Policy ISSUES

on Notifiable
Diseases
MOHD ARIF BIN RAMLI (ARRA)
59362122009
INTRODUCTION

 Notification of communicable diseases is one of the necessary surveillance systems in the

Ministry of Health Malaysia's Public Health department.
 Section 10 of the Infectious Diseases Prevention and Control Act of 1988 state that the
requirement of any medical practitioner who treats or becomes aware of the presence of
any infectious disease in any premises to report the case to the nearest Medical Officer of
Health as soon as possible.
 Allows the Public Health Authority to implement the appropriate preventive and control
measures.

LAWS OF MALAYSIA ACT 342 PREVENTION AND CONTROL

OF INFECTIOUS DISEASES ACT 1988 Incorporating latest
amendment - P.U. (A) 374/2006

Section 10. Requirement to notify infectious disease.

MOH Malaysia: The Organizational Structure For
Surveillance
• National Level:
– Disease Control Division
– Responsible for legislation, policy, norms and
standards for surveillance

• State Level: The State Health Department

• District Level: The District Health Office
Surveillance Systems in
Malaysia
 Mandatory Notification
• Prevention and Control of
Infectious Diseases Act 1988 (Act
342)
• 28 notifiable infectious diseases
• Health facility based reporting
• Notify within 24 hours (9
diseases: cholera, dengue fever,
diphtheria, ebola-marburg
disease, food poisoning, plague,
poliomyelitis, rabies, yellow
fever)
Laboratory-Based Surveillance Sentinel Surveillance
• Introduced in year 2005 • e.g. Influenza-like Illness; ILI and
• Coordinated by the National Severe Acute Respiratory
Public Health Laboratory (NPHL) Infection; sARI
Sg. Buloh
• Pathogens prioritised: S. Typhi, S.
Paratyphi, Salmonella spp., N.
Meningitidis, H. Influenza Type B
and V. Cholerae
 Total notification 2011 - 2017
3000
2854

2500
Number of Outbreaks Notification
25206 2454
4 2305
2213 2147
2000
1891
16594
1500
3

1000

500 447
742 256
149
0 2 1 6 22 61
2011 2012 2013 2014 2015 2016 2017
Year

Total Notification Outbreaks Notification Events Notification

MALAYSIA STRATEGIC PLAN
FOR EMERGING DISEASES
2017-2021
(MY SED II)
Background of Problems

 Very crucial so that any action can be taken to

control the spread.
 A delay in reporting the incident might cause
the situation to worsen.
 It is also crucial that the officer in charge must
be easy to reach so that it become convenient
for a person to reporting any incident of
infectious disease occurred.
 If there any critical case or death happened,
suitable guidelines need to implement to avoid
any unintentional spread of the diseases.
 For example, when cholera occur in boarding school, the school management should bring the
victims to nearest hospital.
 Once the cholera cases is confirmed by medical practitioner, it need to immediately report and
periodically surveillance need to be done.
 School management also should be alert on every source of infectious diseases.
 If the source is found due to bad hygiene, school management should immediately follow given
hygiene control procedure and report any cause found to authorities.
Current policy issues

Delays in notifying
Most of healthcare
infectious diseases can
workers/ practitioners are The list of notifiable
have an impact on the
not aware/not know what diseases are not updated.
efficacy of public health
diseases should be notify
intervention,

Information on the
Lack of staff documents is not
complete/wrong
Delays in notifying infectious diseases

 Healthcare workers/ medical practitioners are intentionally/unintentionally failed to report

the disease within the speculated time.
 Due to no time/busy.
 Not taking serious considerations regarding on the importance of reporting.
 Could cause delay in detecting root sources of the disease and effect the efficacy of public
health interventions
Healthcare workers/ practitioners are not
aware/not known what diseases should be notify
 Lack of knowledges and awareness can cause healthcare practitioners failed to report the
notifiable diseases.
 May due to lack of guideline regarding on what to report and what diseases needed to
report.
 However, some health practitioners are aware and know the diseases need to notify but
they intentionally take not to report or notify the diseases. I.e.: Some general/private
practitioners are not notify measles/chicken pox.
The list of notifiable diseases are not updated.

LIST OF NOTIFIABLE DISEASES ARE SOME OF DISEASES ON THE LIST ARE

NOT UPDATED. OUTDATED AND CANNOT BE A IN
NOTIFIABLE DISEASE ANYMORE.
Lack of staff

Lacking staff to handle and manage the notifiable diseases report would
lead to delay and make the notifiable diseases management and
intervention become less effective.

More staff are needed for handling the report and investigation.
 Awareness
and
Knowledges

Policies
Data Improvement Enforcement

Staff/
personel
 Increase
awareness
among health
practitioners
Provide
Guidelines sufficient
knowledges

Awareness &
Knowledges
 IMPROVE
Improve the way of notifiable diseases
reporting.
Implement an integrated system so that every
health practitioner can conveniently access
UPDATE and report.

Revise and update the list of notifiable

Data
diseases.

Provide an easy access to the notifiable

diseases data so that health practitioners
can easily accessing it.
Staff

Improve/implement Authorities also In rural areas in

staffing policies should provide which far from
enough staff to nearest health
handle all work facilities, a
regarding on representative
notifiable diseases. should be place on
site.
Enforcement

Current legal and policies regarding notifiable diseases should be enforced.

Legal actions must be taken toward any individuals or health practitioners that
intentionally delay or not notify the infectious diseases that occurred.

This actions can make them to take more responsibility regarding the importance
of early notifications.
Policy Recommendation

• Recognized the
MOH • Revise funding on
seriousness issues in notifiable diseases
notify notifiable • Revise the current list of management.
diseases. notifiable diseases
• Enforce the current law • Regularly encourage the
awareness and
knowledges among

GOV healthcare
workers/practitioners/publ Treasury
ic
 Conclusion
 Communicable disease notification is more than just a legal requirement, it is part of a
public health surveillance system that encompasses national and international levels and
has a direct impact on infectious disease prevention and control.
 Without awareness of how critical early notification to the nearest Public Health
Authority is, it is possible that prevention and control efforts may be delayed, resulting
in economic and social consequences.
 References
 Disease Control Division Ministry of Health Malaysia case definitions for infectious
diseases in Malaysia 3rd Edition January 2017.
 ACT 342: PREVENTION AND CONTROL OF INFECTIOUS DISEASES ACT 1988,
(1988).
 Yang, H. H., Gong, J., Zhang, J., Wang, M. L., Yang, J., Wu, G. Z., . . . Szu, S. C. (2010).
An outbreak of Salmonella Paratyphi A in a boarding school: a community-acquired
enteric fever and carriage investigation. Epidemiology and infection, 138(12), 1765-
1774. doi:10.1017/S0950268810001986
 Group, P. H. M. C. D. (2014). Management of Infectious Disease in Schools.