Superbugs: Huge increase in deaths

Deaths caused by a superbug which usually affects long-term care patients using invasive devices has increased significantly within four years.

Statistics from the Health Ministry showed that deaths from carbapenem-resistant enterobacteriaceae (CRE) cases went up from 15 in 2013 to 150 last year.

The Ministry’s infectious disease national head Datuk Dr Christopher Lee said CRE infections usually happened to patients in hospitals and nursing homes who require the use of devices such as ventilators, urinary catheters, or intravenous catheters which exposed them to recurring infections. This results in the use of certain long-course antibiotics which then cause the bacteria to evolve and become resistant, he said.

“Infections with these germs are very difficult to treat, and can be deadly. One report cites they can contribute to death in up to 50% of infected patients” he said.

Centre for Disease Control and Prevention says carbapenems are a class of highly effective antibiotic agents used to treat severe or high-risk bacterial infections, but CRE is a family of germs that is resistant to antibiotics.

Health director-general Datuk Dr Noor Hisham Abdullah said CRE deaths were monitored since 2013.

The overall death rate of the CRE patients increased from 10% (15 out of 150) in 2013 to 18.3% (150 out of 818) in 2017, he said.

“Anti-microbial resistance (AMR) is becoming an increasingly urgent challenge for Malaysia,” he said when contacted.

Deputy Health Minister Dr Lee Boon Chye recently announced that the World Health Organisation and Malaysia jointly launched a five-year National Strategic Action Plan to contain AMR.

Dr Noor Hisham said that in 2017, surveillance of six multidrug (MDR) organisms showed that for every 10,000 admissions, eight patients get infected by them.

An increase in antibiotic resistance is also seen in a common foodborne pathogen Salmonella sp, with resistance rates of 21.6% against ampicillin last year compared to 18.6% in 2013.

“This is a worrying situation,” said Dr Noor Hisham.

He said doctors should always adhere to guidelines and educate patients regarding their illness and antibiotics treatment.

Pharmacists, he said, must also ensure that these patients have a valid prescription.

Patients should also ask for information about their antibiotics and take them as directed, he said.

/theSTAR 18-11-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Daily reported: Nine new HIV cases, two AIDS deaths

Every day, an average of nine new HIV cases and two AIDS-related deaths were reported in Malaysia..

Deputy Health Minister Dr Lee Boon Chye said the Ministry of Health received 3,347 new HIV cases and registered 892 AIDS-related deaths in 2017.

There is a total of 72,339 HIV- positive patients as of 2017 but only 54% of them were receiving antiretroviral (ARV) treatment, he said. “This treatment can increase their lifespan and prevent full-blown AIDS,” he said when officiating World AIDS Day 2018 here.

He said with ARV, HIV patients could live up to 58 years or more.

“Misconception about HIV is one of the main reasons patients are reluctant to take ARV. “As some HIV-positive patients are symptom-free, they think they do not need the treatment until they develop AIDS,” he said, adding that the government provided the treatment for free at clinics.

Dr Lee also said ARV could help reduce HIV by up to 97%. “We hope to have at least 95% of HIV-positive patients undergo the treatment by 2030,” he said.

He urged the public to take HIV screening, which is available for free at government clinics. “Early HIV detection will reduce the chances of developing AIDS and further spreading the virus to loved ones,” he said, adding that those taking the test could also choose to remain anonymous.

/theSTAR 03-12-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Healthcare budget 2019

The Health Ministry is “happy” and “thankful” to the Prime Minister and Finance Minister for increasing the allocation to his ministry by 7.8%.

“This is very encouraging for all the people in Health Ministry,” he told reporters after Budget 2019 was unveiled in Parliament on Friday (Nov 2).

Finance Minister Lim Guan Eng, who had earlier tabled Budget 2019, said the allocation for health services would be increased to RM29 bil from last year's allocation of RM27 bil.

This allocation includes RM10.8bil to restore clinics and hospitals, as well as for the purchase of medicine and medical equipment.

On the Protection Health Scheme (Peka) for individuals in the B40 group, Dr Dzulkefly said it is expected to benefit 800,000 people. “The scheme for this B40 group starts with RM100mil.

“At the very least we have started with these individuals, which is as many 800,000 people,” he said.

The Peka scheme will involve a pilot health screening project for B40s aged 50 and above.

When asked about the enforcement of no-smoking zones in restaurants and eateries, Dr Dzulkefly said he was not worried about it. “It is not a problem, we will do it, we have enforcement (powers),” he said, adding that he has a “good number” of enforcement officials from his ministry for the matter.

theSTAR 03-11-2018

 

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Malaysia to become ageing population by 2020

GETTING more women to work is one of the key remedies to mitigate the negative impact of an ageing population, according to the Economic Outlook 2019.

It said a rethinking of retirement norms beyond the legal retirement age of 60 is necessary.

Malaysia is at risk of becoming an “ageing population” when 7% of the total population is aged 65 and above, based on the definition set by the World Health Organisation.

As of 2017, the number of people aged 65 and above in Malaysia was about two million or 6.3% of the total population.

In a nutshell, the ageing population would put pressure on economic growth as it would impact productivity, labour participation and saving rates.

It is noteworthy that currently, Malaysia has among the lowest female labour participation rates in Asean, China, Japan and South Korea.

According to a study by Moody’s across the Asia-Pacific emerging markets, closing the gap between the female and male labour force participation by 50% could offset up to 1.7 percentage points of a slowdown in the labour force.

In the case of Malaysia, in 2017, the female and male labour participation rates stood at 54.5% and 80.1%, respectively.

If the gap is reduced by 50%, then it would increase the labour force by an additional 1.3 million to 16.3 million.

The report highlighted that another impact of the ageing population is increasing public expenditure.

The higher life expectancy of the population, particularly pensioners and their dependents, tends to increase pension payments.

Therefore, the current pension scheme may not be sustainable in the long run as it will pose a large financial burden on the government’s fiscal position.

As such, the government should seek ways to reform its pension systems in anticipation of fiscal burdens in the future.

Currently, the civil service pension scheme is adopting the unfunded arrangement of pay-as-you-go, where it is disbursed directly from the government budget.

Therefore, to ensure a sustainable fiscal position in the long run, the civil service pension scheme could be improved and modernised by introducing the defined-contribution scheme for new recruitments in the civil service.

/theSTAR 03-11-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Cancer: More needs to be done

At the  the World Cancer Congress 2018, Kuala Lumpur.

Cancer is the fourth most common cause of death in Malaysia with approximately 37,000 cases reported every year. This is estimated to rise to more than 55,000 newly-diagnosed cases by 2030.

Cancer is responsible for 12.6% of all deaths in government hospitals and 26.7% in private hospitals.

The data and findings from the Health Ministry’s Malaysian Study on Cancer Survival (MySCan), which was released at the conference, make for grim reading.

The first population-based cancer survival report in the country aimed to help guide the development of cancer control strategies, it describes poor survival rates of patients who presented late for treatment, specifically at Stage 3 and 4.

Despite existing screening facilities and programmes, those with breast, cervical and colorectal cancers were coming forward late at 41.3%, 38.5% and 63.8% respectively.

Within the period of the report, around 43% of women diagnosed with breast cancer died; for individuals with cervical cancer, it was 56% and 52% for those with ovarian cancer. Nine out of 10 lung cancer patients did not make it.

Gastrointestinal cancers have an average survival rate of less than 40%. Those of the nasopharynx, which badminton ace Datuk Lee Chong Wei is currently battling, also had a similar number.

With such data, it is not surprising that Malaysia has one of the highest mortality to incidence ratio for breast cancer in South-East Asia.

Besides late presentation of disease, insufficient facilities and specialists (particularly outside urban areas), lack of access to innovative surgical, radiotherapeutic and oncological treatments contributed towards this sad state of affairs.

Compounding these factors are complications caused by financial catastrophe and the lack of allied health professional networks.

It is in this spirit that during the pre-Congress event, “Advancing an agenda of hope and action on cancer in Malaysia”, jointly organised by Galen Centre for Health & Social Policy and the National Cancer Society Malaysia, a series of concrete, short-term and long-term policy recommendations for members of parliament and policy makers was launched.

Developed by Malaysian cancer patients, these recommendations are intended to make policymakers take heed and seriously respond to specific challenges which affect cancer treatment and care in the country.
Five short-term recommendations, which can be achieved with minimal effort, were highlighted as low-hanging fruit for the new government to implement in order to demonstrate its ability to deliver on the promises of increasing the quality and depth of existing healthcare services.

These include removal of dual referral charges at public hospitals, standardisation of treatment fees across public healthcare, improving the quality and availability of national cancer data, and providing support to lower-income patients through integration of cancer screening and diagnosis as part of the Skim Peduli Sihat initiative.

There were eight long-term recommendations which require greater institutional reforms to policies, strategies and services on cancer care.

These included ensuring stronger and improved government accountability of the national cancer strategy, establishing multi-sectoral consultative and partnership mechanisms, adopting sustainable healthcare financing strategies, reforming the Social Security Organi­sation (Socso) legislation and regulations relating to cancer, improving public drug procurement policies to respond better to advances in cancer treatment, and establishment of cancer survivorship services as part of care.

To help realise these recommendations, The Cancer Care Working Group was launched as a new cancer advocacy initiative comprising patients, cancer specialists, health professionals and cancer advocates. They currently work in a number of related areas including health service delivery, research, prevention, information and support, care and treatment, and patient involvement.

The Cancer Care Working Group aims to help influence public policies to improve outcomes, treatment and care of cancer in Malaysia.

It will work towards enhancing and adding value to the government’s implementation of the National Strategic Plan for Cancer Control Programme (2016 – 2020), and campaign for action, improvements and change in cancer policy.

Most importantly, it aims to promote the voices of patients and their empowerment and meaningful participation in public policy consultations and discussions. Patients must continue to be at the centre of policy-making which directly affects them.

Perhaps with the strength of their voices, the current situation can change for the better so that more people with cancer can move from always hoping to living.

/theSTAR 05-10-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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Pharmacist's Role: More than Dispensing

THE role of pharmacists is beyond procurement and supply of medicine, says Deputy Health Minister Dr Lee Boon Chye.

Dr Lee said pharmacists are now involved in the production of medicine in the pharmaceutical industry in the country, as well as in the logistics and distribution of local and imported medicinal products.

He said dispensing of medicine is also evolving, and thus dispensing of drugs in government facilities, private hospitals and community pharmacies are carried out by a pharmacist together with drug treatment services, medical safety screening and monitoring of adverse effects of drugs.

“Pharmacists are also involved in clinical activities such as the management of infectious and non-infectious disease drugs.

“They help monitor drug therapy for HIV and tuberculosis patients, the use of antibiotics and monitor drugs prescribed for diabetes, hypertension, heart disease, stroke, rheumatoid arthritis, haematology and asthma.

“Pharmacists are also involved in smoking cessation and weight loss programmes,” Dr Lee said in his speech before launching the Perak state-level World Pharmacists Day 2018 at Ipoh Parade.

The history of pharmacy services in the country, he said, started in 1951 with 20 registered pharmacists, adding that in 1957 there were only 23 registered pharmacists in the public sector.

Dr Lee however said with the rapid development in the profession, the number of registered pharmacists increased yearly. “Until March this year, there are 16,210 registered pharmacists, and out of this, 7,577 work under several divisions of the Health Ministry,” he added.

State Health deputy director (pharmacy division) Leong Weng Choy, who is also Perak Malaysian Pharmaceutical Society chairman, said pharmacists play an important role in determining the success of medication treatment received as an effort to improve a patient’s quality of life.

He said a pharmacist is involved in every aspect of managing the medication, right from the drug formulation until the dispensing of the medication to patients.

As part of the healthcare team, he said pharmacists are required to be in the forefront of all issues involving medicine, health and safety of patients.

Leong said the ultimate goal of pharmacists is to ensure optimum and rational drug therapy.

“This is done through the involvement of pharmacists in the processes associated with the use of such drugs, like providing, distributing, controlling information to those who prescribe, like doctors, and to the end users."

“The responsibility of a pharmacist is becoming increasingly important with the development of new drugs by research scientists and the current challenges faced in relation to medication,” he added.

Leong said every year, thousands of drugs are prescribed to patients and almost all of the dosage are checked first by a pharmacist whether in a hospital, health clinic or community pharmacies.

He said in a mission to empower users and to increase trust among patients, users and pharmacists, several initiatives were taken by the government and the private sector.

Among the initiatives are “Recognise Your Medication” by the Health Ministry which focuses on enhancing awareness of the use of drugs rationally.

Besides that, Leong said the society has also produced posters, videos and pamphlets on the prescription rights, which could be used by pharmacists as a guide in educating patients.

/theSTAR  09-10-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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1% Malaysians signed up as organ donors

The number of Malaysians who have registered to become organ donors is still low, with only less than 1% having made the pledge out of 32 million Malaysians.

National Transplant Resource Centre organ and tissues procurement coordinator head Dr Omar Sulaiman said currently, a total of 25,000 kidney patients throughout the country were still waiting for compatible donors.

“Only an average of 40 patients are able to replace their damaged kidney in a year; the figure is small because we record about 1,000 kidney patients a year in Malaysia,” he added.

Dr Omar said this during the Organ Donors Week 2018 launch at Sultanah Aminah Hospital (HSA) here.

He pointed out that besides kidney patients, a total of 18 critical liver patients and six heart patients were also waiting for the right donors.

Dr Omar added that his side was doubling their effort to get more people to become donors through their “Let’s Talk” campaign.

“Many are still unaware that despite having already registered to become a donor, it does not necessarily mean that this person will have his or her organ donated when a death happens. This is because the hospital will still need to get approval from their family members or next of kin, and check on the condition of the organ before starting the process,” he added.

Dr Omar advised those who have already made the pledge to donate their organs to inform their family first to ensure their loved ones were not shocked at their decision and able to carry out their intention.

/theSTAR 11-10-2018

Disclaimer: Views or opinions expressed are solely those of the Author and should be used with discretion. The Author shall not be held liable for any acts or omissions arising from the use of the information. The user will be personally liable for any damages or other liability arising hereof.

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