MADSA Calls for More Efforts to Safeguard Dietary Supplements in Malaysia

WORDS DR RAJENDRAN MANICKAVASAGAM

FEATURED EXPERT
DR RAJENDRAN MANICKAVASAGAM
Malaysian Dietary Supplement Association (MADSA)

Since the onset of COVID-19, Malaysians have been taking extra care of their health.

In fact, there has been a steady demand for dietary supplements propelled by this new collective awareness towards our overall wellbeing.

However, recent price hikes have raised the average living costs in Malaysia. For some, they may have to cut back on added expenses, which includes dietary supplements.

This situation opens doors for devious, illegal activities to take place within the market, especially through e-commerce websites where counterfeit supplements are sold at absurdly low prices.

For instance, a single joint support supplement may cost RM120 to RM180 at pharmacies, but some unscrupulous sellers offer the same product for only RM38.

Additionally, certain platforms and sellers may take advantage of unassuming consumers by offering attractive discounts and vouchers, further expanding this perpetual market of deceit in terms of people’s health and wellbeing.

VERY CHEAP SUPPLEMENTS: WHAT’S THE CATCH?

The allure of a good bargain can be extremely compelling, especially when one only needs to pay a fraction of the original price. However, the consequences of purchasing from unverified vendors or websites can be severe.

Counterfeits

A multitude of these sellers often operate without the necessary quality control measures.

Without proper scrutiny, these unscrupulous vendors can easily pass off fake supplements as genuine, putting consumers at risk of ingesting unknown and possibly harmful substances.

These products also may not follow proper standards of procedures, leading to higher chances of improper handling and contamination.

Effects on the Local Supplement Market

In addition to the health risks, these unverified sources also undermine the integrity of Malaysia’s legitimate nutritional supplements market, which is valued at USD $644.88 million in 2023.

Certified brands are finding it increasingly harder to earn customers’ trust who have been victims to disingenuous sellers.

THE NEED FOR REGULATORY RECOGNITION TO PROTECT CONSUMERS

In spite of these malicious activities, Malaysia upholds strict laws and regulations to govern the manufacturing and labelling of dietary supplements.

This includes mandatory registration of documented evidence and stringent timelines for health supplements. While some counterfeit products may slip through the cracks, the Ministry of Health, via the National Pharmaceutical Regulatory Agency (NPRA), has laid out various safeguarding measures to help consumers identify the legitimacy of a product.

The Ministry of Health has also mandated that all certified health supplements must be marked with the holographic sticker called the FarmaTag, which is extremely hard for counterfeit producers to replicate. The sticker also includes an MOH-issued QR Code, a gradient design, and holographic serial and pin numbers.

Additionally, the Health Ministry has released a mobile app called FarmaChecker to help consumers confirm a product’s certification status online by scanning its QR code or typing in its serial number.

At the same time, the NPRA continues to ensure the safety and efficacy of dietary supplements, mandating safety data for supplements with new or innovative ingredients. Similarly, the Malaysian Dietary Supplement Association (MADSA) has also worked hand-in-hand with the government to promote and increase awareness of health supplements and its benefits to all Malaysians.

With the collective effort by both the government and consumers alike, we can work towards a future where all our nutritional supplements are safeguarded from the unethical practices of counterfeit producers.

By being mindful of the sources of our purchases, especially when the products involve our health and wellbeing, we can nurture a safe and healthy supplements market in Malaysia.

After all, bargaining our health for cheaper costs will never be worth the price.

MADSA CALLS MALAYSIANS TO BE VIGILANT

MADSA advises Malaysian consumers to always make sure that online supplements have been registered by the NPRA.

Check if the product has an MAL number, which verifies that it has been approved by the NPRA.

If the product that’s delivered doesn’t have such identification, return and request for a refund and report this matter to the Ministry of Health.

Ministry of Health and Local Experts Rally to Call Malaysians to “Check, Confirm, Consult and Change”

WORDS LIM TECK CHOON

On 24 April 2024, YB Dato’ Lukanisman Awang Sauni, the Deputy Minister of Health Malaysia, launched the public health promotion campaign, Stand Against Prediabetes; Don’t Sugarcoat It (SAPd), in Putrajaya.

WHAT IS PREDIABETES?

Prediabetes is a condition where blood sugar levels are higher than normal, but not high enough to be diagnosed as type 2 diabetes.

Nonetheless, this higher-than-normal blood sugar levels will put one at an increased risk of developing type 2 diabetes, heart disease, and stroke in the future, if preventive measures are not taken to control their blood sugar levels.

YOU MAY HAVE PREDIABETES IF YOU HAVE:
  • HbA1c 5.7%-6.2% (39 to 44 mmol/mol).
  • Fasting plasma glucose of 6.1 to 6.9 mmol/L.
  • Oral glucose tolerance test shows that your blood glucose levels are 7.8 to 11.0 mmol/L.
WHY IS THERE A NEED FOR A PREDIABETES CAMPAIGN?
  1. An estimated 3.5 million Malaysians may have prediabetes.
  2. Because prediabetes has no symptoms, many may not be aware that they have it unless they go for a medical check-up.
  3. 1 in 10 people with prediabetes are likely to develop full-blown diabetes within a year, while up to 7 out of these 10 people may face the same outcome in 10 years.
  4. These individuals are already at risk of developing cardiovascular disease, vision loss, nerve damage, and chronic kidney disease even before diabetes sets in!
MORE ABOUT SAPd
FEATURED EXPERT
DR NURAIN MOHD NOOR
President of the Malaysian Endocrine and Metabolic Society (MEMS)

Dr Nurain Mohd Noor said during the launch: “MEMS initiated SAPd and invited the collaboration of seven other medical and allied health societies, as well as the involvement of Ministry of Health Malaysia.”

These societies include Malaysian Diabetes Educators Society (MDES), Malaysian Dietitians’ Association (MDA), Malaysian Family Medicine Specialists’ Association (FMSA), Malaysian Medical Association (MMA), Malaysian Pharmacists Society (MPS), National Heart Association Malaysia (NHAM), and The Chapter of Chemical Pathology & Metabolic Medicine, College of Pathologists, Academy of Medicine Malaysia (CPath AMM).

The SAPd programme is supported by Merck Malaysia.

Dr Nurain further remarked that SAPd managed to attain several important achievements over the last 2 years:

  • Successfully promoted the adoption of standardized prediabetes blood glucose test values in over 200 private chain, independent and hospital laboratories, as well as over 2,000 government clinics and 100 government hospitals.
  • Trained more than 2,000 healthcare professionals including doctors, nurses, pharmacists, and dietitians to enhance their effectiveness in the management of prediabetes.
  • Published a clinical guide for the reference of healthcare professionals, as well an educational website, booklet, and pamphlet for the public.
THE 4Cs OF SAPd
FEATURED EXPERT
PROFESSOR EMERITA DR CHAN SIEW PHENG
Consultant Endocrinologist and Chairperson of the SAPd Programme

Professor Emerita Dr Chan Siew Pheng provided further elaboration into the key message of campaign: the 4Cs or Check, Confirm, Consult, and Change.

CHECK Your Prediabetes Risk

  1. Take the online risk checker at the SAPd website (link opens in a new tab).
  2. If the results show that you are at risk, ask for a simple finger prick blood glucose test at your community pharmacy, private GP clinic, or government health clinic.

SAPd aids to enlist 700 community pharmacies nationwide to provide complimentary finger prick blood glucose tests by mid-May of this year.

CONFIRM the Presence of Prediabetes

If your finger prick blood glucose test results show a higher-than-normal blood glucose level, you will need to get a proper blood test from a laboratory, clinic or hospital.

CONSULT Your Healthcare Professional

The guidance and support of a healthcare professional is important to determine the best approach for you to manage prediabetes with lifestyle intervention and medication, if required.

By attending follow-up visits, your healthcare professional will be able to monitor your progress and keep motivating you to achieve the results you desire.

CHANGE to Reclaim Your Health

The five pillars of prediabetes management are:

  1. Lose excess body weight and maintain healthy weight.
  2. Increase physical activity and exercise.
  3. Adopt healthy lifestyle habits (getting enough good quality sleep, managing stress, and quitting smoking, vaping, alcohol and other substance abuse).
  4. Take your medications as prescribed.
  5. Team up with healthcare professionals.
Visit the SAPd website for more information and free educational downloads (link opens in a new tab). The website is available in English and Bahasa Melayu.

Malaysia’s First Women Ophthalmology Forum Commemorates International Women’s Day

WORDS LIM TECK CHOON

On 7 March 2024 Roche Malaysia Sdn Bhd launched the inaugural Empowering Visions: Malaysia Women Ophthalmology Forum in conjunction with International Women’s Day.

Moderated by talk show host Freda Liu, the forum featured the following prominent panelists:

  • Datuk Dr Nor Fariza Ngah, Deputy Director of Health, Research & Technical Support
  • Dr Tara Mary George, a consultant ophthalmologist
  • Dr Shamala Retnasabapathy, a consultant ophthalmologist

The panelists covered a multitude of relevant topics such as breaking barriers and overcoming stereotypes, patient care, the importance of interpersonal skills, the significance of continuous education as well as the professional development of women in the medical profession.

WOMEN BRING VALUE THAT CAN ELEVATE THE MEDICAL PROFESSION

According to Datuk Dr Nor Fariza, women bring a distinct perspective that enriches the profession and elevates patient care.

“In a domain where empathy, communication, and meticulousness reign supreme, women’s inherent strengths make them indispensable contributors,” she said during the forum.

She added: “Moreover, diverse representation ensures healthcare systems are attuned to the varied needs of patients, including those specific to women. By championing and empowering women in ophthalmology and healthcare at large, we not only advance gender equality but also enhance the caliber and efficacy of healthcare provision for all.”

A COMPASSIONATE APPROACH TO OPHTHALMOLOGY

Dr Tara Mary George said: “It is the compassionate approach commonly associated with us women which can significantly enhance patient care. Through empathetic communication and understanding, we can alleviate fears, clarify treatment plans, address patient concerns with as much sensitivity and understanding as possible, and cultivate a supportive environment where patients feel valued and heard.”

FAMILY SUPPORT VITAL FOR WORK-LIFE BALANCE

This key point was brought up by Dr Shamala Retnasabapathy, who said, “The supportive role of family is pivotal in achieving work-life balance, contributing to the empowerment of women in their professional endeavors.”

For her fellow women in the field of ophthalmology, she advised no to neglect continuous education and professional development, as these are essential when it comes to staying abreast of the latest advancements.

“This is another way of showcasing our commitment to providing the highest standard of care to their patients while contributing to the advancement of the field as a whole—and how we pave the way for greater inclusivity, diversity, and progress within the profession,” she added.

AN INITIATIVE TO CHAMPION DIVERSITY & INCLUSION

Choong Mei Chen, who is the Ophthalmology Country Disease Area Lead for Roche Malaysia, Vietnam, Philippines and Indonesia, told us that initiatives such as the Empowering Visions: Malaysia Women Ophthalmology Forum send a resounding message of support and empowerment.

“Together, let us boldly challenge the status quo, dismantle barriers, and pave the way for a future where every individual, regardless of gender, enjoys equal opportunities to excel!” she said.

UKM & AMM Organized Liver Cancer Awareness Day in Conjunction with World Cancer Day

WORDS LIM TECK CHOON

February 4 was World Cancer Day. In conjunction with World Cancer Day 2024, the Gastroenterology and Hepatology Unit, Department of Medicine and the Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM) collaborated the Academy of Medicine Malaysia (AMM) organized a Liver Cancer Awareness Day event at Komune Living & Wellness, Bandar Tun Razak, Cheras, Kuala Lumpur.

THE MINISTER OF HEALTH CALLS FOR REMOVAL OF GREATER AWARENESS OF CANCER AMONG MALAYSIANS

The event was officiated by YB Datuk Seri Dr Dzulkefly Ahmad, our Minister of Health, and witnessed by the residents of Bandar Tun Razak.

In his speech, Datuk Seri Dr Dzulkefly congratulated the UKM Faculty of Medicine for organizing a community program that has the community closer to the university.

“Approximately 48,639 new cancer cases and 29,530 cancer deaths were reported in 2020 in Malaysia. And more worryingly, experts have predicted that the incidence of cancer in Malaysia will increase 2 times by 2040,” he shared.

He further stated: “There is no doubt that cancer is on the rise. I strongly believe that, as a community, we should learn what cancer is and most importantly to remove the taboo behind the word ‘cancer’.”

LIVER CANCER IS ONE OF THE TOP 5 MOST COMMON CANCERS IN MALAYSIA

“Currently, liver cancer is one of the 5 most common cancers in Malaysia; others are breast cancer, colorectal cancer, lung cancer and nasopharyngeal cancer,” Datuk Seri Dr Dzulkefly revealed. “Primary liver cancer, which starts from within the liver itself, unfortunately, has one of the worst prognoses because it is often diagnosed at a late stage when symptoms appear.”

Our Minister of Health also added that obesity is often associated with an increased risk of fatty liver disease known as metabolic dysfunction associated fatty liver disease (MAFLD), which is becoming the main cause of liver cancer.

However, liver cancer can be prevented either through hepatitis B immunization or early treatment of liver disease detected in patients with known hepatitis or cirrhosis.

LIVER CANCER DAY OFFERED EDUCATIONAL EVENTS & HEALTH SCREENING FOR ALL ATTENDANTS

The objective of the Liver Cancer Awareness Day event was to increase community awareness of liver cancer in addition to knowing more about liver cancer, its symptoms, risk factors, detection, and prevention.

A public forum on liver cancer was held during the event. This forum became a platform for liver cancer patients to share their experiences. Additionally, a group of panelists from the Ministry of Health Malaysia, University Hospitals, agencies and medical associations discussed the issue of public access to affordable cancer medicine in an effort to bridge the gap between the rich and the needy when it comes to cancer care.

In addition to public forums, the Liver Cancer Awareness Day event also provided attendants with screening services such as mammograms by Majlis Kanser Nasional (MAKNA), metabolic disease screening, hepatitis B and C screening, and fatty liver screening as well as consultation by experts, health fairs, quizzes, and lucky draws.

Meanwhile, the Malaysian Relief Agency (MRA) donated food packs to 90 residents of Bandar Tun Razak, Cheras. The participation of residents in this area was made via a community network between the UKM Faculty of Medicine and the residents of Bandar Tun Razak, Kuala Lumpur.

AUSPICIOUS GUESTS ADDED IMPACT TO THE EVENT

In addition to the gracious presence of the esteemed Minister of Health, the Liver Cancer Awareness Day event was attended by: Professor Dato’ Dr. Hanafiah Harunarashid (Pro Vice Canselor Kuala Lumpur Campus UKM), Professor Dr. Abdul Halim Abdul Gafor (Dean of the Faculty of Medicine UKM), Professor Datin Dr Marina Mat Baki (Deputy Dean of Industry Community and Partnerships Affairs), Professor Dato’ Dr Razman Jarmin (Director of Hospital Canselor Tuanku Muhriz UKM), Professor Dato’ Dr Ismail Sagap (Director of Hospital Pakar Kanak-Kanak UKM), Professor Dr Rosmawati Mohamed from the Academy of Medicine Malaysia, as well as various hospital directors and heads of department.

This program was made possible by the efforts of the Dean of the UKM Faculty of Medicine, Professor Dr Abdul Halim Abdul Gafor, and members of the faculty’s top management.

 

Malaysian Medics International (MMI) Responds to Zero HO Protocol

WORDS MALAYSIAN MEDICS INTERNATIONAL (MMI)

We are deeply concerned regarding the article released on 15th January by CodeBlue highlighting the implementation of a “Zero HO Protocol” within the medicine department of the University Malaya Medical Centre (UMMC). This protocol aims to address the critical shortage of house officers (HO) in different medical units as the services provided by house officers are now prioritised based on departmental workload.

Some of the key points of the protocol are as follows:

  1.  ICU prioritization with stable patients being admitted to medicine department wards and at-risk patients being placed in the Intensive Care Unit (ICU).
  2. Encouraging medical officers to perform procedures like IV cannula insertion and blood tests themselves to emphasize clinical judgement and discourage unnecessary test requests.
  3. Proposal for task sharing among medical officers, lecturers and consultants.
  4. Emphasis on mindfulness during patient admission as patient management is the responsibility of the admitting doctor.

House officers and medical officers are the grassroots of the healthcare system to achieve peak efficiency. Thus, we humbly call upon the Ministry of Health and Ministry of Higher Education to consider the following:

Decrease in manpower resulting in more harm than good

The diminishing numbers of house officers in the healthcare system are manifesting as a significant concern with multifaceted repercussions.

The increased workload on the existing staff is leading to burnout, adversely affecting their overall well-being.

Service reductions or cuts to cope with the strain could potentially compromise access to crucial medical services for patients, raising serious concerns about healthcare delivery and patient safety.

Hence, urgent attention is needed to address extreme shortages and maldistribution.

A targeted approach could involve expediting the intake of medical graduates into the housemanship system for a quicker transition from graduation to practical training. This would also overcome the “brain dead” issue which has been a concerning trend in the healthcare system.

On the other hand, Singapore offers a shorter time between graduation and work compared to waiting around six months in Malaysia. Hence, with a shorter gap, more medical graduates are able to work sooner to reduce the shortage of house officers.

Task delegation, focusing on critical departments, is crucial for effective management without compromising quality. Public hospitals should identify critical departments that are particularly affected by the shortage and maldistribution of HOs, as it would allow task prioritisation based on urgency and importance. Task delegation should focus on ensuring that essential responsibilities are managed effectively without shortage drawbacks. This emphasizes the need for immediate attention and comprehensive strategies from healthcare authorities to rectify this concerning trend and fortify the resilience of the healthcare system.

Collaboration between MOH and MOHE

Efficient collaboration between the Ministry of Health (MOH) and the Ministry of Higher Education (MOHE) is essential to bridge gaps and ensure better healthcare outcomes.

Clear communication with specific objectives and anticipated outcomes is necessary to foster a more cohesive and effective healthcare system.

Implementing interdisciplinary training programs for medical students, tailored to their academic schedules can provide essential skills learning for them.

Therefore, the workload among our healthcare workers can be reduced by providing opportunities for medical students to sharpen their skills under supervision.

Moreover, assessing the skills and competencies of available healthcare professionals ensures that responsibilities are delegated to individuals with appropriate expertise.

This diversified approach ensures a more efficient distribution of tasks, compensating for the diminished workforce and minimizing the impact on patient care. Early intervention at the foundation level can mitigate the issue of doctor shortage.

In conclusion

We urge the Ministry of Health and the Ministry of Higher Education to promptly consider and address the aforementioned issues. While this protocol might be perceived as a temporary drastic measure taken to cope with the decrease in house officers or medical officers, it could impact the present and future of Malaysia’s healthcare sector.

Thank you.

MALAYSIAN MEDICS INTERNATIONAL
TERM 2023/2024

About Malaysian Medics International (MMI)

MMI is an international medical student-led organization that aims to connect, educate, and cultivate. Since our inception in 2013, we have grown into a global network of more than 200 leaders from seven countries around the world. Presently, we are an active advocate for inclusivity and diversity, reform in medical education, and the welfare of our junior doctors and medical students.
Website: malaysianmedics.org
Email: admin@malaysianmedics.org

References:

  1. Zainuddin, A., & Su-Lyn, B. (2024, January 17). UMMC’s medicine department mulls ‘Zero HO protocol’, with indefinite critical Houseman shortage. CodeBlue. https://codeblue.galencentre.org/2024/01/15/ummcs-medicine-department-mulls-zero-ho-protocol-with-indefinite-critical-houseman-shortage/
  2. Zainuddin, A. (2024, January 19). MOH and MOHE must resolve their ‘Bad blood’: Musa Nordin. CodeBlue. https://codeblue.galencentre.org/2024/01/18/moh-and-mohe-must-resolve-their-bad-blood-musa-nordin/
  3. Zainuddin, A. (2024a, January 18). UMMC doctors tout parallel houseman system, full independence from MOH. CodeBlue. https://codeblue.galencentre.org/2024/01/16/ummc-doctors-tout-parallel-houseman-system-full-independence-from-moh/

Universiti Kebangsaan Malaysia Confers Distinguished Alumni Award to Minister of Health

WORDS LIM TECK CHOON

On 5 October 2023, the Faculty of Medicine of Universiti Kebangsaan Malaysia (UKM) conferred the Distinguished Alumni award to Dr Zaliha Mustafa, our Minister of Health.

This conferment was in acknowledgment and celebration of Dr Zaliha’s accomplishments and successes as the Minister of Health. Notably, she is the first female Minister of Health of Malaysia.

CELEBRATING THE PRESENT & CONTEMPLATING THE FUTURE

Upon receiving the title, Dr Zaliha shares: “I would like to express my utmost appreciation to UKM, especially the Faculty of Medicine, for bestowing upon me the Distinguished Alumni award. Indeed, I’m very proud of having the privilege to receive my education in the faculty.”

The conferment ceremony was also graced by the presence of Professor Emeritus Dato’ Dr Mohamad Abd Razak, the Chairman of the UKM Board of Directors.

He delivered a talk entitled ‘Reformasi Sistem Kesihatan yang Kalis Masa Hadapan’ (Reformation of a Future-Proof Healthcare System), which touches on relevant health issues that affect the way in which societies in this country would confront the challenges of the future.

Professor Emeritus Dato’ Dr Mohamad Abd Razak also shared his experiences as a student in the faculty around 1983 to 1989. “There are far more advances in technology and methodology today to provide optimal benefits to students,” he said.

Additionally, Dr. Zaliha took the opportunity to officiate the Space for Distinguished Alumni at the Faculty of Medicine of UKM.

A SPACE TO CELEBRATE THE LEGACY OF UKM’S DISTINGUISHED ALUMNI

The Space for Distinguished Alumni is set up by UKM to honour the accomplishments of the Distinguished Alumni of UKM.

A multimedia display is set up in this space to commemorate these accomplishments with visitors.

Aside from Dr Zaliha, the other Distinguished Alumni are Tan Sri Dato’ Seri Dr Noor Hisham Abdullah (2020), Datuk Dr Rohaizat Yon (2021), and Professor Emeritus Dato’ Dr. Lokman Saim (2022).

First Large-Scale Diabetes Cohort Study Launched in Malaysia

WORDS LIM TECK CHOON

On 10 July 2023, the Seremban Diabetes (SeDia) Cohort Study, was officially launched by Duli Yang Maha Mulia Yang Di Pertuan Besar Negeri Sembilan, Tuanku Muhriz ibni Almarhum Tuanku Munawir in Seremban.

PURPOSE OF THE SeDia COHORT STUDY

This study was launched to holistically explore all the factors involved in the development of diabetes as well as the complications experienced by people with diabetes in this country.

THE HISTORY OF THE STUDY

The genesis of the SeDia Cohort Story began on 17 May 2022 when the Ministry of Health Malaysia and the International Medical University signed a memorandum of understanding for the establishment of this study.

The research protocol of the study received the approval of the Medical Research and Ethics Committee (MREC) on 17 March 2023.

OVER 12,000 PARTICIPANTS SIGNED UP TO AID INVESTIGATION

This SeDia Cohort Study will cover a period of 12 years.

The first important step now is to obtain data that is socio-culturally relevant to the local community. So far, over 5,000 patients and over 7,000 of their family members have voluntarily registered as part of the Diabetes Registry of Klinik Kesihatan Seremban.

The investigators will use digital systems and data infrastructure to collect these participants’ personal and medical information.

Blood samples will also be obtained from these participants for genetic profiling, to study individual predisposition to diabetes and, for people with diabetes, their predisposition to complications and response to medications as well as physical and dietary interventions.

These participants will be followed regularly, with the process of data collection conducted every 3 years over the next 12 years.

Additionally, details of the participants’ life events, such as hospital admission and deaths, will be collected and updated every year.

STUDY HOPES TO IMPROVE DIABETES PREVENTION & MANAGEMENT IN MALAYSIA

Using the data obtained from these participants, the investigators will study and analyze the complex web of factors that contribute to the development of diabetes and its complications.

These factors include genetics and family history of diabetes to lifestyle and environmental factors, dietary regimes, physical activity, socio-economic levels, and healthcare delivery.

The investigators believe that the understanding of these complex factors and the connection between them would enable us to uncover optimal strategies for diabetes prevention and treatment.

Such strategies would enable implementation of evidence-based policies and programmes to address the escalating burden of diabetes in Malaysia.

ACCESS WILL BE GRANTED TO LOCAL & INTERNATIONAL RESEARCHERS

To establish the SeDia Cohort as a study of national significance, local and international researchers will be granted access to SeDia Cohort to conduct further analysis and studies, subject to approval of the MREC.

FUNDING INFORMATION

The SeDia Cohort study will be funded through public funds, which includes contributions from corporations and individuals.

Top Dengue-Related Highlights from the Dengue Prevention Advocacy Malaysia Launch

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ABOUT THE DENGUE PREVENTION ADVOCACY MALAYSIA (DPAM) GROUP
  • DPAM is an independent advocacy group co-jointly led by the Malaysian Paediatric Association (MPA), the Malaysian Society of Infection Control and Infectious Disease (MyICID), the Malaysian Society of Infectious Diseases and Chemotherapy (MSIDC), and the Malaysian Public Health Physicians Association (PPPKAM).
  • DPAM collaborates with the Malaysian Society of Parasitology and Tropical Medicine (MSPTM), the Malaysian Medical Association (MMA), Asia-Pacific Academic Consortium for Public Health Kuala Lumpur (APACPH-KL) and Rotary International District 3300.
  • DPAM is established to support the efforts of the Ministry of Health in strengthening dengue prevention, management, and control in Malaysia.
WHY DPAM IS NECESSARY: A POTENTIAL EMERGING DENGUE EMERGENCY
FEATURED EXPERT
DR HUSNINA IBRAHIM
Deputy Director of Disease Control Division (Communicable Diseases)
Ministry of Health Malaysia
  • Malaysia had its worst dengue outbreak in 2019, over 130,000 cases and 182 deaths.
  • The numbers declined during the MCO a few years ago. During this new normal, however, dengue numbers are once again on the rise.
  • From January to epidemiology week-22 this year, there has been a 158% rise in dengue cases and 183% increase in the deaths compared with the same period last year.

Dr Husnina Ibrahim, the Deputy Director of Disease Control Division (Communicable Diseases), said: “As Malaysia typically experiences a surge in dengue cases every 4 to 5 years, it was projected that an outbreak is due around this or next year, with an estimated number of cases potentially surpassing the historic 2019 outbreak.”

RECENT ADVANCES YIELD POSITIVE RESULTS IN THE PREVENTION & CONTROL OF DENGUE
Wolbachia-infected mosquitoes
  • The introduction of Wolbachia-infected mosquitoes has significantly reduced dengue cases in 16 out of 19 localities, by 33% to 100%.
  • Wolbachia is a type of bacteria that can infect many species of invertebrates—organism with no backbone—including mosquitoes such as Aedes aegypti, the mosquito that carries and spreads the dengue viruses.
  • Male Aedes aegypti infected with Wolbachia will mate with female mosquitoes, but the resulting eggs will not hatch.
  • This reduces the number of Aedes aegypti mosquitoes.
Implementation of comprehensive guidelines, proper training, and a critical review of dengue mortality

These efforts have reduced the case-fatality rate by 87.3% from 2000 to 2022.

SETTING TARGETS FOR FUTURE DENGUE PREVENTION & CONTROL EFFORTS
  • The Ministry of Health has in place the National Dengue Prevention and Control Strategic Plan 2022-2026, which aims to annually reduce the number of dengue cases by 5% while maintaining the proportion of deaths compared to the number of cases (case fatality rate or CFR) below 0.2%.
  • The Ministry aims to reduce the CFR to 0% by 2030—which is to say, there should be no deaths due to dengue by that year.
DPAM TO PLAY AN ACTIVE ROLE IN SUPPORTING THE EFFORTS OF THE MINISTRY OF HEALTH TO ACHIEVE THESE TARGETS
FEATURED EXPERT
PROFESSOR DATUK DR ZULKIFLI ISMAIL
Consultant Paediatrician and Paediatric Cardiologist
Chairman of the Dengue Prevention Advocacy Malaysia (DPAM)

Professor Datuk Dr. Zulkifli Ismail expresses his optimism that the Ministry of Health’s aforementioned targets are achievable with the active involvement of key stakeholders such as the government, civil society, academia, private sector, media, and the community.

DPAM aims to synergize efforts by various of these stakeholders in assisting the Ministry of Health to achieve its national and global dengue targets through the strengthening of dengue prevention, management, and control in Malaysia.

He said, “DPAM will focus its efforts on healthcare professional and public education and communication, local research, guideline recommendations, as well as policy recommendations.”

To foster and strengthen regional collaborations, DPAM will work closely with the Asian Dengue Voice & Action (ADVA), a regional advocacy group. Their first collaborative initiative is the hosting of the 7th Asia Dengue Summit in Malaysia next year.

DPAM also released a Resolution Paper that contained key strategies for all relevant stakeholders to create a “whole of society” approach.

Medical Professionals Galvanize to Tackle Obesity Pandemic in Malaysia with Release of Revised Clinical Practice Guidelines

WORDS LIM TECK CHOON

We’ve all read about it and probably memorized the statistics by now: Malaysia is among the heaviest countries in Asia, if not the world. Perhaps unsurprisingly, there is also a high prevalence of chronic diseases such as type 2 diabetes, high blood pressure, and others that are linked to obesity.

AN URGENT IMPETUS TO CURB THE OBESITY PANDEMIC IN MALAYSIA

Obesity is classified as a chronic or long-term disease. As such, Malaysian healthcare professionals have banded together in their commitment to provide Malaysians with the best treatment options and accessibility to these treatments.

A milestone in this commitment took place on 9 June 2023, with the release of the 2nd edition of the Clinical Practice Guidelines for the Management of Obesity.

The clinical practice guidelines are jointly published by the Ministry of Health Malaysia, the Malaysian Endocrine & Metabolic Society (MEMS), the Malaysian Society for the Study of Obesity (MASO), the Malaysian Dietitians’ Association (MDA), and Family Medicine Specialists Association of Malaysia (FMSA)—a multidisciplinary collaboration comprising endocrinologists, dietitians, and more.

The launch of the clinical practice guidelines was officiated by Dr Mohd Ridzwan Shahari, the Deputy Director of Medical Development Branch of the Medical Development Division, representing Dato’ Dr Asmayani Khalib, Deputy Director-General of Health (Medical) of the Ministry of Health Malaysia.

AN UPDATED BLUEPRINT OF NEW & ROBUST STRATEGIES TO PREVENT & MANAGE OBESITY

The initial edition of the clinical practice guidelines was released in 2004. With almost 20 years since then, much had changed when it comes to prevalence of, attitude towards, and management approaches for obesity.

As Dr Nurain Mohd Noor the President of MEMS, puts it: “Overweight and obesity in Malaysia is growing with every passing year. Based on the National Health and Morbidity Survey, in 2011, the prevalence was already at 44.5%, and in 2019, it has risen to a staggering 50.1%, whereby half of the population is now classified as overweight or obese.”

As such, the revision of the existing clinical practice guidelines is most timely and necessary. Professor Dr Norlaila Mustafa, Chairperson of the CPG Development Committee, reveals that the committee attracted experts from diverse field—endocrinology, psychology, dietetics, sports medicine, family medicine, paediatric endocrinology—to revise the existing guidelines to incorporate breakthroughs and advances that offer promising solutions in the last 20 years.

Some of the revisions and expansions include:

  • Expanding the range of recommended medications and medical procedures to treat obesity.
  • Updates on medical nutrition therapy to introduce successful and effective changes to a patient’s diet.
  • Emphasis on psychological interventions, such as cognitive behavioural therapy, to motivate patients into adopting and maintaining lifestyle changes to maintain a healthy weight.

With regards to the third point, Prof Dr Norlaila brings up tools include the Binge Eating Scale, which helps to identify individuals with binge eating disorder, ‘SMART’ strategy that aids in a patient’s goal setting, and problem-solving techniques such as ‘IDEAL’ to support patients when faced with setbacks in their weight management journey.

A NEW BASIS FOR BODY MASS INDEX

A key issue raised during the launch was the need for a lower cut-off point for diagnosis of overweight and obesity among Asians.

This is because the current body mass index or BMI system was initially based on the physiology and fat composition of Caucasians.

Asians, on the other hand, typically have shorter height and higher body fat percentages. Research has shown that the risk of type 2 diabetes, high blood pressure, and other weight-associated chronic diseases tend to rise for Asians at a lower BMI point.

Hence, based on evidence gathered from research on Asians, the following BMI categories are recommended for use in Malaysia:

BMI CATEGORY
23 to 27.4 kg/m2 Overweight
27.5 kg/m2 and above Obese
A FOUNDATION FOR A ROLLOUT OF IMPROVED PREVENTION & MANAGEMENT OF OBESITY PROGRAMME IN MALAYSIA

Prof Dr Norlaila shares her hopes that the release of the revised Clinical Practice Guidelines for the Management of Obesity will become a primary cornerstone for treatment and prevention, as well as health awareness programmes in Malaysia.

She reveals that future plans include making weight management and obesity treatment services available in more primary healthcare points such as general practitioners, educational talks and programmes in schools, and more.

Interested healthcare professionals can download a digital copy of the Clinical Practice Guidelines for the Management of Obesity (2nd Edition) at the Academy of Medicine of Malaysia here (link opens in a new tab).

Great News! Now More Children Are Eligible for Free Pneumococcal Vaccination!

WORDS LIM TECK CHOON

In conjunction with World Immunization Week from 24 to 30 April, the Ministry of Health held a National Immunisation Day 2023 on 31 May 2023.

The event was a collaboration between various divisions in the Ministry of Health’s Public Health Programme and Immunise4Life (link opens in a new tab).

THE BIG CATCH-UP

The theme of National Immunisation Day this year is ‘Tingkatkan liputan, kurangkan keciciran’ or ‘The Big Catch-up’.

Dr Zaliha Mustafa, our Minister of Health, revealed that this theme is in line with the expansion of Malaysia’s free pneumococcal vaccination programme to those born between 2018 and 2019. This expansion will commence from June 1.

Pneumococcal vaccine was included in the National Immunisation Programme (link opens in new tab) to initially cover children born from January 1 in 2020.

With this expansion, our Ministry of Health hopes to target 70% or 700,000 of the 1 million children aged 4 to 5 under the two-year programme.

“The nationwide pneumococcal vaccination programme will start on June 1 until May 31 next year and it will involve the ministry’s primary healthcare facilities,” she explained.

Interested parents can set an appointment for their children’s vaccination using the MySejahtera app.

WHY KIDS SHOULD GET THE PNEUMOCOCCAL VACCINE

Pneumococcal disease, an infection caused by bacteria called Streptococcus pneumoniae is contagious and may cause severe illness, so early diagnosis and treatment is important.

Children 2 years old or younger are vulnerable to such infection.

Hence, these children are also at risk of developing serious, potentially life-threatening complications such as:

  • Pneumonia, which is the infection and inflammation of the air sacs in our lungs
  • Ear infections
  • Meningitis, which is the inflammation of a membrane called meninges in the spinal cord and brain
  • Bacteraemia, or infection of the bloodstream
Pneumococcal pneumonia is a lung infection caused by the bacteria responsible for pneumococcal disease. Click on the image for a larger, clearer version.

Once the bacteria infect the bloodstream, they can find their way to parts of the body that are normally sterile, such as the peritoneum—that’s the membrane lining our abdominal cavity—as well as our joints and heart. This can lead to many more invasive diseases, such as peritonitis, arthritis, and endocarditis (inflammation of the inner layer of the heart) respectively.

Hence, parents with children that are eligible for the free vaccination should consider taking advantage of the expansion of Malaysia’s free pneumococcal vaccine programme. They can consult a doctor should they have any doubts and concerns about the vaccine.