44
Table 1: Available Therapeutic and Diagnostic Facilities in Respiratory Medicine
Population High Dependency
Respiratory Ward
bronchoscopy Suite
Respiratory Laboratory
Sleep Laboratory
No in million No
pmp No
pmp No
pmp No
pmp
Malaysia 26.64
24 100
1 34
100 1
15 100
1 16
100 1
Sector
Public -
9 38
24 71
13 87
9 56
Private -
15 62
10 29
2 13
7 44
State
Johor 3.17
3 12
1 2
6 1
1 7
1 6
Kedah Perlis 2.11
1 4
2 6
1 1
7 1
6 Kelantan
1.53 1
3 1
Melaka 0.73
1 4
1 1
3 1
1 6
1 N. Sembilan
0.96 2
8 2
2 6
2 1
7 1
Pahang 1.45
2 6
1 2
13 1
1 6
1 Perak
2.28 3
12 1
4 12
2 3
20 1
1 6
Terengganu 1.04
1 3
1 1
7 1
1 6
1 Pulau Pinang
1.49 4
17 3
5 15
3 3
20 2
2 13
1 Sabah
3 1
5 5
15 1
1 7
1 6
Sarawak 2.36
1 5
2 6
1 1
6 Selangor W.P.
Kuala Lumpur 6.43
8 33
1 7
21 1
2 13
6 38
1
Population Lung Transplant Unit
Smoking Cessation Centre
Pulmonary Rehabilitation Unit
No in million No
pmp No
pmp No
pmp
Malaysia 26.64
1 100
12 100
9 6
100
Sector
Public -
1 100
12 100
6 100
Private -
State
Johor 3.17
2 17
1 Kedah Perlis
2.11 1
8 Kelantan
1.53 1
8 1
Melaka 0.73
1 8
1 Negeri Sembilan
0.96 Pahang
1.45 1
8 1
1 17
1 Perak
2.28 1
8 Terengganu
1.04 Pulau Pinang
1.49 1
17 1
Sabah 3
1 8
1 17
Sarawak 2.36
1 8
Selangor W.P. Kuala Lumpur
6.43 1
100 3
25 3
50
45
Table 2: Available Medical Devices in Respiratory Medicine
Population Spirometer
Pneumo- tacography
Machine Total
Polysomnograph System
Portable Polysomnograph
Machine No in million
No pmp
No pmp
No pmp
No pmp
Malaysia 26.64
94 100
3 5
100 19
100 1
5 100
Sector
Public -
71 76
5 100
14 74
5 100
Private -
23 24
5 26
State
Johor 3.17
5 5
2 Kedah Perlis
2.11 23
25 11
1 20
1 5
1 20
Kelantan 1.53
6 6
4 2
11 1
Melaka 0.73
2 2
3 2
11 3
N. Sembilan 0.96
3 3
3 1
5 1
1 20
1 Pahang
1.45 5
5 3
1 5
1 2
40 1
Perak 2.28
7 7
3 Terengganu
1.04 1
1 1
1 20
1 Pulau Pinang
1.49 6
6 4
2 40
1 1
5 1
Sabah 3
4 4
1 1
5 1
20 Sarawak
2.36 7
7 3
1 5
Selangor W.P Kuala Lumpur
6.43 25
27 4
1 20
9 47
1
Population body
pletysmograph “body box”
Adult bIPAP system
Adult CPAP system
Adult broncho- videoscope
System No in million
No pmp
No pmp
No pmp
No pmp
Malaysia 26.64
7 100
107 100
4 55
100 2
147 100
6
Sector
Public -
7 100
82 77
21 38
72 49
Private -
25 23
34 62
75 51
State
Johor 3.17
4 4
1 5
9 2
9 6
3 Kedah Perlis
2.11 1
1 2
4 1
3 2
1 Kelantan
1.53 5
5 3
1 2
1 11
7 7
Melaka 0.73
8 7
11 10
18 14
9 6
12 N. Sembilan
0.96 4
4 4
2 4
2 7
5 7
Pahang 1.45
1 14
1 12
11 8
2 4
1 9
6 6
Perak 2.28
9 8
4 2
4 1
8 5
4 Terengganu
1.04 1
14 1
5 5
5 2
1 2
Pulau Pinang 1.49
1 14
1 6
6 4
10 18
7 25
17 17
Sabah 3
1 14
4 4
1 4
7 1
6 4
2 Sarawak
2.36 5
5 2
2 4
1 13
9 6
Selangor W.P Kuala Lumpur
6.43 3
43 44
41 7
15 27
2 45
31 7
46
Population Medical
Pleurascope Paediatric CPAP
Flow Driver Paediatric biPAP
system with Appropriate
Mask Paediatric
bronchoscopy rigid Set
No in million No
pmp No
pmp No
pmp No
pmp
Malaysia 26.64
7 100
41 100
1 10
100 18
100 1
Sector
Public -
6 86
29 71
7 70
6 33
Private -
1 14
12 29
3 30
12 67
State
Johor 3.17
3 7
1 1
6 Kedah Perlis
2.11 1
14 5
12 2
1 10
Kelantan 1.53
2 5
1 1
6 1
Melaka 0.73
3 7
4 1
10 1
1 6
1 Negeri
Sembilan 0.96
3 7
3 Pahang
1.45 1
14 1
2 5
1 3
30 2
Perak 2.28
8 20
4 2
11 1
Terengganu 1.04
1 14
1 1
2 1
Pulau Pinang 1.49
1 14
1 1
2 1
1 10
1 4
22 3
Sabah 3
1 14
1 6
Sarawak 2.36
2 11
1 Selangor W.P
Kuala Lumpur 6.43
2 29
13 32
2 4
40 1
6 33
1
47
CHAPTER 13 GASTROENTEROLOGY FACILITIES AND DEVICES
Chairperson: Dr. Hj. Rosemi Salleh
1
Secretary: Dr. Hjh. Rosaida Hj. Md. Said
2
Representative: Y. Bhg. Dato’ Dr. Hj. Muhammad Radzi bin Abu Hassan
3
, Dr. Sheikh Anwar Abdullah
4
Contributors: Dr. Jeyaram Menon
5
, Dr. S. Ganesananthan
2
1 Hospital Raja Perempuan Zainab II, 2 Hospital Kuala Lumpur, 3 Hospital Sultanah Bahiyah, 4 Pusat Perubatan Universiti Kebangsaan Malaysia, 5 Hospital Queen Elizabeth.
REPORT
For the irst time in Malaysia, we are able to report national estimates on the devices pertaining to Gastroenterology Units.
Gastroenterology is one of the medical subspecialties which involve a substantial amount of medical devices. These devices cover use for therapeutic as well as diagnostic purposes. The provision
of therapeutic and diagnostic facilities in Gastroenterology can be divided into 1 Non-Invasive Gastroenterology Laboratory; and 2 Endoscopy Day Care UnitSuite. Non-invasive gastroenterology
laboratory refers to provision of devices that do not involve endoscopes, for example capsule endoscopic system, manometry and breath test system.
In Malaysia, more services are provided in endoscopy day care units or suites 55. This is in comparison to only 9 non-invasive gastroenterology laboratories available around the country, in Pahang, Sabah,
Sarawak and Selangor Kuala Lumpur. This may be because the expertise technologies were not readily available in the past. Now, there are more and more centres providing these non-invasive
services, but they are incorporated into the endoscopy day care units or suites. Those with separate non-invasive laboratories were mostly from the private sector. As there are more private health services
available in the Klang Valley, this may explain why the most number of non-invasive gastroenterology laboratories were recorded for Selangor W.P. Kuala Lumpur.
The endoscopy day care unitssuites are available in all states except Terengganu. The highest number was recorded by Selangor W.P. Kuala Lumpur 17 followed by Pulau Pinang 6, with Sarawak,
Johor and Kedah Perlis having the 3
rd
highest number 5. The case of Terengganu having no available therapeutic and diagnostic facilities in gastroenterology
may not be fully accurate, as the data is based on the feedback provided only. If there is a lack of cooperation or communication between the departments or in the feedback process, there will be
under-reported data.
The devices that related to gastroenterology specialty can be divided into: 1. Endoscopes Gastroenterology devices
2. Invasive 3. Non-invasive
48
1. Endoscopes Gastroenterology devices
Base on the survey done last year 2007, the gastroduodenoscope and colonoscope devices are the most available in Malaysia with the average of 6 and 5 per million population respectively.
Gastroduodenoscope systems have the largest number in the country, which is about 167, followed by 137 colonoscopes.
Other endoscopic devices are 84 duodenoscopes followed by 47 sigmoidoscopes, 16 Endoscopic ultrasound EUS, 12 enteroscopy and 4 Double Balloon Enteroscopic DBE systems.
Majority of these devices are located in Selangor and Wilayah Persekutuan. Based on the survey, the number of availability is still not enough for screening purposes, for example
screening for colorectal cancer.
Other devices such as DBE and EUS are still low in numbers due to the need of special trainings and their usage are still low.
2. Invasive 3. Non-Invasive
There are ive non-invasive procedures in which four of them are considered relatively new in Malaysia. The newer non-invasive procedures involve the total water perfused low compliance
software pneumohydraulic pump with transducers for anorectal and oesophageal manometry, total 24-hour digitrap per recording device, wireless 48 hour bravo pH recording system, GI breath test
system and capsule endoscopic system.
The newer non-invasive procedures are technically simpler and easier to do, and may replace some of the invasive procedures. However, the limitations of these tests are costly and need expertise. Thus,
the non-invasive tests will not be available in every centre but to the targeted main centre chosen.
Presently, the individual non-invasive procedures that available in Malaysia are as stated below:-
