuine specialists

Filed under: Uncategorized — malaysianmedicine @ 9:39 am

Star: PUTRAJAYA: There is no room for any “wannabe” in the National Specialist Register (NSR) to be launched in August.
“If you do not meet the criteria to be on the list, then you are not a specialist,” said Health Ministry director-general Tan Sri Dr Ismail Merican.
The registration process, which would include a check on credentials and competency, was vital to maintain and safeguard the highest standards of specialist practice in the country, he told reporters here yesterday.
Describing the register as a landmark move, he said action could be taken against those who falsify information to claim they were specialists.
Dr Ismail said because there was no such register at the moment, the exact number of specialists in the country, especially in the private sector, was not known.
The Medical Act 1971, he said, was being amended to include a provision to register specialists. He hoped it would be passed this year.
“The NSR will ensure that doctors designated as specialists are appropriately trained and fully competent to practise at the expected higher level of care in the particular specialty.
“Until the Act is passed, credentialing of specialists will be undertaken by the National Credentialing Committee established by the ministry.
“Practitioners admitted to the NSR will be deemed to be specialists under the amended Act,” he added.
Dr Ismail said the NSR would be a source of reference for the impending National Health Financing Scheme, where payment for service would be based on the credentials of the practitioner.
He said the NSR was important once Malaysia opened its doors to foreign medical specialists in compliance with the General Agreement on Trade in Services.
The registration exercise for the NSR is a joint effort between the ministry and the Academy of Medicine of Malaysia (AMM).
Those who meet the stipulated criteria can register with the NSR secretariat housed at the academy. The fees are at RM1,200 for AMM members and RM1,500 for non-members. The NSR registration is renewable every five years.
The AMM, set up in 1969, has 2,200 members from various specialities.
Health Minister Datuk Dr Chua Soi Lek will launch the NSR on Aug 24 at the ministry’s annual congress. Registration can be done online at http://www.nsr.org.my

Govt Hospitals To Churn Out Doctors

Filed under: Uncategorized — malaysianmedicine @ 9:36 am

PENANG, June 29 (Bernama) — The public hospitals will be transformed into teaching hospitals to churn out doctors, says Health Minister Datuk Dr Chua Soi Lek.
He said the Cabinet decided this Wednesday in efforts to produce more doctors and reduce the cost involved in sending medical students overseas.
A committee jointly chaired by the secretary-general and director general of the Health and Higher Education Ministry has been established to look into the matter.
Dr Chua said the committee would look into ways on how the hospitals could be modified to accommodate classrooms, seminar rooms, research and development rooms and lecture rooms.
When met by reporters after visiting the Balik Pulau Hospital here, he said currently 98 of the 131 hospitals are being used by the 10 private and 9 public institutions of higher learning for the clinical training of their medical students.
The experienced specialists in the hospitals would tutor the medical students, he said.
He said while the specialists’ new role as “lecturers or presenters” would not disrupt hospital operations, the big number of students may not provide a comfortable atmosphere for the patients and therefore it must be implemented carefully.
The rules and the implementation methods would be worked out by both parties.
Dr Chua said the government spent RM330 million annually to sponsor 530 medical students overseas and if they could be trained locally it would contribute to big savings.

June 29, 2006

Apathy a reason for rising dengue cases

Filed under: Uncategorized — malaysianmedicine @ 9:15 pm

Star: The ignorant and indifferent attitude of Selangor residents is one of the reasons why the state has the highest number of dengue cases in the country.
Last year, the number of cases in the state numbered 9,178, with 12 deaths. Cases in Selangor alone contributed almost 27% of the total number of cases in the country, a grave cause for concern for the state government.
On Tuesday, state exco for tourism, health and consumer affairs Datuk Dr Lim Thuang Seng said Selangor residents should work with the state government to curb the disease.
“The state is going all out to do its part but residents should also buck up and be more proactive.
“They should know the dangers of having unkempt compounds and must be particularly vigilant during the rainy season when there is usually a surge in dengue cases,” he explained.
“When the authorities carry out fogging, residents should be cooperative and let them in.
“They should also participate in gotong-royong activities organised by residents’ associations,” he added.
Lim was speaking after visiting several dengue-prone areas under the jurisdiction of the Kajang Municipal Council (MPKj). Accompanying him were officers from the council and the Hulu Langat District Health Office.
According to Lim, the number of dengue cases recorded in areas under MPKj and the Subang Jaya Municipal Council (MPSj) were at an alarming level.
Bandar Teknologi Kajang in Semenyih is one of the areas often prone to dengue but efforts to curb the disease were still unsatisfactory.
Aedes larvae were found in several locations and almost all the situations could have been prevented if residents were more concerned for their health and surroundings.
Tyres stacked in the front compound of one house, old plastic trays kept in the garden of another house and discarded water containers around the playground were all breeding grounds for the larvae.
Similar scenes were witnessed in Bandar Baru Bangi while larvae were also present in water collecting in plastic sheets discarded at the temporary MPKj store located on private land on Jalan Low Ti Kok.
At a briefing at the Hulu Langat District Health Office earlier, Lim was told that the World Health Organisation (WHO)-sanctioned programme called Combi (Communication for Behavioural Impact) was successful in reducing 75% of the dengue cases in Sections 3 and 4 of Bandar Baru Bangi in 2004 and 85% of dengue cases in Kampung Sungai Ramal Dalam last year.
The Combi only works if residents are willing to take a serious role in efforts to curb dengue.

Drastic Increase In New Cases Of HFMD In Sarawak

Filed under: Uncategorized — malaysianmedicine @ 8:57 pm

KUCHING, June 29 (Bernama) — The number of new cases of Hand, Foot and Mouth Disease (HFMD) in Sarawak increased drastically to 71 yesterday.
Deputy Chief Minister Tan Sri Dr George Chan in his daily update Thursday said the highest number came from Kuching, followed by Bintulu, Miri, Sri Aman, Sibu and Betong.
“There are 11,062 cumulative cases,” he said, adding that 16 new hospital admissions were reported but there was no critically ill case.
For the past two months since the first HFMD case was detected in February, the number of new HFMD cases had been dwindling with an average of 30 to 50 cases per day.
Last week, a two-year-old boy from Marudi became the latest fatality of the HFMD outbreak in Sarawak, prompting the state goverment to put on hold its decision to declare the state HFMD-free.
The latest case brought the death toll to 11.

Online Course In Occupational Medicine For Socso Panel Doctors Launched

Filed under: Uncategorized — malaysianmedicine @ 8:56 pm

PETALING JAYA, June 29 (Bernama) — A web-based certificate course in occupational medicine is now available to Social Security Organisation (Socso) panel doctors.
Launched by Deputy Human Resources Minister Datuk Abdul Rahman Bakar here Thursday, the course is made available by the ministry, Zenith Institute of Medicine, Socso and the Malaysian Society of Occupational Health Physicians.
“The programme consists of 30 reviewed articles on occupational medicine authored by experts in the field. Ten assessment questions are set for each article and a pass is awarded to candidates who score a minimum of 60 per cent for each article completed,” Zenith Institute president Wong Mei Chan said at the launch.
The overall objectives of the course are to identify workplace hazards, assess the hazards, suggest intervention strategies and familiarise the panel doctors with legislation governing workers and their health.
Wong said the launch of the online course had made e-learning possible to busy doctors throughout Malaysia and offered them the opportunity to learn from experts in the field from the convenient comfort of their homes or offices.
Malaysian Society of Occupational Health Physicians president Datuk P. Krishnan told reporters after the launch that the society was happy to support the online certificate course.
“This course, while giving the medical practitioners a basic knowledge in occupational medicine, also meets the requirement of Socso to have all its panel doctors trained in occupational medicine,” he said.
Considering it as an innovative project, Krishnan hoped the course could give more information and awareness to the panel doctors on the problems faced by their patients.

HIV/AIDS Blood Donors May Be Jailed

Filed under: Uncategorized — malaysianmedicine @ 8:55 pm

PUTRAJAYA, June 29 (Bernama) — The government proposes to impose mandatory jail sentence besides a fine on HIV/AIDS sufferers who falsify information on their condition to donate blood.
Deputy Prime Minister Datuk Seri Najib Tun Razak said the Prevention and Control of Infectious Diseases Act 1988 would be amended to provide for this.
“There have been several cases of HIV and AIDS sufferers who donated blood. We want to make it a crime,” he told reporters after chairing the meeting of the Cabinet Committee on AIDS here.
“You can kill people by that act. If you knowingly donate blood when you are HIV+, you could cause the death of other people. That’s why we are taking it seriously,” Najib said.
Last year, 643 blood donors were found to be infected with various viruses, seven of them with HIV/AIDS.
And this is the scary picture painted by Najib if effective measures are not taken to curb HIV/AIDS — a projected 300,000 Malaysians will contract the disease by 2015.
He said the trend of the disease in Malaysia was most worrisome with about 11,000 HIV/AIDS cases and 8,334 deaths recorded last year.
“On average, 6,000 HIV/AIDS cases are reported annually, 70 per cent of them involving drug addicts,” he said.
He said the percentage of women infected with HIV rose 10 times from only 1.2 per cent in 1990 to 12 per cent last year.
“This trend will rise because the spread of the disease through sex will rise, so the spread of the disease among women will increase,” he said.
Among the measures decided upon today to check the disease is to require all the states to conduct HIV/AIDS screening on Muslim couples intending to get married.
The states that have not done so are Kedah, Penang, Negeri Sembilan, Sabah, Sarawak and the Federal Territories of Kuala Lumpur and Labuan.
Najib said the important thing was to raise the people’s awareness of the dangers of HIV/AIDS through various channels like the media, talks and Friday sermons.
He also said that the committee agreed that the supply of methadone should be increased to bring down the current price of RM5 per 40mg of the drug. Methadone is used in therapy for drug addicts.
Najib said the pioneer methadone replacement programme which started last October with 1,200 drug addicts had proven effective with 85 to 90 per cent of them now free of drug and 71 per cent to 90 per cent having found jobs.
Phase two of the programme in 2006-2007 will be extended to all government hospitals.

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