Table 1. Summary table of studies included in the present systematic review.
Title of the article (year Study objective(s) Study methodology Health status measured Health status reported Quality of publication) assessment Epidemiology of To determine the Retrospective cross‐sectional study design with Incidence of malaria infection at The incidence of malaria was found to be 2.6/1000 people/year, and 77% Plasmodium knowlesi epidemiological burden of quantitative method Kudat Plasmodium knowlesi was observed in 1.4/1000 people/year malaria in north‐east Plasmodium knowlesi at Study was conducted at Kudat Distribution of cases according to The most common malaria species at Kudat was Plasmodium Sabah, Malaysia: Family Kudat, Sabah Data were collected in all positive malaria cases age and family cluster knowlesi clusters and wide age To determine the at Kudat Hospital from January 2009 to This study found that malaria affects all ages from young children distribution association between November 2011 (n = 653) to the elderly and men and women similarly (2012) malaria cases and rainfall events at Kudat
Individual‐level factors To evaluate the potential Case‐control study design with quantitative Risk factors such as demographic, Age 15 years or older, male sex, working a at plantation site, 95% associated with the risk exposure risk associated method behavioural, and socioeconomic history of outdoor activities, being aware of the presence of of acquiring with Plasmodium knowlesi Study was conducted at Kudat and Kota factors, housing condition, red monkeys in the area, and having open eaves or gaps in walls were human Plasmodium malaria Marudu blood cell polymorphism, independently associated with increased risk of symptomatic knowlesi malaria in Data were collected from December 2012 to serological and immunological Plasmodium knowlesi infection Malaysia: A case‐control December 2014 blood markers were compared Known case of glucose‐6‐phosphate dehydrogenase deficiency, study (2017) ‘Case’: a patient with positive malaria infection between the case and control farming as an occupation, and having long grasses around the who was febrile and lived in the study area for patients. house were significantly associated with Plasmodium knowlesi the past 3 weeks during the data collection infection but not with other Plasmodium species infections period (n = 320) ‘Control’: individual who lived in the study area for the past 3 weeks and did not have fever during the data collection period (n = 953)
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Title of the article (year Study objective(s) Study methodology Health status measured Health status reported Quality of publication) assessment Changing epidemiology To describe the changes in Retrospective cross‐sectional study design with Malaria infection notification rate Notifications rate of Plasmodium malariae/Plasmodium knowlesi 82% of malaria in Sabah, epidemiology of malaria in quantitative method and species of Plasmodium reported increased from 703 in 2011 to 815 in 2012 and 996 in 2013 Malaysia: Increasing Sabah from one species to Study reported data for Kudat, Keningau, Association between age and sex Majority of malaria notifications was caused by Plasmodium incidence of Plasmodium another species of Ranau, Tawau, Sandakan, and Kota Kinabalu with malaria infection malariae/Plasmodium knowlesi accounting for 62% of all malaria knowlesi (2014) Plasmodium Malaria notification data were collected from notifications in 2013 To determine whether the 2007 to 2013 Plasmodium polymerase chain reaction testing among samples
increasing incidence of Demographic and epidemiological information diagnosed with Plasmodium malariae/Plasmodium knowlesi infection Plasmodium knowlesi of infected individuals were also collected from showed that 85% of the cases were Plasmodium knowlesi represents microscopic the surveillance monoinfection. This demonstrates that the increase in notifications misdiagnosis or increased Rainfall data were obtained from January 2009 is likely to represent a true increase in the incidence of Plasmodium recognition of Plasmodium to 2012 for Kudat, Keningau, Ranau, Tawau, knowlesi rather than the microscopic misdiagnosis of Plasmodium knowlesi Sandakan, and Kota Kinabalu species To describe the age and sex distribution of malaria infection
To determine the association between malaria notification and rainfall events Association between To assess the potential Retrospective cross‐sectional study design with Incidence of Plasmodium knowlesi The range of the estimated annual parasitic incidence expressed as 86% landscape factors and associations between quantitative method infection cases/1000 person/y) for Plasmodium knowlesi malaria was spatial patterns of Plasmodium knowlesi Study was conducted at Kudat and Kota Association between the approximately 102 Plasmodium knowlesi incidence and Marudu environmental factors and infections in Sabah, environmental variables Data were collected for all positive malaria cases Plasmodium knowlesi incidence Malaysia (2016) derived from satellite‐based from 2008 to 2012 (n = 739) remote‐sensing data Data for environmental variables were collected from various datasets derived from satellite‐based remote‐sensing data Plasmodium knowlesi To describe the Retrospective case‐series study design with Demographic characteristic of The incidence of Plasmodium knowlesi malaria was higher in men 86% malaria in children demographic, clinical, and quantitative method children with Plasmodium knowlesi than in women (2011) laboratory features of Study was conducted at Kudat district hospital malaria Overall mean age of the children: 8.9 years Plasmodium knowlesi Data were collected for all children (paediatric Clinical features of Plasmodium Children infected with Plasmodium falciparum malaria were infection in children in cases) admitted with positive malaria cases from knowlesi and Plasmodium falciparum significantly younger than children infected with Plasmodium Kudat, Sabah January to November 2009 (n = 41) malaria knowlesi infection Laboratory features of Plasmodium Clinically, the duration of fever was shorter with Plasmodium knowlesi—anaemia, knowlesi malaria than with Plasmodium falciparum; however, it was thrombocytopaenia not statistically significant Response to treatment
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Title of the article (year Study objective(s) Study methodology Health status measured Health status reported Quality of publication) assessment Pulmonary tuberculosis To describe the Cross‐sectional study design with quantitative Demographic characteristics of TB Demographic characteristics: 59% of the patients were men with 91% in outpatients in Sabah, epidemiological method patients median age of 30 years. A total of 67% were Malaysians, and 33% Malaysia: advanced characteristics of patients Study was conducted at Luyang TB clinic in Patients’ clinical characteristics and were foreigners or stateless. disease but low with tuberculosis (TB) Kota Kinabalu comorbidities Clinical characteristics and comorbidities among the patients: incidence of HIV To determine the Data were collected for all smear‐positive diabetes mellitus (6.8%), hypertension, (5.1%), HIV infection co‐infection (2015) prevalence of human pulmonary TB patients who were 15 years old (1.7%), smokers (22.7%), ex‐smoker (28%), and past TB (7.4%). immunodeficiency virus and above from July 2012 to July 2014 (n=176) Radiological severity: cavitary disease (65%) (HIV) co‐infection Smear grade: scanty (17.0%), 1+ (28.9%), 2+ (25.2%), and 3+ (28.9%) To assess the sensitivity Haemoptysis (46.0%) and specificity of the locally available point‐of‐care HIV test kits Understanding To assess the knowledge Qualitative study design through in‐depth Knowledge and perceptions of TB A total of 96% of the respondents (TB patients) did not know the 95% tuberculosis: and perceptions of TB interviews disease actual cause of TB. They believed it was due to stress, perspectives and patients and the Study was conducted in seven districts (Kota Health‐seeking behaviours of the contaminated food, exposure to rain, sharing utensils with other experiences of the community about TB Kinabalu, Penampang, Putatan, Tuaran, Kota patients infected patients, and hereditary or genetic people of Sabah, East To assess the experiences of Marudu, Kudat, and Keningau) A total of 98% of the patients believed that TB is not an infectious Malaysia (2010) healthcare services Interviews were conducted on TB patients, disease To examine the impact of other non‐patient respondents (who were either A total of 74% of the patients reported that they only sought TB on patients and families spouses, relatives, or other people in the same treatment due to worsening of symptoms such as following village as the patients), and healthcare haemoptysis or shortness of breath personnel in the districts (n=58) Majority of the patient often felt weak and never fully recovered to their pre‐illness physical state Following the diagnosis of TB, patients changed their life practices—not sharing their utensils, had a separate sleeping area, and practised social distancing TB causes significant burden to the patient due to stigmatisation A total of 91% of patients reported that the healthcare services provided for TB were good Majority of healthcare workers were unaware that the knowledge regarding TB was insufficient, and they did not know the effects of TB on their patients. This was mainly due to limited discussion between the health staff and the patients on the impact of TB
An outbreak of To describe the case series Case report study with quantitative method Number of cases reported and the Patients with tetrodotoxin poisoning presented with several 100% tetrodotoxin poisoning of tetrodotoxin poisoning in Study was conducted at Kota Marudu Hospital socio‐demographic and clinical manifestations such as dizziness (80%), circumoral and lingual from consuming order to determine the risk Data were collected for all positive and possible characteristics of the patient numbness (80%), hand and feet numbness (63.3%), nausea and horseshoe crabs in factors to prevent further cases from June to August 2011 (n = 30) vomiting (30%), and weakness and difficulty in breathing (26.6%) Sabah (2017) outbreaks Three patients (10%) died, while 27 patients recovered. Forty‐seven per cent of the patients had onset of symptoms within 30 minutes of ingestion of horseshoe crabs
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Title of the article (year Study objective(s) Study methodology Health status measured Health status reported Quality of publication) assessment Case report: Paralytic To understand paralytic Case report study with quantitative method Socio‐demographic and clinical Of the 58 patients (24 men and 34 women), only 24 were 100% shellfish poisoning in shellfish poisoning (PSP) Study area included all cases from coastal areas characteristics of the patients were Malaysians. The others were from neighbouring countries Sabah (2017) outbreak cases in Sabah such as squatter area in Taman Jaya Diri, recorded The overall mean age of all cases was 30.7 years and making future Sepanggar, Kota Kinabalu and Tuaran, Numbak Information on their ethnicity, age, Among the victims, five were less than 10 years old (the youngest informed decisions to village, Sepangar and Rancangan Mawao sex, occupation, residence, shellfish was 8 years old), while the six patients were greater than 50 years prevent it village, Membakut consumed, old (the oldest was 67 years old). The highest percentage was Data were collected from respective hospitals symptoms, and onset of the recorded for 11–20‐year age group that reported positive cases of PSP. The symptoms were recorded Of the positive 58 patients, 44 were admitted to the hospitals, and hospitals included were Queen Elizabeth four of the patient died due to PSP Hospital in Kota Kinabalu, Tuaran Hospital, The remaining 14 patients received outpatient treatment due to and Beaufort Hospital dizziness and vomiting Data were collected for 6 months from January The most common symptoms shown by the patients were to June 2013 (n = 58) circumoral, lingual, and neck numbness (83%), whereas breathing difficulty and faintness were presented by few patients. Approximately 35% of the patients also experienced nausea, and 9% of the patients fainted
Iodine status among To evaluate the iodine Cross‐sectional study design with quantitative Data on the date of birth, ethnicity, Of all the included patients, five of them (1%) had an enlarged 90% pregnant women in status of pregnant women method nationality, gestational week, thyroid, indicating iodine deficiency disorder; four had grade 1 rural Sabah, Malaysia living in several selected Study was conducted at three rural divisions of gravida, weight, and height were goitre, and one had grade 2 goitre (2017) rural divisions in Sabah 13 Sabah (the Interior, the West Coast, and Kudat) obtained Regarding geographical location, three patients with grade 1 goitre years after the Data were obtained through The respondents were asked about were living in the West Coast, and the remaining two were living implementation of the (i) face‐to‐face interviews, (ii) physical their domestic iodised salt use and in Kudat mandatory universal salt examination of the neck, and (iii) urine analysis iodine‐ containing supplement The median UIC among the participants was 105 μg/L iodisation programme Data were collected from all pregnant women consumption More than half (60.5%) of the women had a UIC <150 μg/L attending the government maternal and child Neck examination was performed (insufficient iodine), 22.8% had a UIC of 150–249 μg/L (adequate health clinics from early May to end of June by trained nurses, and if neck iodine), and 16.6% had a UIC ≥ 250 μg/L (more than adequate or 2013 (n = 524) enlargement was observed, it was excessive iodine) graded based on the international The median UICs differed significantly between all three divisions, classification and Kudat had significantly higher UICs than those from the Urine analysis was performed to Interior examine urinary iodine concentration (UIC)
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Title of the article (year Study objective(s) Study methodology Health status measured Health status reported Quality of publication) assessment Antenatal care practice To assess the antenatal care Cross‐sectional study design with quantitative Level of knowledge and practice Among the study participants, 53% of them had insufficient 86% and pregnancy outcome (ANC) related knowledge method on ANC care and outcomes of knowledge, in contrast to 47% with sufficient knowledge on ANC at Kudat area, Sabah, To assess the antenatal Study was conducted among community pregnancies Nearly all of the respondents received antenatal care (99%), and Northern Borneo (2017) practice villages in Kudat they were encouraged to receive ANC by the healthcare providers To assess the outcome of Data were obtained through face‐to‐face ANC was started to be obtained at 1 month (11%), at 2 months pregnancy interviews using a semi‐structured (36%), and at 3 months (40%), and late ANC was reported by 13% questionnaire of the respondents Data were collected from women who were The mean ANC visit was 9 times, and greater than 80% of the ever‐married and having at least one pregnancy respondents received all types of ANC services experience in 5 years and resided in the villages All deliveries were performed in the hospitals (97%) and health at Kudat area clinics (3%). Approximately 92% of pregnant women did not Data were collected from December 2014 to experience maternal and infant complications October 2016 (n = 300)