Browsing by Author "Peter Seah Keng Tok"
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- PublicationEffectiveness of COVID-19 vaccines among children 6–11 years against hospitalization during Omicron predominance in Malaysia(2024)
;Vivek Jason Jayaraj ;Masliyana Husin ;Jing Lian Suah ;Peter Seah Keng Tok ;Azahadi Omar ;Sanjay RampalSheamini SivasampuThere is currently limited data on the efectiveness of COVID-19 vaccines for children aged 6–11 years in Malaysia. This study aims to determine vaccine efectiveness (VE) against COVID-19-related hospitalization after receipt of one- and two-doses of BNT162b2 mRNA (Comirnaty-Pfzer/BioNTech) vaccine over a duration of almost 1 year in the predominantly Omicron period of BA.4/BA.5 and X.B.B sub lineages. This study linked administrative databases between May 2022 and March 2023 to evaluate real-world vaccine efectiveness (VE) for the BNT162b2 mRNA (Comirnaty-Pfzer/BioNTech) vaccine against COVID-19-related hospitalization in the Omicron pre-dominant period with BA.4/BA.5 and X.B.B sub lineages. During the Omicron-predominant period, the cumulative hospitalization rate was almost two times higher for unvaccinated children (9.6 per million population) compared to vaccinated children (6 per million population). The estimated VE against COVID-19 hospitalization for one dose of BNT162b2 was 27% (95% CI − 1%, 47%) and 38% (95% CI 27%, 48%) for two doses. The estimated VE against hospitalization remained stable when stratifed by time. VE for the frst 90 days was estimated to be 45% (95% CI 33, 55%), followed by 47% (95% CI 34, 56%) between 90 and 180 days, and 36% (95% CI 22, 45%) between 180 and 360 days. Recent infection within 6 months does not appear to modify the impact of vaccination on the risk of hospitalization, subject to the caveat of potential underestimation. In our pediatric population, BNT162b2 provided moderate-non-diminishing protection against COVID-19 hospitalization over almost 1 year of Omicron predominance. - PublicationImpact evaluation of guidelines on antibiotic utilisation & appropriateness in Malaysian public primary care: an interrupted time series analysis(Informa UK Limited, trading as Taylor & Francis Group, 2024)
;Audrey Huili Lim ;Norazida Ab Rahman ;Su Miin Ong ;Siti Raidah Mohamad Azman ;Fairus Zana Mohd Rathi ;Mastura Ismail ;Peter Seah Keng Tok ;Bee Kiau HoSheamini SivasampuBackground: The National Antimicrobial Guidelines (NAG) 2014 and NAG2019 in Malaysia targeted rational and judicious use of antimicrobials. In this study, we assessed the change in antibiotic utilisation and appropriateness due to the guidelines that were implemented from 2011 to 2019. Methods: Interrupted time series analyses on rates of antibiotic appropriateness and utilisation were performed using prescription data from public primary care clinics in Malaysia between January 2011 and December 2019. Rates of antibiotic utilisation, reported as Defined Daily Dose (DDD) per 1000 patients per day, were stratified by antibiotic classes. Results: Of the 16,081,492 prescriptions recorded during the study period, 4.98% (n = 800,899) contained antibiotics. NAG2014 resulted in a significant increase in antibiotic utilisation trend by 0.029 (p < 0.0001) while NAG2019 had a substantial impact on antibiotic utilisation, decreasing DDD by 1778 and increasing appropriateness by 54.6% (p < 0.0001). Variation in the number of antibiotic molecules being prescribed also decreased after NAG2019. Conclusion: Our findings indicate that the introduction of NAG2019 led to a substantial improvement in antibiotic appropriateness. At the same time, antibiotic utilisation decreased. Further research is needed to ascertain and ensure the sustainability of these changes and to establish targeted improvement strategies focusing on reducing inappropriate and unnecessary prescribing. - PublicationPost COVID-19 condition among adults in Malaysia following the Omicron wave: A prospective cohort study(PLOS ONE, 2024)
;Peter Seah Keng Tok ;Kong Yeow Kang ;Sock Wen Ng ;Norazida Ab Rahman ;Muhammad Aminul Syahmi ;Mohan Dass Pathmanathan ;Maheshwara Rao Appannan ;Kalaiarasu M. Peariasamy ;Sheamini SivasampuYoon-Seok ChungPost COVID-19 condition is an important public health problem as we emerge from the COVID-19 pandemic. In this prospective cohort study, we aimed to determine the prevalence of this condition and assess its associated factors and impact on health-related quality of life in a population setting in Malaysia. Study was conducted from April to June 2022 when the Omicron variant predominated. All individuals testing positive for SARS-CoV-2 infection (RT-PCR, RTK-Ag) were invited for participation. Study questionnaires were delivered via the MySejahtera platform (mobile application). From the total of 44,386 participants who provided responses up to 3-months interval, 1,510 participants (3.4%) fulfilled the post COVID-19 condition criteria. Majority of the affected participants (83.8%, n = 1,265) experienced either cough, fatigue or forgetfulness-the three most common symptoms. Being females, having existing comorbidities, presence of symptoms and requiring hospital admission during the acute illness were associated with higher likelihoods of developing the post COVID-19 condition at 3-months interval. Amongst the 1,510 individuals, one in five had limitations in performing their usual daily activities while at least one in three expressed that their work was affected. Understanding this condition better is essential to guide strategic and responsive plans of action, which may require coordinated multidisciplinary interventions.