Pada minggu ke-28 tahun 2016, iaitu seminggu selepas sambutan Hari Raya Aidilfitri dari 10 Julai hingga 16 Julai 2016, sejumlah 2,240 kes telah dilaporkan di seluruh negara, meningkat 728 kes (48.1%) berbanding dengan minggu ke-27 (1,512 kes). Peningkatan kes ini memang telah dijangkakan kerana ia menyerupai tren kes denggi pada tahun sebelum ini. Selain keadaan cuaca, pergerakan masyarakat semasa cuti hari raya pada minggu sebelumnya yang mempengaruhi penyebaran dan peningkatan kes denggi. Daripada Januari sehingga 16 Julai 2016, jumlah kumulatif kes denggi dilaporkan adalah 61,534 kes, berbanding 65,395 kes bagi tempoh yang sama tahun 2015, iaitu penurunan sebanyak 5.9% (3,861 kes).

Manakala untuk kematian denggi pula, bagi tempoh yang sama sebanyak 1 kematian dilaporkan pada minggu ke-28. Jumlah kumulatif kematian denggi sehingga minggu ke-28 adalah sebanyak 135 kematian, berbanding 175 kematian bagi tempoh yang sama tahun 2015, menunjukkan pengurangan sebanyak 40 kematian (22.8%).

Pada minggu ke-28 juga, terdapat 666 lokaliti wabak yang masih aktif dilaporkan di 14 negeri iaitu Selangor (445), WPKL & Putrajaya (66), Johor (57), Sarawak (17), Kelantan (17), Sabah (16), Perak (16),  Negeri Sembilan (11),  Melaka (8), Pahang (4), Pulau Pinang (3), dan masing masing 2 lokaliti di Kedah, Perlis dan Terengganu. Tiada kejadian wabak dilaporkan di WP Labuan.

Bagi mengatasi peningkatan kes yang berlaku ketika ini, Kementerian Kesihatan menggesa semua pihak, khususnya di negeri Selangor, Johor, Perak, Terengganu, Kelantan, Sabah dan Wilayah Persekutuan Kuala Lumpur  mengambil tindakan segera seperti berikut:-

1. Individu dan pemilik premis membersihkan dalam dan luar rumah mereka setiap minggu serta bebas dari pembiakan nyamuk Aedes.

2. Ketua dan pemimpin masyarakat setempat mengambil tanggungjawab mengadakan gotong-royong membersihkan persekitaran kawasan perumahan masing-masing, khususnya di kawasan wabak dan hotspot.

3. Guru besar, pengetua dan majikan mengambil tanggungjawab memastikan persekitaran sekolah, kolej dan tempat kerja bersih dan bebas dari pembiakan Aedes.

4. Pemaju tapak binaan dan kontraktor hendaklah memastikan tapak pembinaan mereka juga bebas daripada air yang bertakung yang menjadi tempat pembiakan Aedes.

5. Pihak Berkuasa Tempatan dan syarikat konsesi pelupusan sampah hendaklah memastikan urusan pelupusan sampah berjalan lancar bagi mengelakkan longgokan sampah yang boleh menjadi tempat pembiakan Aedes.

6. Pihak Berkuasa Tempatan hendaklah memastikan longkang, saliran, taman-taman permainan serta tempat riadah diselenggara dengan baik bagi mengelak daripada air bertakung. Tempat pembuangan sampah haram juga hendaklah dibersihkan dan tindakan tegas diambil terhadap mereka yang melakukannya.

Semua pihak perlu  memberikan  kerjasama  bagi  menangani  masalah pembiakan Aedes dan penyakit demam denggi. Tanpa kerjasama individu, masyarakat, pemimpin setempat dan majikan bagi memastikan persekitaran bebas daripada nyamuk Aedes, masalah demam denggi tidak akan berjaya dikawal.

Berdasarkan situasi terkini penyakit Zika yang telah dikemas kini oleh Pertubuhan Kesihatan Sedunia (WHO) pada 13 Julai 2016, terdapat sebanyak 65 buah negara yang melaporkan jangkitan virus Zika. Manakala di Malaysia, tiada jangkitan virus Zika yang dikesan setakat ini berdasarkan kepada 508 sampel yang telah diuji oleh Makmal Kesihatan Awam Kebangsaan (MKAK) dan juga Institut Penyelidikan Perubatan (IMR). Selain itu, saringan pelawat di Pintu Masuk Antarabangsa (PMA) masih diteruskan dan setakat ini tiada pelawat yang disyaki dijangkiti virus Zika tersebut.

DATUK DR. NOOR HISHAM BIN ABDULLAH

Ketua Pengarah Kesihatan

Kementerian Kesihatan Malaysia

23 Julai 2016

Pada minggu ke-29 tahun 2016, iaitu dari 17 hingga 23 Julai 2016, sejumlah 2,188 kes Denggi telah dilaporkan, pengurangan sebanyak 52 kes (2.3%) berbanding dengan minggu sebelumnya iaitu 2,240 kes. Terdapat enam (6) buah negeri yang menunjukkan peningkatan kes berbanding minggu sebelumnya iaitu Kelantan 50 kes (40.3%), WP Kuala Lumpur dan Putrajaya 39 kes (15.7%), Negeri Sembilan 3 kes (5.4%), Terengganu 1 kes (10.0%), Sabah 1 kes (0.8%) dan WP Labuan 1 kes. Dari Januari sehingga 23 Julai 2016, jumlah kumulatif kes Denggi dilaporkan adalah 63,722 kes, berbanding 67,944 kes bagi tempoh yang sama tahun 2015, iaitu penurunan sebanyak 6.2% (4,222 kes).

Manakala untuk kematian Denggi pula, bagi tempoh yang sama sebanyak tujuh (7) kematian dilaporkan. Jumlah kumulatif kematian Denggi sehingga 23 Julai 2016 adalah sebanyak 142 kematian, berbanding 185 kematian bagi tempoh yang sama tahun 2015, menunjukkan pengurangan sebanyak 43 kematian (23.2%).

Dari 17 hingga 23 Julai 2016, terdapat sejumlah 14 negeri dan 43 daerah berwabak melibatkan 770 lokaliti termasuk 98 lokaliti hotspot dilaporkan. Terdapat tujuh (7) daerah baru dilanda wabak iaitu daerah Penampang, Beaufort, Tambunan, Song, Bachok, Tumpat dan Kampar.

Masalah  Denggi  adalah  berpunca daripada persekitaran yang tidak dijaga dengan baik. Sehubungan dengan itu, penglibatan masyarakat dalam aktiviti pencegahan Denggi seperti aktiviti gotong royong perlulah diberikan penekanan oleh semua pihak, terutamanya di negeri yang mengalami peningkatan kes dan bilangan wabak yang berterusan pada tahun ini. Dengan keadaan musim hujan dan panas yang melanda negara pada masa ini, masyarakat perlu berhati-hati dengan memastikan tiada bekas-bekas yang boleh menakung air di dalam dan luar rumah yang boleh menjadi punca tempat pembiakan Aedes.

Di samping itu, Pihak Berkuasa Tempatan juga perlu menjalankan aktiviti pemusnahan pembiakan Aedes terutama di projek rumah terbengkalai, tanah/lot kosong dan tempat pembuangan sampah yang masih menjadi tempat pembiakan Aedes. Ini kerana daripada pemantauan KKM, didapati sebanyak 21.8% projek rumah terbengkalai, 8.8% tanah atau lot kosong, 8% tempat pembuangan sampah dan 5.1% taman rekreasi di lokaliti berwabak didapati membiak nyamuk Aedes. Bagi pihak yang mengurus tanah perkuburan dan rumah ibadat serta persatuan penduduk perlu membersihkan tanah perkuburan dan tempat ibadat yang menyumbang kepada pembiakan Aedes masing-masing sebanyak 6.8% dan 4.5%. Pihak industri pula diminta memastikan kawasan persekitaran kilang adalah bersih kerana 6% daripada kilang-kilang didapati positif pembiakan nyamuk Aedes.

Sehubungan itu, PKD perlu memastikan aktiviti pencegahan ditingkatkan di kawasan berisiko apabila mendapati Indeks Aedes melebihi piawaian standard iaitu melebihi 1% bagi membendung peningkatan kes Denggi.

Berdasarkan situasi terkini penyakit Zika yang telah dikemas kini oleh Pertubuhan Kesihatan Sedunia (WHO) pada 20 Julai 2016, terdapat sebanyak 65 buah negara yang melaporkan jangkitan virus Zika. Manakala di Malaysia, tiada jangkitan virus Zika yang dikesan setakat ini berdasarkan kepada 651 sampel yang telah diuji oleh Makmal Kesihatan Awam Kebangsaan (MKAK) dan juga Institut Penyelidikan Perubatan (IMR). Selain itu, saringan pelawat di Pintu Masuk Antarabangsa (PMA) masih diteruskan dan setakat ini tiada pelawat yang disyaki dijangkiti virus Zika tersebut.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan

2 OGOS 2016

Kementerian Kesihatan Malaysia (KKM) mengambil maklum isu vaksin tiruan di negara Indonesia baru-baru ini. Pihak agensi regulatori Indonesia, Badan Pengawas Obat dan Makanan (BADANPOM) pada 20 Julai 2016 telah mengeluarkan kenyataan mengenai penemuan vaksin tiruan di Indonesia. Susulan itu, kerajaan Indonesia telah mengambil langkah-langkah untuk menghentikan pengedaran vaksin tiruan tersebut.

Agensi Regulatori Farmasi Negara (NPRA), dahulunya dikenali sebagai Biro Pengawalan Farmaseutikal Kebangsaan (BPFK) bertanggungjawab kepada Pihak Berkuasa Kawalan Dadah dalam mendaftarkan produk termasuk vaksin setelah dinilai dari segi kualiti, keselamatan dan efikasi serta turut menjalankan aktiviti pemantauan dan pensampelan.

Vaccine Lot Release telah dilaksanakan ke atas semua produk vaksin yang berdaftar di Malaysia mulai 1 Januari 2015. Aktiviti ini terdiri daripada penilaian Lot Summary Protocol, pemeriksaan rangkaian sejuk (Cold Chain) dan pemeriksaan fizikal ke atas produk vaksin bagi memastikan setiap lot vaksin terjamin dari segi keselamatan, kualiti dan efikasi. Susulan itu, mulai Januari 2015, pihak pemegang pendaftaran, pemegang lesen mengimport dan pemegang lesen pemborong produk vaksin berdaftar di Malaysia telah diarahkan untuk mematuhi keperluan tersebut seperti yang tertera dalam Peraturan-peraturan Kawalan Dadah dan Kosmetik 1984, Arahan Bilangan 16 Tahun 2014-Direktif untuk Pelaksanaan Vaccine Lot Release. Maklumat vaksin yang telah diberikan sijil Lot Release boleh diperolehi dari laman sesawang http://npra.moh.gov.my

PERINGATAN KEPADA ORANG AWAM, PEMEGANG PENDAFTARAN, PEMEGANG LESEN MENGIMPORT DAN PEMEGANG LESEN PEMBORONG

KKM memandang serius isu vaksin tiruan. Pemeriksaan dijalankan dari masa ke masa untuk memastikan tidak ada produk vaksin yang tidak berdaftar dan produk vaksin tiruan di pasaran. Pemegang pendaftaran juga bertanggungjawab berkaitan produk yang dipasarkan di Malaysia dan sehingga kini tiada syarikat vaksin yang mengesan ada produk vaksin mereka yang telah dipalsukan.

KKM memberi amaran bahawa memiliki, menjual atau membekal vaksin tidak berdaftar dan vaksin tiruan adalah merupakan satu kesalahan di bawah Akta Jualan Dadah 1952 dan Peraturan-Peraturan Kawalan Dadah dan Kosmetik 1984 dan jika disabitkan kesalahan individu boleh dikenakan denda sehingga RM25,000 atau penjara sehingga 3 tahun untuk kesalahan pertama atau denda sehingga RM50,000 atau penjara sehingga 5 tahun untuk kesalahan kedua dan berikutnya. Jika kesalahan dilakukan oleh syarikat, jika disabitkan kesalahan syarikat boleh didenda sehingga RM50,000 untuk kesalahan pertama atau denda sehingga RM100,000 untuk kesalahan kedua dan berikutnya.

KKM juga mengingatkan hospital/klinik swasta untuk membeli stok bekalan vaksin daripada pembekal-pembekal yang berlesen sahaja dan tidak terpedaya dengan mana-mana pihak yang menawarkan vaksin dengan harga yang lebih murah dari harga pembekal yang berlesen.

Orang awam dinasihatkan untuk berkomunikasi dengan pegamal perubatan mengenai vaksin yang diberikan dan kesan sampingan yang mungkin timbul serta tindakan yang harus dilakukan apabila kesan sampingan yang tidak diingini berlaku selepas mendapatkan vaksin tertentu.

Orang awam boleh menghubungi NPRA di talian 03-78835400 sekiranya terdapat vaksin yang meragukan.

Sekian, terima kasih.

DATUK DR NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan Malaysia

Merangkap Pengerusi PBKD

Kementerian Kesihatan Malaysia

4 Ogos 2016

The 8th National Public Health Conference 2016, 2-4 August 2016 with the theme “Managing Society in Combating Public Health Challenges” was held at Malacca. It was well attended by Public health physicians, paramedics working in health sectors, dieticians, nutritionist, health educators and NGOs such as PPPKAM. It was officiated by YAB Datuk Seri Ir Hj Idris Hj Haron, Chief Minister of Malacca.

Professors and fellow delegates of the 8th National Public Health Conference 2016.

• It is a great honor to be here at this conference to deliver the keynote address on the topic of ‘Managing Society in Combating Public Health Challenges’. I would like to thank the organising committee for this opportunity and for choosing the theme, which is apt and relevant with current public health climate both locally and globally.

• Throughout time, diseases and health issues changes. Globally, the World Health Organisation (WHO) had identified a number of public health challenges that need to be addressed in this era. The unfinished agenda of Millennium Development Goals (MDGs) that ends in 2015 and the public health issues of acute epidemic diseases, escalating epidemic of non-communicable diseases, mental health disorders, conflicts and inequalities in all parts of the world are among of the notable important issues that need to be strategically addressed. The new Sustainable Development Goals (SDGs) which came into effect on 1st January 2016 has broader and more ambitious goals. The new agenda integrate all 3 dimensions of sustainable development – economic, social and environmental; and relevant to all people in all countries. One of the 17 goals in the SDGs has been specifically devoted to health that is the 3^rd The goal is to “Ensure healthy lives and promote well-being for all at all ages”. The health goal itself is associated with 13 targets, including four means of implementation targets. I urge everyone here to have some knowledge about SDG and internalized the goals in our day-to-day work.

• In Malaysia, although we can take pride of our accomplishments in improving health status, we certainly cannot be complacent. We are experiencing the double burden of diseases where both the non communicable diseases and communicable diseases are on the rise. Almost half (47.7%) of Malaysian adults (above 18 years old) are either overweight or obese which makes us the fattest country in Asia. This is a worrying health problem because obesity is a risk factor for many diseases such as diabetes, heart diseases and some cancers. Another worrying concern is tobacco smoking. We have an estimation of 4.7 million adult smokers and most of them start before the age of 18. More than 40% of Malaysian men smoke. Four out of 10 adults were found to be exposed to second-hand smoke at home (7.6 million adults). Our fight against tobacco is now challenged with the new and classy method of vaping or e-cigarette, which is appealing to the youth and younger generation. Addiction and social ills happen when the opportunities to get involved in the menace are easily accessible and available. Truly frightening, these colors will paint an ugly picture of our nation’s health if not handled strategically.

• Unfortunately, we are repeatedly being challenged with the epidemics of communicable diseases such as dengue and tuberculosis. In 2015, we had the highest number of dengue fever cases ever reported i.e. 120,836 cases with 336 death. Diseases such as Zika infection and Ebola are knocking on our door and becoming threats to our population with the ease of air travel and globalisation. Recently, the notorious vaccine preventable diseases such as diphtheria and measles are being reported and even led to death among our children. As of 27^th July 2016, there were 25 confirmed cases of diphtheria with 5 deaths. Sadly these avoidable diseases happened because a small part of our society is misguided and misinformed.

• With the advancement of information technology and social media, activist or groups with deviant health belief are increasing in number and influence. The so-called naturalistic or conservatives and religious groups are using social media to spread their misconceptions and misguided information or belief to the wider community about natural defense or foods advocated by religious belief. The worst part being that these traditional or natural foods and drinks such as alkaline water claim to be a cure for chronic diseases and conditions. To make the matters worst, some public figures and persons well respected by the community including celebrities, religious figures, social media advocates and community leaders produce testimonials in support of such products or practices.

• As you may have noticed by now, many of the challenges are related to human behavior, beliefs and attitude towards health. The question before us, though, as professional healthcare community, is how do we handle those challenges, how do we manage these individuals that constitute of family and society to choose and live a healthier life and to protect health? How do we ensure a healthy environment and how do we safeguard our society from deadly, mutated and antimicrobial-resistance infectious agents? There will always be challenges. That’s what makes life interesting. Overcoming the challenges is what makes life meaningful. Within challenges, therein lies the opportunity. Do not bow to these challenges, for they will become obstacles; instead look for a way not for a way out. Conferences like this is one of the ways for healthcare professionals to be updated and to have scientific based discussion on the matters at hand. The Malaysian Association for Public Health Physician (PPPKAM) and Melaka State Health Department are doing their part in tackling the issues on how to manage our society in ensuring healthy lives and promote well-being for all at all ages as in the Sustainable Development Goals.

• The global agenda as in SDGs will work if it is given the local context. Our government and Ministry of Health in particular is working in tandem with other ministries and our stakeholders to achieve these SDG targets. We are using all the strategic tools of educating, marketing and policies or laws to ensure healthy lives and promote well being in Malaysia. Investing in public health will and does work. Although there will always be skepticism and criticism but I believe through partnership and collective actions within us, we will be able to combat public health issues.

• Our government has given its commitment in addressing health in SDG and Paragraph 26 of the 2030 agenda states:

To promote physical and mental health and wellbeing, and to extend life expectancy for all, we must achieve universal health coverage and access to quality health care. No one must be left behind.

We commit to accelerating the progress made to date in reducing newborn, child and maternal mortality by ending all such preventable deaths before 2030.

We are committed to ensuring universal access to sexual and reproductive health-care services, including for family planning, information and education.

We will equally accelerate the pace of progress made in fighting malaria, HIV/AIDS, tuberculosis, hepatitis, Ebola and other communicable diseases and epidemics, including by addressing growing antimicrobial resistance and the problem of unattended diseases affecting developing countries.

We are committed to the prevention and treatment of non-communicable diseases, including behavioral, developmental and neurological disorders, which constitute a major challenge for sustainable development

• I believe each and every one of us here are passionate in safeguarding the health of our nation. Public health physicians, paramedics working in health sectors, dieticians, nutritionist, health educators and NGOs such as PPPKAM play crucial roles as they are very close to the community. Most of you are the front liners in the community in helping them to achieve better health. Health professionals should understand the lay of the problem or conflicts and work within each other and with other groups that have the same and aligned interest. Be more responsive and spend more time to plan and deal constructively with change. Make appropriate changes in collaboration with the community or groups. Make changes in more cooperative and constructive manner. Healthcare professionals could no longer continue to be indifferent to the interest and preferences of the society.

• Society themselves should view health as an asset just like monetary entity. Every transaction or exchange in which each individual gives and receives should be viewed as something of value.
• Empowering the community to be active participants in maintaining their health, enabling them to rely less on public services, and empowering them to make better lifestyle and health related decisions is quite a challenge to the professional healthcare community. New and innovative community-based programs or technology are needed and should be welcome.

• Information technology and social media should be used to our advantage in promoting health and clarify the misinformation or misconceptions arising from the public. Healthcare providers should use technology and social media to provide true and scientific based information. Fight back the myths and never give up in educating our society. Provide information that is just, easy to digest, interesting and attractive. Be technology savvy and social media-friendly in handling communication conflicts or health issues.
• The bigger the challenges the bigger the opportunity. Today’s challenges call for very bold approaches and the inclusion of universal health coverage (UHC) in the Sustainable Development Goals is an encouraging. Let’s change our challenges into opportunities so that the health and well-being of every niche and corners of our society is well taken care. Working in togetherness and mutual understanding in ensuring healthy lives and promote well-being for all at all ages.

Thank you.

Pada minggu ke-30 (iaitu dari 24 hingga 30 Julai 2016) kes Demam Denggi di seluruh negara telah menunjukkan pengurangan sebanyak 13.3% iaitu 1,896 kes berbanding 2,188 kes pada minggu sebelumnya. Walau bagaimanapun, terdapat enam (6) buah negeri yang menunjukkan peningkatan kes berbanding minggu sebelumnya iaitu Kelantan 44 kes (25.3%), Sarawak 14 kes (21.9%), Pahang 11 kes (25.6%), Melaka 11 kes (20.0%), Terengganu 2 kes (18.2%) dan Perlis 1 kes (100.0%). Manakala secara kumulatif dari Januari hingga 30 Julai 2016, jumlah kes Demam Denggi adalah sebanyak 65,618 kes, berbanding 70,680 kes bagi tempoh yang sama tahun 2015, iaitu penurunan sebanyak 7.2% (5,062 kes).

Di samping itu, terdapat lima (5) kematian yang dilaporkan pada minggu ke-30. Jumlah kumulatif kematian Denggi dari Januari sehingga 30 Julai 2016, adalah sebanyak 147 kematian berbanding 190 kematian bagi tempoh sama tahun 2015, dengan peratusan pengurangan sebanyak 22.6% (43 kematian).

Hasil pemantauan Kementerian Kesihatan Malaysia (KKM) juga mendapati penurunan lokaliti wabak pada minggu ke-30 berbanding minggu sebelumnya iaitu daripada 770 lokaliti pada minggu ke-29 kepada 755 lokaliti pada minggu ke-30. Manakala, jumlah lokaliti hotspot juga didapati berkurangan daripada 98 lokaliti pada minggu sebelumnya kepada 93 lokaliti pada minggu ke-30. Lokaliti hotspot ini melibatkan tujuh (7) buah negeri iaitu di Selangor (82), Johor (5), WP Kuala Lumpur & Putrajaya (2) dan masing-masing satu (1) lokaliti di Perak, Melaka, Kelantan dan Sabah.

Dalam satu kajian yang telah dijalankan oleh Danial et al (2016) berkenaan faktor luaran yang mempengaruhi wabak Demam Denggi dan amalan masyarakat di lima (5) daerah di Pulau Pinang, didapati walaupun terdapat kesedaran yang tinggi tentang Demam Denggi iaitu 94.2% tetapi amalan pencegahan adalah rendah. Ini termasuk penglibatan dalam aktiviti gotong-royong (75.0%), aktiviti cari dan musnah tempat pembiakan (77.0%) dan aktiviti membubuh bahan pembunuh jentik-jentik (40.0%). Daripada kajian ini, didapati walaupun tahap kesedaran dan pengetahuan masyarakat dalam pencegahan Demam Denggi adalah tinggi, namun ia tidak dijadikan sebagai amalan dalam kehidupan mereka.

Oleh sebab itu, untuk pencegahan Demam Denggi, pasukan COMBI yang terdiri daripada masyarakat hendaklah menjadi agen perubahan (change agent) kepada komuniti setempat. Pasukan COMBI boleh menggerakkan penduduk setempat untuk menjalankan aktiviti pembersihan persekitaran setiap minggu.

Berdasarkan situasi terkini penyakit Zika yang telah dikemas kini oleh Pertubuhan Kesihatan Sedunia (WHO) pada 28 Julai 2016, terdapat sebanyak 67 buah negara yang terlibat. Manakala di Malaysia, berdasarkan kepada 668 sampel yang telah diuji oleh Makmal Kesihatan Awam Kebangsaan (MKAK) dan juga Institut Penyelidikan Perubatan (IMR) dari Jun 2015 sehingga 30 Julai 2016, tiada jangkitan virus Zika yang dikesan setakat ini. Selain itu, saringan pelawat di Pintu Masuk Antarabangsa (PMA) masih diteruskan dan setakat ini tiada pelawat yang disyaki dijangkiti virus Zika tersebut.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan

Kementerian Kesihatan Malaysia 

6 Ogos 2016

Kementerian Kesihatan Malaysia (KKM) ingin memaklumkan mengenai situasi semasa penyakit Tangan, Kaki dan Mulut atau Hand, Foot And Mouth Disease (HFMD) di Malaysia. Penyakit HFMD adalah endemik di Malaysia dan berlaku sepanjang tahun. Pada Minggu Epid (ME) 31/2016 (31 Julai 2016 – 6 Ogos 2016) bilangan kes HFMD yang dilaporkan di seluruh negara ialah 1,885 kes iaitu peningkatan 600 kes (46.7%) berbanding minggu sebelumnya (1,285 kes). Dari 3 Januari 2016 hingga 6 Ogos 2016, sejumlah 23,454 kes HFMD telah dilaporkan dengan purata kes dilaporkan seminggu untuk seluruh negara sebanyak 757 kes. Jumlah ini menunjukkan peningkatan kes sebanyak 17.8% jika dibandingkan dengan minggu yang sama pada tahun 2015 di mana sebanyak 19,916 kes telah dilaporkan dengan purata mingguan sebanyak 642 kes.

Negeri Selangor menyumbangkan jumlah kes tertinggi berbanding negeri lain iaitu 7,471 kes (31.9%), diikuti oleh Sarawak 3,007 kes (12.8%), Johor 2,294 kes (9.8%), WPKL 2,084 kes (8.9%), Sabah 1,535 kes (6.5%), Perak 1,361 kes (5.8%), Pulau Pinang 1,357 kes (5.8%), Melaka 1,198 kes (5.1%), Negeri Sembilan 889 kes (3.8%) dan Kedah 641 kes (2.7%) dan sementara negeri-negeri lain kurang daripada 500 kes.  Tiga (3) daerah di Selangor yang mencatatkan bilangan kes tertinggi HFMD adalah daerah Petaling (2,699 kes), Hulu Langat (1,801 kes) dan Klang (1,023 kes).

Wabak HFMD ditakrifkan apabila terdapat dua (2) atau lebih kes HFMD dimana gejalanya timbul dalam tempoh dua (2) minggu di dalam lokaliti yang sama.  Pada ME 31/2016 sebanyak 69 wabak telah dilaporkan di seluruh negara iaitu peningkatan 30.2% (16 wabak) berbanding minggu sebelumnya (53 wabak). Dari 3 Januari 2016 hingga 6 Ogos 2016, jumlah wabak yang dilaporkan adalah 844 wabak, hampir menyamai jumlah wabak yang dilaporkan dalam tempoh yang sama tahun 2015 (895 wabak). Trend peningkatan wabak ini berlaku selari dengan peningkatan kes yang berlaku di seluruh negara. Negeri Sarawak mencatatkan bilangan kejadian wabak tertinggi dengan 316 wabak (37.4%) berbanding negeri lain, diikuti Selangor 185 wabak (21.9%), WPKL 90 wabak (10.7%), Johor 56 wabak (6.6%), Melaka 54 wabak (6.4%), Perak 33 wabak (3.9%), Pulau Pinang 31 wabak (3.7%) dan Negeri Sembilan 24 wabak (2.8%) sementara negeri-negeri lain kurang daripada 20 kejadian wabak.

Penyakit HFMD disebabkan oleh enterovirus dengan majoriti kes di Malaysia adalah disebabkan oleh Coxsackie Virus A16 dan diikuti oleh Enterovirus 71 (EV 71). Virus ini merebak melalui kontak dengan air liur, sentuhan cecair lepuh (blister) dan najis dari mereka yang berpenyakit. Tempoh inkubasi adalah antara 3-5 hari. Kebiasaan jangkitan adalah ringan (mild) dengan gejala demam diikuti ruam melepuh (blister) pada tangan, kaki, mulut dan lidah. Hampir keseluruhan pesakit yang menghidap penyakit HFMD pulih tanpa rawatan perubatan dalam masa tujuh (7) ­ke sepuluh (10) hari. Selain itu, kanak-kanak juga boleh mengalami gejala jangkitan saluran pernafasan, muntah, cirit birit dan kurang selera makan. Walau bagaimanapun, jangkitan EV71 boleh menyebabkan komplikasi teruk seperti encephalitis, pulmonary edema dan myocarditis namun, ianya jarang berlaku.

Walan pun penyakit HFMD ini kebiasaannya gejala ringan namun ianya cepat menular dengan kadar serangan hampir 100% di kalangan kanak-kanak kurang dari sepuluh (10) tahun terutamanya di premis tempat tumpuan kanak-kanak seperti di taska/tadika. Di samping itu, ianya mempunyai implikasi sosial kepada ibubapa dan penjaga yang terpaksa bercuti bagi menjaga kanak-kanak di rumah. Justeru, KKM ingin menasihatkan ibu bapa atau penjaga kepada kanak-kanak yang mempunyai tanda-tanda jangkitan supaya mengamalkan langkah-langkah pencegahan seperti berikut:

1. Tidak membawa anak ke tempat-tempat awam/ sekolah / taska / tadika / pusat asuhan kerana boleh merebakkan jangkitan;
2. Membawa anak yang mempunyai tanda jangkitan berjumpa doktor untuk mendapatkan rawatan;
3. Mengamalkan kebersihan dengan mencuci tangan dengan sabun dan air bersih selepas ke tandas, selepas menukar lampin, dan selepas menyentuh / merawat lepoh dan semasa mencuci najis kanak-kanak tersebut;
4. Membersihkan (basmi kuman menggunakan larutan chlorine based) permainan anak serta lantai rumah terutama tandas;
5. Memastikan pembuangan lampin pakai-buang dibuat dengan betul; dan
6. Menggunakan peralatan makan dan minum yang berasingan dan tidak berkongsi barangan dengan anak-anak yang lain.

Pihak pengusaha TASKA, TADIKA dan lain-lain pusat jagaan kanak-kanak disarankan supaya mengambil langkah-langkah yang sama seperti di atas.  Di samping itu, saringan di pintu-pintu masuk (gate-keeping) dilakukan bagi memastikan tiada tanda-tanda jangkitan HFMD sebelum kanak-kanak dibenarkan memasuki premis.

Oleh itu, langkah-langkah pencegahan seperti di atas adalah amat penting bagi mengelakkan peningkatan kes pada tahun ini. KKM sentiasa memantau kejadian penyakit HFMD di seluruh negara dan mengambil tindakan kawalan dan pencegahan. Penyakit HFMD merupakan penyakit berjangkit yang perlu dinotifikasi mengikut Akta Pencegahan dan Pengawalan Penyakit Berjangkit 1988 (Akta 342). Pengamal Perubatan dan orang ramai boleh melaporkan kejadian kes HFMD di premis taska/tadika/sekolah ke Pejabat Kesihatan Daerah yang berhampiran. Klik: Senarai Pejabat Kesihatan Daerah

Sekian, terima kasih.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan Malaysia

11 Ogos 2016

The 19th Family Medicine Scientific Conference 2016, 10-13 August 2016 with the theme “Excellence in Primary Care; Make It Matter, Make it Better” was held at Grand Dorsett, Subang. It was well attended by almost 700 participants which includes Family Medicine Specialists, GPs, Medical Officers, Public Health Physicians and other health professionals.

Fellow delegates,

It is my pleasure to welcome all participants from all over Malaysia to this 19^th Family Medicine Scientific Conference. It is a great honour for me to be here today to officiate this conference and I would like to thank the organising committee for inviting me.

Primary care is an important aspect of health care in a country’s health system. Many developed countries contributed substantial proportion of their health care expenditure to the primary care. Australia for instance, spent almost equal amount of their healthcare budget to the primary care as compared to the secondary and tertiary care in the hospitals.

Over the past 3 decades, many aspect of primary healthcare has evolved in Malaysia. Realising its importance, the government has spent more investments into the primary care as we move towards making primary care as the thrust of the health care system; in order to uplift further the health status of the nation. Primary care in Malaysia has started its services way back in 1950s. At that point of time, the focus was mainly on the maternal and child health with basic infrastructure and human resource. In the earlier years, the main bulk of the healthcare system was largely focused on the curative components of healthcare which are largely based in the secondary and tertiary care in the hospitals.

Under the 10^th Malaysia Plan, the government has initiated 4 key initiatives which focus on:

(1) transformation of the health system;

(2) increasing the quality, equity and accessibility of health services;

(3) shifting the focus on prevention rather than curative; and

(4) increasing the quality of the health human resource.

Efforts have been made to improve the accessibility to quality primary care especially to the underserved areas in both urban and rural areas.

Today in Malaysia we can see that remote areas too enjoy accessibility to healthcare, albeit to basic health care. About 10 days ago, I visited Pulau Aman in Penang State which is about 30 minutes boat ride from the Penang Island. Despite having a population of just 187 people, MOH strived to provide health service there. We have a Klinik Desa in Pulau Aman that has been managed by 2 nurses, and I was glad to see that they kept good record of health status of the islanders in Pulau Aman. They run the full national vaccination programme for 25 school children there, and I was glad to be informed that the immunisation coverage there is 100%.

In the 11^th Malaysia Plan, the government plans to continue to provide the universal access of quality healthcare to the community. To date, there are 966 health clinics, 100 maternal and child health clinics, and 1,806 community clinics all over the country. Soon there will be a Super Type 1 Clinic called Kuala Lumpur Health Clinic in the city of Kuala Lumpur with extensive building that will be offering primary healthcare services for the surrounding community. The development of new facilities also takes into account the functionality, cost effectiveness and health needs of the local population.

However, massive, extensive and impressive clinic buildings does not guarantee improved health service delivery in primary care. More importantly is the capacity building of its health human resource. This without a doubt is an important component that need to be developed in parallel with facility planning. I am glad to see that our local Master program in Family Medicine that was started initially in Malaya University in 1993 has now been expanded further to include 5 other public universities. Until this date, we have 294 gazetted Family Medicine Specialists in the Ministry of Health and more than 100 Family Medicine Specialists working in various local universities. The Academy of Medicine has also offered a parallel programme to train more Family Medicine Specialist for the country, whereby it offers postgraduate diploma program and MAFP /FRCGP to encourage more doctors to pursue their postgraduate career in this field. Until 2014, we have 340 primary care specialists with FRACGP qualifications in the private sector.

Apart from training the doctors, other health professionals for instance the paramedics have also been trained to have specialised skills in various disciplines like diabetes educators, HIV counsellors and many others. The Ministry of Health is also getting more dieticians, nutritionists, physiotherapists, occupational therapists, social welfare officers and psychologists to complete the team in the primary care.

We have heard many success stories about the achievement and progress made in primary health care in Malaysia. They were all achieved through comprehensive planning, networking and collaboration between various stake holders. However, the gained made in the last 3 decades has now plateaued. Further gain has proven to be difficult to achieve, and we are not left without new challenges in our health system.

Today we are challenged with double disease burden; by both Communicable Diseases and Non-Communicable Diseases.

Diabetes for instance; through the National Diabetes Registry, we now have better access on the information of performance of our health clinics in terms of care for the diabetics. Through the annual Clinical Diabetes Audit, we can see improvements in the percentage of those reaching target HbA1c (HbA1c less 6.5%) from 19% in 2009 to 23% in 2012. In terms of treatment, larger percentage of patients received insulin therapy in 2012 compared to 2009, which signify the success in educating the doctors to treat patient more diligently.

However the recent findings from National Health Morbidity Survey (NHMS) 2015 showed increasing prevalence of diabetes, whereby almost 1 in 5 adults aging 30 years and above are diabetics. More worrying is that, not only that the prevalence were high but about 50% of these diabetics were actually undiagnosed. That means, about 50% of adult diabetics in Malaysia do not actually know that they have diabetes. Literally, 1 out of 10 of us Malaysian adults has diabetes and he/she does not even know it! To add to that, Malaysia is the most overweight nation in Southeast Asia with 44.2% of our adults in 2011 are overweight.

Therefore, more work has to be done to screen and diagnose people early to prevent later complications. Healthy lifestyle has to be promoted and living healthily should be made a trend especially for our younger generation. Thus I urge the primary care providers to double your efforts in early detection, health promotion and preventive activities. One of the initiatives by MOH to address this is by initiating the community program Komuniti Sejahtera Perkasa Negara (KOSPEN) to various communities to promote healthy life style.

Another important initiative at health clinics is the introduction of the Family Doctor Concept (FDC) led by the FMS in various parts of the country. This has also been introduced in stages to provide a holistic and comprehensive care to the patient via a model of a patient-centred and integrated care. With this initiative, it is expected that the chronic disease management of a patient and his family as well as the community would see further improvement. I visited Klinik Kesihatan Penaga during my recent working visit to the Penang State where I was briefed on the progress made by our FMS in expanding this Family Doctor Concept there. I was pleased to be informed that this concept received good feedback from patients and our ground staff.

We are also facing challenges with the maternal and child health. Whilst we thought mothers dying from unsafe home deliveries and children dying from infectious diseases were relic of the past, we are now seeing the re-emergence of unsafe deliveries and children dying from vaccine preventable infections.

In the past, one of the main reason for maternal mortality is because of the unsafe deliveries conducted by untrained personnel. We then trained the traditional midwives and get them to be ‘registered’ with us. We also built Alternative Birthing Centre (ABC) in some of our health clinics to give better access to safer birthing practice, especially for those in remote areas to allow them to deliver their babies in a safer environment. But now we are getting parents and women who made decision to give birth at home ‘naturally” without any help from the trained midwives or doctors.

We also introduced immunisation to help overcome the morbidity and mortality of our children related to vaccine preventable diseases. In fact immunisation has been well regarded as the second most successful public health intervention after sanitation that has helped save countless life, not only in Malaysia but also throughout the world. For many years our immunisation coverage has been said to be excellent, reaching more than 95%. But of late, the number of mothers and parents that refused to vaccinate their children has started to increase. This is truly concerning. We often hear about anti-vaccine group and we are all aware these groups influence other parents through social media.

For the good and the worse, the public including parents are getting information at their fingertips. News spread within seconds like wildfire. Unfortunately there are many false information placed on the social media and our mother/parents/communities are getting the wrong information and can be misguided by netizens that misuse the social media. Surely there are other causes of infection outbreaks such as diphtheria and measles. However it is rather evident that this anti-vaccine movement has contributed largely to this sad and gruesome outcome: the re-emergence of vaccine preventable diseases which we previously only heard in medical text books.

We really need to win this battle again. Primary care whether in public and private, need to work harder and empower the community especially young parents with the correct knowledge and information. Our voice has to be louder than those abusing the social media and mislead our community. We have to be proactive and persistent in empowering knowledge via the social media. Recently I helped launch a Facebook page called the Medical Mythbusters Malaysia which was created by our fellow doctors, pharmacist and paramedics. Their aim was to help empowering the public with correct information in a professional manner and to literally “bust the myth” related to health issues. This is certainly not the only way to address this issue, but surely can help to guide the public to the right path of living healthily. Of course, there are certainly many other areas that we have to look into to comprehensively and effectively address this issue.

On the other hand, we are still challenged with the HIV infections in this country. I am glad that we have managed to reduce HIV infection rate by half, falling from 21.8 per 100,000 in the year 2000 to 10.9 per 100,000 population in the year 2009. Primary healthcare had contributed largely in this reduction through its harm reduction program (methadone therapy, needle exchange, Prevention of Maternal to Child Transmission program) and access to treatment of HIV drugs at primary care clinics with Family Medicine Specialist services. Even though we have made impressive progress on some of the areas in combating HIV infections, there are now new challenges in this area whereby we are noticing a change in the epidemiological demography of HIV infections. The mode of transmission of HIV among the newly diagnosed HIV patients has shifted from needle sharing for among Intravenous Drug Users (IVDU) to sexual transmission. In 2010, the percentage of mode of transmission between IVDU and sexual transmission was almost equal. However in 2014, 78% of the HIV transmission were from sexual activities, whereby 28.3% were due to homosexuality practice. This is indeed a very concerning finding, and it requires multidisciplinary effort to address this holistically.

Through National Strategic Plan Ending AIDS (NSPEA) 2016-2030, we aspire to achieve the 95-95-95 target, of which:

• 95% of key populations tested for HIV and know their results,
• 95% of people infected with HIV placed on Anti-Retroviral Therapy (ART), and
• 95% of these adhering to treatment with suppressed viral load.

The commitment includes reaching 90% of the key populations with effective prevention. Primary care initiatives are important in the overall plan to achieve this.

What I have mentioned here are just some of the examples of the progress that we have made and some of the challenges that are being encountered in the primary care system of Malaysia. Definitely this system can be further strengthened by effective public-private partnership as private clinics certainly served a significant portion of the primary care health facilities in the community. It is important for the private primary health care providers to also update themselves in the recent advances of medical management. I hope conferences like this can be utilised to address the gap between private and public practitioners. Here, the private practitioners can join the public Family Medicine Specialist and practitioners to communicate, build bond, establish rapport and collaborate to form cohesion in working together as a nation for better health.

Apart from updating the participants with latest and new information on medical knowledge, it is hoped that this conference serves as a platform to share research and studies done at individual localities. I certainly am pleased to see more research has been done at our MOH clinics, and would encourage all of you to publish your good work in local, regional and international journals so that the works done in the primary care are made visible.

I would like to congratulate Family Medicine Specialist in Selangor, Family Medicine Specialist Association and the Selangor State Health Department for their hard work in organising this event. I hope all of you will take this golden opportunity here to garner knowledge via the organised scientific programme and talks given by distinct international and local speakers. Hopefully this conference will be able to boost your motivation to strive further in improving the primary healthcare system in this country. May all the objectives be achieved and to all the participants have a fruitful conference.

Thank you.

Untuk tempoh tiga minggu kebelakangan ini, tren Demam Denggi di seluruh negara menunjukkan penurunan kes. Pada minggu ke-31 (iaitu dari 31 Julai hingga 6 Ogos 2016) kes Demam Denggi di seluruh negara berkurangan sebanyak 4.1% iaitu 1,819 kes berbanding 1,896 kes pada minggu sebelumnya dan tiada kematian yang dilaporkan. Walau bagaimanapun, terdapat lapan (8) buah negeri yang menunjukkan peningkatan kes berbanding minggu sebelumnya iaitu Pahang 32 kes (59.3%), Kelantan 18 kes (8.3%), Perak 13 kes (30.2%), Pulau Pinang 8 kes (47.1%), Terengganu 4 kes (30.8%), Perlis 3 kes (150.0%), Kedah 3 kes (18.8%) dan WP Labuan 2 kes.

Secara kumulatif dari Januari hingga 6 Ogos 2016, jumlah kes Demam Denggi adalah sebanyak 67,437 kes, berbanding 73,263 kes bagi tempoh yang sama tahun 2015, iaitu penurunan sebanyak 8.0% (5,826 kes). Manakala bagi jumlah kumulatif kematian Denggi dari Januari sehingga 6 Ogos 2016 pula, sebanyak 147 kematian telah dilaporkan berbanding 201 kematian bagi tempoh sama tahun 2015, iaitu pengurangan sebanyak 26.9% (54 kematian).

Hasil pemantauan Kementerian Kesihatan Malaysia (KKM) juga mendapati penurunan lokaliti wabak pada minggu ke-31 berbanding minggu sebelumnya iaitu daripada 755 lokaliti pada minggu ke-30 kepada 661 lokaliti pada minggu ke-31. Manakala, jumlah lokaliti hotspot juga didapati berkurangan daripada 93 lokaliti pada minggu sebelumnya kepada 85 lokaliti pada minggu ke-31. Lokaliti hotspot ini melibatkan enam (6) buah negeri iaitu di Selangor (74), Johor (6), Perak (2) dan masing-masing satu (1) lokaliti di WP Kuala Lumpur & Putrajaya, Kelantan dan Sabah.

Negeri Selangor tetap menunjukkan bilangan hotspot yang tinggi setiap minggu. Antara faktor penyumbang adalah peningkatan dari segi kepadatan penduduk, tapak binaan, pembuangan sampah tidak terurus dan bangunan bertingkat. Dalam satu kajian yang dilakukan oleh Farah Amirah et al 2016 untuk melihat profil nyamuk Aedes di bangunan bertingkat di negeri Selangor, didapati indeks ovitrap yang agak tinggi di pangsapuri (16.7%) berbanding apartmen (6.1%). Antara penemuan penting hasil kajian tersebut adalah keadaan sanitasi dan kebersihan pangsapuri yang tidak memuaskan kerana terdapat banyak bekas-bekas domestik seperti baldi, pasu dan mangkuk plastik selain sampah yang dibuang di atas bumbung bangunan oleh penduduk setempat yang tidak bertanggungjawab. Di samping itu, kajian tersebut juga mendapati air bertakung di koridor dan parit selepas hujan yang menyumbang kepada tempat pembiakan nyamuk Aedes.

Sehubungan itu, bagi mengatasi masalah peningkatan kes Demam Denggi, komuniti setempat perlu memainkan peranan untuk melakukan aktiviti gotong-royong untuk membersihkan kawasan tempat tinggal mereka secara berkala. Bahan pembunuh jentik boleh digunakan pada tempat air bertakung seperti di parit dan koridor. Bagi bangunan bertingkat, pihak pengurusan bangunan hendaklah memastikan penyelenggaraan pengurusan sampah dilakukan secara berkala untuk mengekalkan persekitaran bersih.

Mengenai situasi terkini penyakit Zika yang telah dikemas kini oleh Pertubuhan Kesihatan Sedunia (WHO) pada 4 Ogos 2016, terdapat sebanyak 68 buah negara yang terlibat. Survelan berterusan untuk mengesan jangkitan Zika masih dilakukan oleh Makmal Kesihatan Awam Kebangsaan (MKAK) dan juga Institut Penyelidikan Perubatan (IMR). Dari Jun 2015 sehingga 6 Ogos 2016 sebanyak 672 sampel telah diuji dan tiada jangkitan virus Zika yang dikesan setakat ini. Selain itu, saringan pelawat di Pintu Masuk Antarabangsa (PMA) masih diteruskan dan setakat ini tiada pelawat yang disyaki dijangkiti virus Zika tersebut.

DATUK DR. NOOR HISHAM ABDULLAH
Ketua Pengarah Kesihatan
Kementerian Kesihatan Malaysia
12 Ogos 2016

Beberapa hari yang lalu telah timbul kenyataan bahawa ubat terbaik untuk bebas daripada penyakit kencing manis (diabetes) adalah dengan mengambil biji buah rambutan. Berdasarkan semakan rujukan ilmiah, tiada rujukan didapati menyatakan kegunaan tradisional atau perubatan biji rambutan (N. lappaceum) untuk sebarang rawatan termasuk penyakit kencing manis. Biji rambutan dikatakan mempunyai kandungan lemak (saponin) yang tinggi dan bahan ini adalah dikatakan toksik kepada manusia.

Kajian yang menyeluruh iaitu kajian praklinikal dan klinikal perlu dijalankan sebelum sesuatu bahan berasaskan herba dapat membuat sebarang tuntutan perubatan dan keselamatan bahan tersebut adalah terjamin. Oleh kerana tiada kajian keselamatan/klinikal yang menyeluruh dijalankan untuk menyokong tuntutan dan keselamatan pengambilan biji rambutan, pengguna adalah digalakkan untuk mendapat khidmat nasihat daripada pegawai farmasi atau pegawai perubatan sebelum mengambil sebarang bahan/produk berasaskan biji rambutan.

Sehingga kini juga, Pihak Berkuasa Kawalan Dadah (PBKD), KKM belum pernah mendaftar produk dengan bahan aktif biji rambutan (Nephelium lappaceum). Sesiapa yang ingin menjual/membekalkan produkproduk dengan tuntutan kesihatan seperti ini adalah dinasihatkan untuk mendaftarkan produk tersebut dengan menghantar permohonan kepada Agensi Regulatori Farmasi Negara (NPRA) yang merupakan sebuah agensi di bawah KKM yang dipertanggungjawabkan untuk mengawalselia semua produk farmaseutikal termasuk produk tradisional di Malaysia. Permohonan tersebut perlulah lengkap dengan maklumat yang menyokong keselamatan dan kualiti produk mengikut keperluan seperti yang tertera di dalam Garis Panduan Pendaftaran Produk (Drug Registration Guidance Document) yang boleh didapati dari laman sesawang http://www.npra.moh.gov.my. Secara umumnya produk-produk tersebut akan dinilai dan mesti mematuhi kriteria kualiti, keselamatan dan efikasi sebelum didaftarkan.

KKM memberi amaran bahawa memiliki, menjual atau membekal produk tidak berdaftar adalah merupakan satu kesalahan di bawah Akta Jualan Dadah 1952 dan Peraturan-Peraturan Kawalan Dadah dan Kosmetik 1984 dan jika disabitkan kesalahan individu boleh dikenakan denda sehingga RM25,000 atau penjara sehingga 3 tahun untuk kesalahan pertama atau denda sehingga RM50,000 atau penjara sehingga 5 tahun untuk kesalahan kedua dan berikutnya. Jika kesalahan dilakukan oleh syarikat, jika disabitkan kesalahan syarikat boleh didenda sehingga RM50,000 untuk kesalahan pertama atau denda sehingga RM100,000 untuk kesalahan kedua dan berikutnya.

Masyarakat juga dinasihatkan untuk memastikan terlebih dahulu kesahihan maklumat atau tuntutan perubatan sesuatu bahan, makanan, produk atau peralatan sebelum menyebarkan maklumat kepada orang lain.

Sekian, terima kasih.

DATUK DR. NOOR HISHAM ABDULLAH
Ketua Pengarah Kesihatan Malaysia
15 Ogos 2016

Kementerian Kesihatan mengambil maklum laporan oleh akhbar Kosmo  pada 15 Ogos 2016 di mukasurat 3 bertajuk “Lambakan madu palsu, sintetik” dan pada 16 Ogos 2016 di mukasurat 2 bertajuk “Kandungan toksik bawa maut“. Laporan tersebut menyatakan bahawa 80% madu yang dijual di negara ini merupakan madu palsu berdasarkan kandungan hydroxymethyl fulfural (HMF) yang terlalu tinggi dan aktiviti enzim yang kurang daripada paras yang ditetapkan oleh standard antarabangsa. Madu palsu ini didakwa boleh mengundang pelbagai penyakit dalam jangka masa panjang.

Kementerian Kesihatan ingin menjelaskan bahawa kandungan HMF merupakan indikator kualiti madu dan kandungannya akan meningkat apabila suhu meningkat dan tempoh penyimpanan bertambah. Menurut The Federal Institute for Risk Assessment (BfR), Jerman, HMF tidak memberikan kesan toksik kepada kesihatan manusia.

Peraturan 130, Peraturan-Peraturan Makanan 1985 di bawah Akta Makanan 1983 menetapkan standard bagi madu. Kegagalan mematuhi peraturan tersebut adalah satu kesalahan dan jika sabit kesalahan, boleh didenda tidak melebihi RM5,000 atau dipenjara tidak melebihi tempoh dua (2) tahun.

Kementerian Kesihatan telah menjalankan pemantauan ke atas madu tempatan di peringkat pemprosesan dan sehingga kini, hasil pemantauan menunjukkan bahawa satu (1) sampel tidak mematuhi standard yang ditetapkan di bawah Peraturan 130, Peraturan-Peraturan Makanan 1985. Kementerian Kesihatan akan meneruskan pemantauan bagi memastikan madu yang dijual di pasaran adalah tulen.

Selain itu, Kementerian Kesihatan telah memperkenalkan Skim Pensijilan Makanan Autentik bagi madu mulai 19 Januari 2016. Pengeluar madu adalah digalakkan untuk menyertai skim ini. Maklumat lanjut mengenai skim tersebut boleh didapati di laman sesawang Bahagian Keselamatan dan Kualiti Makanan http://fsq.moh.gov.my .

Kementerian Kesihatan menasihatkan orang ramai agar membuat  aduan mengenai penjualan madu yang disyaki palsu di Jabatan Kesihatan Negeri atau  Pejabat Kesihatan Daerah yang terdekat atau melalui laman web http://moh.spab.gov.my atau Facebook Bahagian Keselamatan dan Kualiti Makanan www.facebook.com/bkkmhq.

DATUK DR. NOOR HISHAM ABDULLAH

KETUA PENGARAH KESIHATAN

KEMENTERIAN KESIHATAN MALAYSIA

17 Ogos 2016

The 2nd Telemedicine Conference 2016, 16-18 August 2016 with the theme “Shaping Tomorrow’s Healthcare Today” was held at Swan Convention Centre, Sunway Medical Centre. It was well attended by almost various stakeholders and key players of Information and Communications Technology (ICT) industry, as well as relevant ministries/agencies.

Today, I am indeed very delighted to be here again to officiate the second telemedicine conference. Congratulations to the Organising Committee. The conference theme of Shaping Tomorrow’s Healthcare Today, offers a more pragmatic approach to discuss and address key issues on the ground to help propel Malaysia into the information technology age. I am very pleased to note the significant progress made since the last conference which I would like to share with the audience today.

In the conference last year, I spoke of Malaysia’s vision of an equitable health care for all Malaysians. I spoke of our aspiration for Malaysia to be a nation of healthy individuals, families and communities through a robust health system, which is equitable, affordable, efficient, technologically appropriate, environmentally adaptable and consumer friendly. It should emphasize on quality, innovation, health promotion, respect for human dignity and community participation towards an enhanced quality of life. Integration of public and private healthcare deliveries is also very much required to optimise healthcare resources for more choices and availability of providers in a multidisciplinary teams approach and for better quality of care. In short, a healthcare that is affordable, available, accessible, and more importantly sustainable.

This simplistic vision is in reality a hugely complex and challenging undertaking and beyond any individual or agency. I emphasised this too during the conference last year, that there is a need for all of us to come together to realise this vision. The various healthcare sectors from the industry, the researcher, innovators, the academics to the policy makers, regulators and service providers should not work in their individual silo. Each stakeholder has its strengths and shortcomings, and there are considerable overlap among the stakeholders.

By coming together, not only we avoid duplication, we could also unlock the synergy between us. We could achieve more if we could collaborate to combine and coordinate our individual effort. That was the aims of our conference last year, to bring together key stakeholders namely policy makers, industries, academia, medical practitioners and the medical providers to deliberate, discuss and collaborate on key issues and challenges faced by the field of telemedicine. I am happy to note that this was achieved successfully. There are increased stakeholder participation in this year conference. In addition, some of the existing stakeholders have also increased their involvement.

Ladies and Gentlemen

Following the conference last year, we had several meetings to put this vision into action. After much discussion and deliberation, we conclude that the healthcare scene in Malaysia is complex and pluralistic. To be effective, a collaborative approach will be more engaging and a unified and centralised ecosystem to support this vision will indeed align very well with the government’s effort to elevate our economy into a knowledge economy. I am therefore very pleased to announce to the audience today that we have set in motion a telemedicine development group, TDG in short, for the country.

The primary aim of TDG is to form and nature an ecosystem with multi stakeholders’ collaboration to support development, research and innovation of telemedicine / telehealth initiatives in Malaysia.  I have agreed to accept the invitation to chair this group and invite all stakeholders to join me to realise this vision. TDG will be inclusive and not exclusive. We promote active participation from all stakeholders. I emphasise the need for an active public-private partnership where I envisage the industry to help innovate ICT solutions in healthcare.

The MOH with its stables of hospitals and health clinics will follow up to evaluate these products or application with clinical and solutions trials; and other agencies providing financial solution and supports where appropriate. We have in fact started on this journey already. We hope to be able to engage our industry partners like Stethee and Hypoband to name a few, in some of our healthcare transformation programme which MOH will embark. We also expected to encounter legislative and regulatory issues in our endeavour and will look to our partnering regulators and policy makers for guidance.

TDG will also participate and collaborate in other national initiatives. The National Internet of Things (IoT) strategic roadmap launched in July 2015 has also been focusing on healthcare as one of its iconic project, with CREST leading its implementation. TDG will be an active participant in this initiative.

Ladies and Gentlemen

I have always advocated a patient-centered approach in my patient care. The days of a paternalistic approach to patient care are numbered. Patient’s welfare should be utmost priority in our mind. This could also be an important approach in the era of digitalisation. What I mean here is the patient’s medical data. Doctor hopping is a norm in many countries including Malaysia and this resulted in data scattering which is a huge problem as sharing is not a common practice among medical practitioners.

However, the scene is changing. With a health financing scheme, all medical practitioners will be compelled legally to provide and share the medical data of their patients. Consequently, we need only to overcome the technology hurdle in medical data sharing. Centralisation of data is also being strategized nationally in MOH for the coming years with the Lifetime Health Record project and Malaysia Health Data Warehouse. Both would have portals for the consumer or patients. I understand that there are projects among the academics to research into Patient Centred Electronic Record or PACER in adult and in children. This bottom-up approach focus on the patient owning and managing the data. I am therefore hopeful that this approach will be successful.

One may ask if our patients are ready. I think some are.

A survey by Dr Wong’s team in this hospital shows that the majority, 75%, of patients attending Sunway Medical Centre received tertiary education (75.74%) and working at the administrative and executive levels. This surveyed also shows that many owned more than one smart device (>100%) and the technology literacy is high among those surveyed. 70-75% were comfortable with wireless communication and searching for information online.

I am also pleasantly surprised to note the position acceptance of incorporating telemedicine in healthcare. More than half of the patients surveyed (55.14%) were comfortable with healthcare professionals monitoring their health through mobile health devices.

This cohort survey is however not representative of the Malaysia population. We have to make sure that the rural folks and remote communities are not marginalized in our quest for digitalization. More education is required to educate the public on the effectiveness and safety of telemedicine, and it is important that the infrastructure and coverage are in place.

The TDG similarly conducted a survey of undergraduate students in health care related courses. This cohort is likely to be future providers of telemedicine / telehealth services and I understand that some of them are here today, sponsored by TDG and Clinical Research Centre of MOH.

Besides all owning a smart phone, majority (75%) also wear a fitness band or smart watch. Most (> 65%) are in favour of bringing smart, convenient & affordable health care to the home and are comfortable with using applications and services such as Doctor on the Go and Book Doc.  Many also indicated their interest to develop system/application in their respective field of interest. Majority (92%) are also aware of the barriers or challenges in implementing Telehealth and the ethical issues relating to telemedicine / telehealth.

Both surveys suggest that the many end users are ready and it is up to the industry to bridge the technology and infrastructure gap in order to implement nationwide telemedicine / telehealth initiatives.

Ladies and gentlemen,

Now, moving on from telehealth to health issues challenges globally, the unfinished agenda of Millennium Development Goals (MDGs) and the public health issues of acute epidemic diseases, escalating epidemic of non-communicable diseases, mental health disorders, conflicts and inequalities in all parts of the world are among of the notable important issues that need to be strategically addressed. The MDGs were about a set of human development targets up to 2015, set by the United Nation (UN) for its member countries. The UN’s new Sustainable Development Goals (SDGs) which came into effect this year to 2030 has broader and more ambitious goals. The SDGs cover the economic, environmental and social pillars of sustainable development with a strong focus on equity.

Out of 17 goals, the 3^rd goal specifically devoted to health is to “Ensure healthy lives and promote well-being for all, at all ages”. However, all other goals have direct or indirect effect on health; thus all sector is health sector.  Monitoring these goals in itself will be a challenge and opportunity to all countries. Alignment of funding and technical support for a strong health information system are essential. We need standards, tools and repository of information. We need to strengthen country systems for monitoring programmes and accountability, and, better reporting national and global progress on SDG. Hence information communication and technology play a vital role, more so now than ever.

The SDGs has strong emphasis on universal health coverage and access to quality health care. This place Universal Health Coverage (UHC) as the target that underpins and is key to achievement to all the other health targets.

To this note, it is crucial to transform the Malaysian health system to serve the people better and to ensure improved health outcomes for the population. Besides the strategies we have included in the 5-year Malaysia Plans, we are currently planning the health system reform holistically by restructuring the services delivery, organisation and financing mechanism of the health system. As I have mentioned in this same conference last year of our engagement with Harvard School of Public Health for Malaysia Health System Research, we have completed the phase 1 findings. The Ministry have started the roadshow of this findings. Now we are in the midst of designing strategic transformation options for the country. These options will have to ensure social justice, appropriate care, fair financing and financial protection for its citizen. The health transformation is to develop a sustainable health system which addresses the needs of Malaysia, now and in the future.

In transforming the health sector, we will need to innovate. We will have to move away from the normative approach and embrace a new model. And we must do this by taking into account local and historical perspectives, while preserving the strengths of the current system. Leaders, in public and private sectors that shape the health system; must come together to collaboratively design the reforms with the above values. There is a need to enhance smart-partnership that aims on a win-win arrangement, among agencies in government, private and NGOs, resting on a mutual understanding and shared-benefit. The use of available health resources in the public and private sectors should be optimised by strengthening the collaborative mechanisms. And I see the TDG as one of the important platform in moving towards health reform.

Distinguished Guest, Ladies and Gentleman

Finally, immerse yourself in this 3-day event to learn and share your experiences and knowledge, and network with your fellow participants. Let this be the platform to cross-fertilise ideas and create a potpourri of solutions in Malaysian Telemedicine with focus on mobile health (mHealth), Big Data and Internet of Things (IoT).  Specifically, the conference has introduced the “From Idea to Product” session on the 3^rd day to bring together the entrepreneurs, start-ups and ecosystem builders for the benefits of those who like to translate their dreams and novel ideas into leading edge healthcare solutions. The panel will share their respective experiences and offerings on how anyone could play in this innovation sandbox and progress systematically toward successful health innovation is a brilliant idea. This session will definitely be helpful for the Telemedicine Innovation Challenge participants, perhaps as the next step in their innovation journey. I must congratulate the TIC participants for taking the courage and passion to work relentlessly since March 2016 and translate their creative ideas into working prototypes to be showcased and judged today. This clearly demonstrates how the creative and inventive minds of Malaysians are able to rise to the occasion and innovate leading edge healthcare solutions.

Once again, I congratulate the organising committee for its visionary approach and I am very pleased indeed to note that my colleagues in other relevant agencies share my view and are participating in this conference as well.

Last but not least, let’s envisioned Malaysia’s Future Health System with a restructured integrated health system that is responsive and provides choice of quality health care, expanding universal coverage for the health care needs of the population based on solidarity and equity. Let us all, as a nation work together for better health.

I wish you all a successful conference and hope this annual conference will continue.

Thank you.

The Asian and Oceanian Association of Neurology (AOAN) was established on the 26^th of June 1961, initially with 9 member countries which has since then grown to 20 member countries currently. The main objectives of the AOAN are to promote and foster the advancement, exchange and diffusion of information and ideas relating to the nervous system, as well as encourage scientific research in neurological problems, on an international scale. The Asian and Oceanian Congress of Neurology (AOCN) has been held biennially since 2012. At the 15^th AOCN in Kuala Lumpur, with a theme of “Advanced Education in Neurology in the Asian-Oceanian Region”, delegates can look forward to receiving unparalleled and powerful insights of the latest research, developments and treatments in the field of neurology and other important subspecialties including Multiple Sclerosis (MS). This year, the AOCN serves as a platform for the launch of the Malaysian Clinical Practice Guidelines (CPG) on the Management of Multiple Sclerosis, which is also the first CPG on MS in the South-East Asian region.

MS is an immune-mediated, inflammatory demyelinating disease. It affects mainly young women between the ages of 20 and 40 years, and is characterised by recurrent attacks on the nerves of the eyes, brain and spinal cord by cells of the immune system. Most patients have a relapsing-remitting course in which recurrent attacks on the central nervous system lead to temporary dysfunction such as visual problems, weakness in the legs, and bowel and bladder problems, without leaving the patients with much neurological deficits. However over time, these attacks fail to recover completely and the patients are left with increasing disabilities leading to a more progressive type of disease.

In Malaysia, this disease is still quite uncommon compared to other neurological conditions. Based on recent data from the Ministry of Health (MoH), the MS prevalence has increased to 3.23 per 100,000 with females predominantly being affected and all races at risk of the disease. The exact cause is still undergoing much research worldwide but it is hypothesised to be related to a combination of genetic and environmental factors. It is important to diagnose the disease accurately and early while ruling out other diseases that may mimic it such as neuromyelitis optica spectrum disorders (NMOSD).  Early diagnosis and initiation of appropriate treatment has been found to make a difference in the overall outcome of this disease by reducing the number of attacks, and delaying the progression and disability related to it.

Treatment involves managing the acute attacks with steroids and preventive treatments with disease-modifying treatments early in the disease. When treating patients with MS, it is important to use a multidisciplinary approach which incorporates physiotherapy, occupational therapy, psychiatric counselling and intervention as well as rehabilitation to manage the symptomatology of MS.

MoH Malaysia is aware of the advances in diagnostic methods and new treatment modalities available for MS. The development of the first edition of the CPG on the Management of MS is in line with the ministry’s efforts to improve early and accurate diagnosis and the management of this disease. The evidence-based CPG has been developed by a multidisciplinary team from MoH, Ministry of Higher Education, the Malaysian Society of Neurosciences and the private healthcare sector. These guidelines provide recommendations on the diagnosis of MS, its diagnostic tools and treatment options available currently in the country. Implementation strategies such as a quick reference and training modules have also been developed to improve the utilisation of the CPG.

Thank you.

DATUK DR. NOOR HISHAM ABDULLAH

Director General of Health Malaysia

Ministry of Health Malaysia

19 August 2016

Kementerian Kesihatan Malaysia (KKM) ingin memaklumkan bahawa selaras dengan keperluan Peraturan-peraturan Kesihatan Antarabangsa  (International Health Regulations) 2005 dan Akta Pencegahan dan Pengawalan Penyakit Berjangkit 1988, Malaysia melaksanakan pemantauan ke atas pelawat-pelawat yang tiba dari negara yang berisiko mengalami transmisi Demam kuning (Yellow fever). Sehingga kini terdapat sebanyak 42 buah negara yang disenaraikan oleh pihak World Health Organisation (WHO) iaitu 13 buah negara di Amerika Selatan dan Tengah manakala 29 negara di Afrika.  Brazil merupakan salah sebuah negara yang disenaraikan oleh pihak WHO sebagai sebuah negara yang berisiko mengalami transmisi Demam kuning.

Satu taklimat mengenai Demam kuning dan keperluan suntikan vaksinasi Demam kuning serta berkaitan penyakit Zika virus telah diberikan di Institut Sukan Negara pada 29 Jun 2016 kepada semua pegawai dan atlit kontinjen Olimpik Malaysia. Taklimat ini diberikan untuk memastikan semua atlit dan pegawai yang terlibat dalam Sukan Olimpik Rio Brazil mengambil vaksin Demam kuning selewatnya 10 hari sebelum berlepas ke Rio Brazil.

Selain itu, KKM juga melaksanakan beberapa langkah ketat dalam usaha untuk mencegah kemasukan penyakit Demam kuning ke dalam Negara bagi mengekalkan status Malaysia sebagai Negara tiada kes Demam kuning. Di antaranya adalah, seseorang pelawat warganegara asing atau waraganegara Malaysia yang tiba dari atau pernah melawat negara yang tersenarai sebagai berisiko mengalami transmisi Demam kuning dikehendaki mengemukakan sijil vaksinasi antarabangsa Demam kuning yang sah. Vaksinasi Demam kuning juga diperlukan bagi mereka yang transit melebihi 12 jam melalui pintu masuk udara negara yang mengalami risiko transmisi Demam kuning. Kegagalan mematuhi keperluan Kesihatan ini boleh menyebabkan pengembara dikuarantin di pusat kuarantin kesihatan untuk tempoh tidak melebihi enam (6) hari sebelum dibenarkan memasuki Malaysia. Keperluan kesihatan ini dikuatkuasakan ke atas semua warganegara asing dan warganegara Malaysia yang tiba dari atau pernah melawat negara risiko tinggi tersebut, termasuklah Brazil.

Bermula dari 12 Ogos 2016 sehingga 21 Ogos 2016, seramai 37 orang yang tiba dari Brazil telah disaring di Lapangan Terbang Antarabangsa Kuala Lumpur (KLIA) (36 penumpang) dan Pulau Pinang (seorang penumpang). Namun begitu terdapat empat (4) orang yang didapati tidak mematuhi keperluan vaksinasi Demam kuning dan diletakkan di bawah prosedur kuarantin untuk tujuan pemantauan sebelum dibenarkan memasuki Malaysia. Ke-empat-empat mereka didapati berada dalam keadaan sihat. Namun, ke-empat-empat mereka telah memilih untuk pergi ke negara lain sebelum dibenarkan memasuki Malaysia.

Demam kuning adalah penyakit berjangkit yang akut yang disebabkan oleh Arbovirus dari Genus Flavivirus dan keluarga Flaviviridae. Ia adalah penyakit bawaan vektor iaitu nyamuk aedes yang telah dijangkiti oleh virus tersebut. Demam kuning yang berlaku di bandar disebarkan oleh nyamuk kepada manusia. Manakala Demam kuning di hutan merebak dari nyamuk kepada monyet dan juga kepada manusia (zoonotic). Penyakit ini pada peringkat awal (fasa pertama) menunjukkan gejala seperti demam, badan menggigil (chills), sakit badan, sakit kepala, loya dan muntah. Sebanyak 15% (fasa kedua) akan menunjukkan gejala demam dengan jaundis, sakit bahagian abdomen, muntah dan perdarahan di mana sebanyak 50% dari mereka ini akan meninggal dunia. Dilaporkan sehingga sebanyak 85% kes menunjukkan gejala ringan atau tidak menunjukkan gejala. Tiada rawatan khusus untuk mengubatinya dan pengambilan vaksin Demam kuning merupakan salah satu langkah perlindungan yang amat penting dari mendapat jangkitan penyakit tersebut.

Sehingga kini tiada kes Demam kuning yang dilaporkan di Malaysia. Namun begitu, Malaysia mempunyai risiko transmisi jangkitan penyakit ini disebabkan terdapatnya vektor pembawa penyakit ini yang banyak iaitu nyamuk Aedes. Virus Demam kuning boleh dibawa masuk ke Malaysia melalui tetamu atau pelawat yang tiba dari negara-negara yang berisiko mengalami transmisi Demam kuning yang tidak mengambil vaksinasi Demam kuning dan dijangkiti penyakit ini.

Sehubungan itu, dimaklumkan KKM akan terus melaksanakan langkah-langkah pencegahan yang sewajarnya dalam usaha untuk mencegah kemasukan penyakit Demam kuning ke dalam Negara dan bagi mengekalkan status Malaysia sebagai Negara tiada kes Demam kuning, kerjasama semua pihak adalah amat diperlukan dalam mematuhi keperluan kesihatan ini demi kesihatan dan keselamatan negara. Maklumat lanjut berkaitan penyakit Demam kuning boleh diperolehi di laman sesawang KKM iaitu http://www.moh.gov.my atau facebook CPRC Kebangsaan KKM.

 Terima kasih.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan Malaysia  

22 Ogos 2016

Hasil pemantauan Kementerian Kesihatan Malaysia (KKM) mendapati walaupun terdapat tren penurunan kes Demam Denggi untuk tempoh tiga minggu bermula pada minggu ke-29, namun pada minggu ke-32 (iaitu dari 7 Ogos hingga 13 Ogos 2016) telah menunjukkan peningkatan kes sebanyak 7.9% iaitu 1,963 kes berbanding 1,819 kes pada minggu sebelumnya dan enam (6) kematian dilaporkan pada minggu lepas iaitu empat (4) daripadanya berlaku di Kelantan. Sebanyak tujuh (7) buah negeri yang menunjukkan peningkatan kes berbanding minggu sebelumnya iaitu Selangor 117 kes (13.7%), Kelantan 36 kes (15.3%), Negeri Sembilan 32 kes (128.0%), Johor 25 kes (21.2%), Melaka 21 kes (60.0%), Terengganu 7 kes (41.2%) dan Kedah 5 kes (26.3%). Secara kumulatif dari Januari hingga 13 Ogos 2016, jumlah kes Demam Denggi adalah sebanyak 69,400 kes, berbanding 75,795 kes bagi tempoh yang sama tahun 2015, iaitu penurunan sebanyak 8.4% (6,395 kes). Manakala sebanyak 153 kematian telah dilaporkan berbanding dengan 212 kematian bagi tempoh sama 2015.

Hasil pemantauan Kementerian Kesihatan Malaysia (KKM) juga mendapati penurunan lokaliti wabak pada minggu ke-32 berbanding minggu sebelumnya iaitu daripada 661 lokaliti pada minggu ke-31 kepada 635 lokaliti pada minggu ke-32. Namun begitu, jumlah lokaliti hotspot didapati meningkat daripada 85 lokaliti pada minggu sebelumnya kepada 90 lokaliti pada minggu ke-32. Lokaliti hotspot ini melibatkan tujuh (7) buah negeri iaitu di Selangor (72), Johor (6), Kelantan (5), WP Kuala Lumpur & Putrajaya (3), Perak (2) dan masing-masing satu (1) lokaliti di Negeri Sembilan dan Sabah.

Daripada pemantauan KKM, didapati berlaku perubahan serotype Denggi (serotype shift) pada bulan Jun 2016 iaitu perubahan serotype DEN-1 kepada DEN-3. Adalah dijangkakan akan berlaku peningkatan kes dalam tempoh beberapa bulan selepas perubahan serotype tersebut kerana ramai masyarakat tidak immun kepada serotype DEN-3. Bagi menghalang kejadian kes Denggi terus berleluasa, kebersihan persekitaran adalah menjadi keutamaan semua masyarakat. Ketiadaan tempat nyamuk untuk membiak boleh mengurangkan populasi nyamuk Aedes seterusnya mengurangkan penyebaran virus Denggi. Pihak Berkuasa Tempatan (PBT) juga dipohon untuk meningkatkan aktiviti pencegahan dan kawalan Denggi serta memastikan kutipan sampah dilakukan sekurang-kurangnya tiga kali seminggu di kawasan pengurusan mereka. Di samping itu, PBT juga hendaklah meningkatkan aktiviti pembersihan dan penguatkuasaan dilaksanakan terhadap pembuang sampah haram untuk membendung masalah pembiakan Aedes.

Mengenai situasi terkini penyakit Zika yang telah dikemas kini oleh Pertubuhan Kesihatan Sedunia (WHO) pada 11 Ogos 2016, terdapat sebanyak 69 buah negara yang melaporkan jangkitan Zika ketika ini. Survelan berterusan untuk mengesan jangkitan Zika masih dilakukan oleh Makmal Kesihatan Awam Kebangsaan (MKAK) dan juga Institut Penyelidikan Perubatan (IMR). Dari Jun 2015 sehingga 13 Ogos 2016 sebanyak 715 sampel telah diuji dan tiada jangkitan virus Zika yang dikesan setakat ini. Tiada pelawat yang disyaki dijangkiti virus Zika berdasarkan saringan yang dijalankan di Pintu Masuk Antarabangsa (PMA).

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan

Kementerian Kesihatan Malaysia

22 Ogos 2016

Kementerian Kesihatan Malaysia ingin memberi peringatan bahawa Kementerian pernah mengeluarkan satu kenyataan rasmi mengenai isu pengambilan Vaksin Homeopati pada 3 Disember 2015 seperti berikut:

PAUTAN KENYATAAN AKHBAR KETUA PENGARAH KESIHATAN MALAYSIA BERTARIKH 3 DISEMBER 2015

LIHAT VIDEO INI

Kementerian Kesihatan Malaysia (KKM) ingin memaklumkan bahawa Jabatan Kesihatan Negeri Selangor telah melaporkan satu (1) kes disahkan difteria. Kes merupakan seorang kanak-kanak warganegara berumur 3 tahun yang tidak pernah mendapat imunisasi difteria kerana keluarganya mengamalkan kaedah rawatan homeopati. Kanak-kanak ini mula mengalami demam, batuk dan muntah semenjak 13 Ogos 2016. Pesakit telah dibawa ke Hospital Sungai Buloh pada 18 Ogos 2016 kerana sesak nafas dan telah terus dimasukkan ke Unit Rawatan Rapi untuk rawatan dan pengawasan rapi. Ujian kultur swab tekak pesakit ini didapati positif bakteria Corynebacterium diphtheria. Pesakit telah menerima rawatan antitoksin dan kini masih diberi rawatan antibiotik.

Adalah dimaklumkan bahawa setakat ini kesemua empat belas (14) orang kontak pesakit tersebut adalah berada dalam keadaan sihat termasuk tiga (3) orang kontak yang tinggal serumah dengan pesakit dan sebelas (11) orang kontak lagi di rumah pengasuh. Status imunisasi kesemua 14 kontak ini adalah tidak lengkap. Pemantauan ke atas mereka masih diteruskan.

Sehingga hari ini, bilangan kes disahkan difteria di Malaysia meningkat kepada 27 kes termasuk 5 kematian; iaitu Kedah sembilan (9) kes dengan satu (1) kematian, Negeri Sembilan tujuh (7) kes dan tiada kematian, Sabah lima (5) kes dengan tiga (3) kematian, Melaka tiga (3) kes dengan satu (1) kematian, Pulau Pinang dua (2) kes dan tiada kematian dan Selangor satu (1) kes.

KKM ingin menegaskan bahawa istilah vaksin homeopati tidak diiktirafkan oleh badan-badan homeopati antarabangsa termasuklah Majlis Perubatan Homeopati Malaysia. Malah, badan-badan ini menyokong pemberian vaksin konvensional sebagai satu cara yang berkesan dan selamat bagi melindungi dari penyakit cegahan vaksin dan komplikasinya. Vaksin sedia ada telah terbukti keberkesanan dan keselamatannya melalui kajian saintifik berskala besar sebelum ia digunakan ke atas manusia.

LIHAT KENYATAAN AKHBAR KPK 3 DISEMBER 2015 MENGENAI ISU PENGAMBILAN “VAKSIN HOMEOPATI”

Justeru, ibubapa diseru untuk memastikan anak-anak di bawah umur 7 tahun diberikan imunisasi. Pastikan mereka mendapat imunisasi lengkap untuk keberkesanan optima bagi mengelakkan jangkitan penyakit cegahan vaksin dan komplikasinya.

Sekian, terima kasih.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan Malaysia

23 Ogos 2016

Tren Demam Denggi di seluruh negara menunjukkan peningkatan dalam tempoh dua (2) minggu yang lepas dengan purata kes mingguan sebanyak 1,900 hingga 2,000 kes. Pada minggu ke-33 (iaitu dari 14 Ogos hingga 20 Ogos 2016) terdapat peningkatan kes sebanyak 11.6% iaitu 2,190 kes berbanding 1,963 kes pada minggu sebelumnya. Selain itu, terdapat sembilan (9) kematian dilaporkan pada minggu lepas. Sebanyak lapan (8) buah negeri yang menunjukkan peningkatan kes berbanding minggu sebelumnya iaitu WP Kuala Lumpur & Putrajaya 88 kes (53.0%), Selangor 84 kes (8.7%), Kelantan 25 kes (9.2%), Perak 23 kes (52.3%), Johor 18 kes (12.6%), Pahang 17 kes (29.3%), Pulau Pinang 13 kes (81.3%) dan Terengganu 8 kes (33.3%). Secara kumulatif dari Januari hingga 20 Ogos 2016, jumlah kes Demam Denggi adalah sebanyak 71,590 kes, berbanding 78,245 kes bagi tempoh yang sama tahun 2015, iaitu penurunan sebanyak 8.5% (6,655 kes). Manakala sebanyak 162 kematian telah dilaporkan berbanding dengan 216 kematian bagi tempoh sama 2015 iaitu penurunan sebanyak 25%.

Hasil pemantauan Kementerian Kesihatan Malaysia (KKM) mendapati peningkatan lokaliti wabak dan hotspot pada minggu ke-33 berbanding minggu sebelumnya. Lokaliti wabak didapati meningkat daripada 635 lokaliti kepada 698 lokaliti, manakala hotspot juga meningkat daripada 90 lokaliti kepada 91 lokaliti.

Secara keseluruhannya tren Demam Denggi pada tahun ini masih menunjukkan corak yang sama seperti tahun lepas yang mana kes meningkat secara perlahan dari pertengahan tahun dan akan memuncak pada akhir tahun. Tambahan pula, terdapat perubahan pada serotype Denggi yang dikesan bermula dari bulan Jun 2016 iaitu DEN-1 kepada DEN-3 yang turut dijangka menyumbang kepada peningkatan kes Demam Denggi dalam beberapa bulan yang akan datang.

Oleh itu, untuk membendung peningkatan kes Demam Denggi ini tindakan bersepadu dalam mencegah dan mengawal Denggi daripada pelbagai agensi perlu dilaksanakan dan difokuskan di tempat-tempat berisiko seperti projek perumahan terbengkalai, tapak bina dan tanah lot kosong. Selain itu, aktiviti penguatkuasaan perlu dijalankan sekurang-kurangnya sebulan sekali oleh agensi-agensi terlibat seperti Kementerian Kesihatan Malaysia (KKM), Pihak Berkuasa Tempatan (PBT), Lembaga Pembangunan Industri Pembinaan Malaysia (CIDB) dan Jabatan Keselamatan dan Kesihatan Pekerjaan (DOSH).

KKM turut menyarankan agar pihak pemaju dan kontraktor tapak bina memainkan peranan aktif dalam pencegahan Demam Denggi dengan mewujudkan program Communication for Behavioural Impact (COMBI). Sekiranya ada pemaju dan kontraktor yang ingin melaksanakan program COMBI di tapak bina, maka boleh menghubungi Pejabat Kesihatan Daerah berhampiran untuk mendapatkan bantuan dan khidmat nasihat. Jabatan Kesihatan Negeri hendaklah memantau perlaksanaan program COMBI ini agar pembiakan Aedes dapat dikurangkan di tapak bina tersebut.

Menurut laporan situasi terkini penyakit Zika oleh Pertubuhan Kesihatan Sedunia (WHO) yang dikeluarkan pada 18 Ogos 2016, terdapat sebanyak 70 buah negara yang melaporkan jangkitan Zika ketika ini. Bagi situasi di Malaysia, tiada jangkitan virus Zika yang dikesan setakat ini berdasarkan 752 sampel darah telah diuji dari Jun 2015 sehingga 20 Ogos 2016 oleh Makmal Kesihatan Awam Kebangsaan (MKAK) dan juga Institut Penyelidikan Perubatan (IMR). Selain itu, tiada pelawat yang disyaki dijangkiti virus Zika hasil saringan yang dijalankan di Pintu Masuk Antarabangsa (PMA).

DATUK DR. NOOR HISHAM ABDULLAH 

Ketua Pengarah Kesihatan

Kementerian Kesihatan Malaysia

26 Ogos 2016

Kementerian Kesihatan Malaysia (KKM) ingin memaklumkan bahawa pada 25 Ogos 2016, Jabatan Kesihatan Negeri Perak telah melaporkan satu (1) kes disahkan difteria. Kes melibatkan seorang kanak-kanak perempuan berumur 4 tahun warganegara Malaysia mula mengalami demam, batuk dan sakit tekak sejak 12 Ogos 2016. Pesakit yang masih mengalami gejala tersebut telah dibawa mendapatkan rawatan pada 17 Ogos 2016 dan telah dimasukkan ke wad Hospital Taiping. Pesakit ini telah dirawat sebagai exudative tonsillitis. Ujian kultur swab tekak kes ini didapati positif bakteria Corynebacterium diphtheria.

Kanak-kanak ini hanya mengalami gejala yang ringan tanpa komplikasi kerana beliau telah mendapat imunisasi difteria yang lengkap. Kanak-kanak ini hanya diberikan rawatan antibiotik dan tanpa rawatan antitoksin dan kini beransur sembuh.

Tujuh (7) orang kontak yang tinggal serumah dengan kes berada dalam keadaan sihat dan telah diberi rawatan profilaksis. Tiga (3) adik-beradik kes yang tinggal serumah telah menerima imunisasi difteria yang lengkap, sementara status imunisasi empat (4) yang lain termasuk ibubapa masih dalam siasatan. Kontak di kalangan keluarga yang tinggal berdekatan juga adalah sihat dan telah diberi rawatan profilaksis. Sebanyak 23 sampel swab tekak telah diambil dari kontak serumah dan keluarga yang tinggal berdekatan untuk ujian makmal.

Sebanyak dua (2) daripada 38 kontak di tabika KEMAS di mana kes belajar, ada mengalami batuk ringan dan telah diisolasi secara sukarela di rumah. Mereka dipantau oleh anggota kesihatan. Sampel swab tekak kedua-dua kanak-kanak ini juga telah diambil untuk ujian makmal. Guru, pekerja dan kanak-kanak lain di tabika adalah sihat dan tiada sebarang gejala jangkitan. Seorang (1) kontak di tabika cicir imunisasi dan telah dirujuk kepada klinik kesihatan. Pemantauan ke atas semua kontak masih diteruskan.

Sehingga hari ini, bilangan kes disahkan difteria di Malaysia meningkat kepada 28 kes termasuk 5 kematian; iaitu Kedah sembilan (9) kes dengan satu (1) kematian, Negeri Sembilan tujuh (7) kes dan tiada kematian, Sabah lima (5) kes dengan tiga (3) kematian, Melaka tiga (3) kes dengan satu (1) kematian, Pulau Pinang dua (2) kes dan tiada kematian, Selangor dan Perak masing-masing satu (1) kes dan tiada kematian.

KKM ingin menegaskan bahawa imunisasi yang lengkap mampu mencegah jangkitan dan sekiranya dijangkiti, gejala adalah ringan dan tiada komplikasi. Justeru, ibubapa dan masyarakat diseru untuk memastikan anak-anak di bawah umur 7 tahun diberikan imunisasi lengkap.

Sekian, terima kasih.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan Malaysia

26 Ogos 2016

Kementerian Kesihatan Malaysia (KKM) mengambil maklum kejadian keracunan makanan yang berlaku di sekolah dan institusi pendidikan.

Terkini, kejadian keracunan makanan yang berlaku melibatkan dapur asrama Sekolah Menengah Poh Lam, Lahat, Perak pada 25 Ogos 2016 yang melibatkan 70 orang pelajar. Siasatan awal oleh KKM mendapati makanan yang disyaki adalah kari telur bagi menu makan tengahari pada 25 Ogos 2016 dan bakteria yang disyaki adalah Salmonella spp. Selain itu kejadian keracunan makanan juga berlaku melibatkan dapur asrama Sekolah Sukan Malaysia Terengganu pada 24 Ogos 2016 yang melibatkan 12 orang pelajar. Siasatan awal KKM mendapati makanan disyaki adalah ayam masak merah yang dihidangkan semasa menu makan malam pada 23 Ogos 2016 dan bakteria disyaki adalah Salmonella spp. Kedua-dua premis ini ditutup di bawah Akta Kawalan Penyakit Berjangkit 1988.

KKM memandang serius kejadian keracunan makanan yang berlaku di kantin dan dapur asrama sekolah serta institusi pendidikan. Dalam hal ini, KKM  telah mengambil beberapa langkah kawalan yang berterusan. Di samping pemeriksaan rutin, KKM telah meningkatkan pemeriksaan ke atas kantin dan dapur asrama sekolah serta institusi pendidikan melalui Operasi Premis Bersih di seluruh negara.

Pada tahun 2015 sehingga 30 Jun 2016, melalui pemeriksaan rutin sebanyak 30,314 pemeriksaan telah dijalankan yang meliputi pemeriksaan ke atas 24,280 kantin sekolah dan kantin institusi pendidikan serta 6,034 dapur asrama sekolah di seluruh negara. Melalui pemeriksaan ini, sebanyak 261 (0.9%) arahan penutupan di bawah Seksyen 11, Akta Makanan 1983 telah dikeluarkan.

Manakala melalui Operasi Premis Bersih, sehingga 7 Jun 2016 sebanyak 1,063 pemeriksaan telah dijalankan yang meliputi pemeriksaan ke atas 757 kantin sekolah dan 306 dapur asrama sekolah di seluruh negara. Melalui pemeriksaan ini, sebanyak 18  (2.1%) arahan penutupan di bawah Seksyen 11, Akta Makanan 1983 telah dikeluarkan. Manakala 141 notis kesalahan di bawah Seksyen 32B, Akta Makanan 1983 telah dikeluarkan kepada pengusaha kantin sekolah atau dapur asrama sekolah  yang gagal mematuhi Peraturan-Peraturan Kebersihan Makanan 2009. Di bawah Peraturan-Peraturan Kebersihan Makanan 2009, semua pengendali makanan diwajibkan menjalani latihan pengendali makanan dan mendapat suntikan vaksin anti tifoid.

KKM juga menjalankan pelbagai aktiviti promosi keselamatan makanan seperti pelaksanaan Pemeriksaan Sendiri (KENDIRI) tahap kebersihan kantin dan dapur asrama sekolah serta institusi pendidikan, pameran dan ceramah keselamatan makanan dan Akta Makanan 1983 serta Peraturan-Peraturan Kebersihan Makanan 2009 kepada pihak pengusaha dan pengendali makanan.

KKM dan KPM bekerjasama rapat bagi mengurangkan kejadian keracunan makanan yang berlaku di kantin dan dapur asrama sekolah  serta institusi pendidikan. Ini termasuk memperkukuh syarat-syarat perjanjian Kontrak Pembekalan Makanan Bermasak, semakan menu makanan yang berisiko tinggi, menambahbaik garispanduan kebersihan premis makanan di sekolah dan institusi pendidikan serta mewujudkan modul latihan.

KKM tidak akan berkompromi dengan kejadian keracunan makanan dan akan mengambil tindakan penguatkuasaan seperti penutupan premis dan mengenakan kompaun sekiranya pihak pengusaha dapur asrama, kantin sekolah atau kantin institusi pendidikan yang didapati tidak mematuhi Akta Makanan 1983 dan Peraturan- Peraturan Kebersihan Makanan 2009.

Sehubungan itu, pengguna tidak perlu khuatir kerana KKM sentiasa menjalankan aktiviti penguatkuasaan dan pemantauan ke atas isu-isu yang berhubung dengan keselamatan makanan bagi memastikan kesihatan orang ramai sentiasa terjamin. Sekiranya pengguna merasa ragu-ragu dengan status keselamatan pengguna boleh membuat laporan kepada KKM melalui Pejabat Kesihatan Daerah (PKD) atau Jabatan Kesihatan Negeri (JKN) terdekat atau melalui laman web http://moh.spab.gov.my atau facebook Bahagian Keselamatan dan Kualiti Makanan www.facebook.com/bkkmhq.

DATUK DR. NOOR HISHAM ABDULLAH

Ketua Pengarah Kesihatan

Kementerian Kesihatan Malaysia

27 Ogos 2016