The article focuses on countries and areas of South-East Asia, which are seriously affected by drug abuse and the problems associated with it. Opium has traditionally been used for treating illnesses and alleviating physical and mental stress, as well as for recreational and social purposes. The prohibition of the sale and use of opium in Burma, Hong Kong, Malaysia, Singapore and Thailand forced many habitual opium users to switch to heroin. Over the past two decades there has been an increasing trend towards drug use, often involving experimentation with more than one substance, among youth in and out of school. For example, a survey of students at teachers' colleges in northern Thailand showed that at some time in their lives 30-40 per cent of the male respondents and 3-6 per cent of the female respondents had used cannabis, and that 18-20 per cent of the males and 12-27 per cent of the females had sniffed volatile solvents. The same survey showed that 5-10 per cent of both the males and females had used stimulants and nearly 2 per cent had used heroin. During the 1970s the abuse of heroin and other opiates emerged as a serious problem of epidemic nature, predominantly affecting young people in many countries of South-East Asia. While opiates, including heroin, have been abused by inhaling and by smoking, there has recently been an increasing trend towards injecting heroin of high purity (80-90 per cent pure heroin). Heroin addiction spread first to the populations of capital cities and then to other cities and towns and even to the hill tribes, as studies in Thailand have revealed. Most recent studies have shown that heroin abuse has spread further in Asia, both socially and geographically, involving such countries as India and Sri Lanka, which had no previous experience with the problem. Studies have also shown that the abuse of manufactured psychotropic substances has been increasing and that heroin addicts resort to these substances when heroin is difficult to find. The article also briefly reviews the history of opium use in China and the history of drug abuse in Japan, particularly with regard to the problem of methamphetamine abuse, which has appeared in two epidemic-like waves. The first followed the end of the Second World War and disappeared at the end of the 1950s; the second reappeared in 1975 and since then has gradually been increasing in size.
Data are presented from a long-term study of banded langurs in three contrasting rain forest habitats in Peninsular Malaysia. Results from different sites and months are used to correlate ranging patterns with food availability and other environmental variables. Day range lengths are correlated with availability of preferred foods; the degree of territoriality is related to the distribution and size of food sources and length of time for which any one of these produces favoured food items.
During the early months of 1985 and 1986, 408 non-immune British soldiers undertook training in the jungles north of Kota Tinggi, in southern Malaysia. In this geographical location, where malaria transmission is now light, a combination of strict personal antimosquito measures plus proguanil 200 mg daily produced effective, safe protection, with only a single case of vivax malaria occurring. Given the limited malaria risk, however, the results of this study should be extrapolated only with caution to other areas of Malaysia.
MeSH terms: Proguanil/therapeutic use*; Clothing; Humans; Insect Repellents; Malaria/prevention & control*; Malaysia; Male; Military Personnel; Mosquito Control
MeSH terms: China; India; Indonesia; International Cooperation*; Japan; Korea; Malaysia; Philippines; Research*; Thailand; United States; World Health Organization
Twenty-five strains of enterobacteria, isolated from man in Peninsular Malaysia and consisting of seven Enterobacter spp., five Escherichia coli, five Salmonella spp., four Klebsiella spp., two Shigella spp., one Proteus sp. and and one Providencia sp., were tested for antibiotic resistance and conjugative R plasmids. They were all sensitive to nalidixic acid and resistant to at least three antibiotics. The number of resistances ranged from 3 to 11 antibiotics, including cefoperazone and sisomicin (two) newly released antibiotics), in addition to common drugs of current use. Of the 25 isolates, 19 (76%) conjugally transferred, at varied frequencies, at least two resistance determinants. Results from equilibrium density gradient centrifugation, agarose gel electrophoresis and transformation experiments provided proof that the transferable resistances were plasmid-mediated. Restriction endonuclease cleavage patterns showed that the plasmids from Proteus strain K005 and Providencia strain K001 may be identical.
MeSH terms: Anti-Bacterial Agents/pharmacology*; Conjugation, Genetic; Drug Resistance, Microbial; Electrophoresis, Agar Gel; Enterobacteriaceae/drug effects*; Enterobacteriaceae/genetics; Malaysia; Nalidixic Acid/pharmacology; Phenotype; R Factors*; Transformation, Bacterial
This is the first report in which a marine mollusc, Oliva vidua fulminans (olives), generally not known to be poisonous, was responsible for death in five children after consuming boiled olives with tamarind. The onset of symptoms was rapid 10 to 20 min after consumption of the olives. Signs and symptoms included nausea, vomiting, abdominal pain, tingling sensation around the lips, numbness around the mouth, drowsiness, lethargy and generalized weakness with paraesthesia in the limbs. The five deaths occurred within 3 to 4 hours after eating the poisoned olives and resulted from respiratory failure. Left-over olives from the affected household and freshly collected live olives had a toxicity of 14,200 mouse units (M.U.) and 15,000 M.U. per 100 g meat respectively. No other common chemical poison and organophosphorus insecticides were detected. The neurotoxic agent was acid and heat stable and was toxic at pH less than 4. Its action was similar to that of paralytic shellfish poisoning which was caused by toxins from certain dinoflagellates.
This article describes a study designed to test a method for assessing the cost to the health services of illegally induced abortion and the feasibility of estimating the incidence of induced abortion by a field interviewing approach. The participating centers included three hospitals in Ankara, Turkey; three hospitals in Ibadan, Nigeria; one hospital in Caracas and one in Valencia, Venezuela; and two hospitals in Kuala Lumpur, Malaysia. Hospitalized abortion cases were classified as induced or spontaneous or as "probably induced," "possibly induced," or "unknown" according to a classification scheme comprising certain medical criteria. The sociodemographic characteristics of induced and spontaneous abortion cases were subjected to discriminant function analysis and the discriminating variables best characterizing the induced versus the spontaneous abortion groups were identified for each center. On the basis of this analysis, the "probably" and "possibly" induced and "unknown" categories were further classified as induced or spontaneous abortion, with stated probabilities. Thus an overall estimate is made of the proportion of all hospitalized abortions that can be considered illegally induced outside the hospital. Selected results on costs of induced and spontaneous abortion are shown. The method further tested the feasibility of obtaining valid survey data on abortion from the communities studied by re-interviewing the women hospitalized for induced and spontaneous abortion six months later in their homes. This exercise showed a degree of under-reporting of abortion that varied widely among centers, even among women who had admitted illegal induction at the time of hospitalization. The feasibility of estimating the incidence of illegal abortion by field studies is discussed in the light of these findings.
MeSH terms: Abortion, Criminal*; Costs and Cost Analysis; Data Collection; Developing Countries*; Female; Health Services/economics*; Humans; Malaysia; Nigeria; Pregnancy; Turkey; Venezuela; Pregnant Women; Internationality*
A simple atomic-absorption spectrophotometry method is described for the determination of silver, bismuth, cadmium, copper, iron, nickel and zinc in lead- and tin-base solders and white-metal bearing alloys, with use of a single sample solution. The sample is dissolved in a mixture of hydrobromic acid and bromine, then fumed with sulphuric acid. The lead sulphate is dissolved in concentrated hydrochloric acid. The method is particularly suitable for the determination of silver and bismuth, which are co-precipitated with lead sulphate. The other elements can also be determined after removal of the lead sulphate by filtration.
The cocoa pod borer,Conopomorpha cramerella (Snellen) (Lepidoptera: Gracillariidae), is the most serious pest of cocoa in Southeast Asia. Analyses of ovipositor washings and entrained volatiles from virgin female moths by gas chromatography (GC) linked to electroantennography (EAG), and comparison of EAG responses from the male moth to synthetic compounds indicated the presence of theE,Z,Z andE,E,Z isomers of 4,6,10-hexadecatrienyl acetate and the corresponding alcohols, and of hexadecyl alcohol. Amounts of pheromone produced were less than 0.1 ng/female, and no peaks for the unsaturated components were observed on GC analysis. Extensive field testing of synthetic mixtures in Sabah, East Malaysia, showed that traps baited with a polyethylene vial impregnated with 1.2 mg of a mixture of the above five components in 40∶60∶4∶6∶10 ratio caught more maleC. cramerella moths than traps baited with a virgin female moth.
Field observations were made on Coquillettidia crassipes during a study of Mansonia in a swamp forest ecotype in Tanjong Karang. There was an increase in abundance in July consistent with the increase in abundance of Mansonia and an increase in rainfall. The biting cycle showed a dramatic early peak during the period 1900-2000 hours. The probability of daily survival through one day for the first three gonotrophic cycles was 0.770, 0.722 and 0.759. Two of the 54 Cq. crassipes dissected were infective, with two and 25 L3 larvae of Brugia. Both subperiodic B. malayi and B. pahangi developed into L3 larvae in laboratory bred Cq. crassipes. The index of experimental infection was higher for B. pahangi. Mansonia bonneae and Ma. uniformis showed higher indices of experimental infection than Cq. crassipes for subperiodic B. malayi. It is concluded that in an endemic area with a high density of Cq. crassipes it could act as a secondary vector of Brugian filariasis.
Sera obtained from 3,472 persons in Malaysia, Thailand, Philippines and Indonesia were tested for the presence of antibody to adult T-cell leukemia-associated antigen by the gelatin particle agglutination test and indirect immunofluorescence. Among these, only two seropositives were identified. One was a 30-year-old male Malaysian of Indian origin. The other was a 42-year-old female Thai who resided in Bangkok. These results suggested that the infection of human T-lymphotropic virus type 1 might not be endemic in these countries.
Analysis of mothers' recall data collected in 1976-1977 by a probability survey in Peninsular Malaysia shows an association between breastfeeding up to six months of age and improved survival of infants throughout the first year of life. Inappropriate sample selection and inadequate control of confounding can introduce large biases in these analyses. The magnitude and direction of these biases are presented. Even when these biases are dealt with, unsupplemented breastfeeding appears more beneficial than supplemented breastfeeding. The younger the infant and the longer the breastfeeding, the greater the estimated benefits in terms of deaths averted. The use of powdered infant formula did not appear to offset the detrimental effects of early weaning and supplementation. The positive relationships found in these analyses between breastfeeding and survival are not due to death precluding or terminating breastfeeding. Nor are they likely to be due to a shift away from breastfeeding because of recent illness, which was also controlled in the analyses. Nor are they likely to be due to other factors that both increase mortality risk and shorten breastfeeding; when such factors are taken into account, the beneficial effects of breastfeeding become stronger and imply that, if there had been no breastfeeding in this sample, twice as many babies would have died after the first week of life.
"Health for all by year 2000" was the subject of the WHO Conference at Alma-Ata in 1978. It was evident that good primary care was a requirement to reach this goal. However, knowledge about this was scanty, and the instrument, an acceptable classification for analyses of primary care, was lacking. Since 1978 a WHO Working Party on Classifications of Primary Care has been working on a Reason for Encounter Classification. A RFEC test form was produced. In 1983 a feasibility study was conducted in nine countries: Australia, Barbados, Brazil, Hungary, Malaysia, The Netherlands, Norway, the Philippines, and the USA. The results of this were changing the original proposal very much. In addition, the WONCA/WHO Classification of Health Problems in Primary Care was included in the final version. In 1984 this final version was accepted by WONCA Classification Committee. This is called ICPC = The International Classification of Primary Care. ICPC is biaxial with the chapters of organ/organ systems along the one axis, in addition of three chapters: General, Mental, and Social problems. The other axis comprises seven components: Complaints, Process and Diagnosis. An alphanumeric code is used. The feasibility study of RFEC comprised ten test sites, and 138 primary care professionals recorded a total of 100 452 reasons for encounter. The English version of the RFEC was translated into five other languages, and these versions were used during the study. ICPC is a comprehensive, simple and practicable classification which can be used in medical records and in different areas of primary care research.
MeSH terms: Diagnosis; Disease/classification*; Health Priorities/trends; Humans; International Cooperation*; Primary Health Care/trends*; Referral and Consultation/trends; Therapeutics; World Health Organization
Over two years cord blood from 27 879 babies was screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency. The overall incidence was 3.1% in boys and 1.6% in girls. Sixty nine babies had severe jaundice (bilirubin concentration greater than 380 mmol/l (20 mg/100 ml], and exchange transfusion was performed. Parents were given written and verbal instructions to avoid herbs and drugs that trigger kernicterus, which reduced the incidence of kernicterus and thereby prevented mental retardation. G6PD deficiency is common in all three ethnic groups (Malays, Chinese, and Indians) in Malaysia and screening is recommended.
Purified preparations of Getah virus strains have been analysed by sodium-dodecyl-sulphate polyacrylamide gel electrophoresis (SDS-PAGE) to reveal their structural proteins. Two envelope proteins (E1 and E2) and core protein (C) were found with the prototype AMM2021 strain both under reducing and nonreducing conditions, while separation of E1 and E2 was observed only under nonreducing conditions for 3 strains isolated in Japan. Limited digestion by Staphylococcus aureus V8 protease revealed difference in the peptide patterns of E1 between AMM2021 and Japanese isolates. Mobility of E1 and E2 was slower for the virus grown in BHK21 cells compared with the virus grown in Aedes albopictus cells, indicating host-controlled modification on the envelope glycoproteins.
Two soap formulations, both containing 20% deet and one each containing permethrin at 0.5 and 1.0%, respectively, were applied to exposed arms and legs of volunteers as personal protection against outdoor human biting mosquitoes in six locations on Penang Island, Malaysia. The predominant mosquito species collected from these locations were Aedes albopictus, Mansonia uniformis, Culex gelidus, Anopheles lesteri and Armigeres subalbatus. Efficacy and residual effects up to 4 hours indicated good protection against these species. Reduction in mosquito landing-biting rates in treated groups ranged from 83.8 to 100.0%. At high densities, small percentages of Ma. uniformis and An. lesteri landed or bit on treated skin. Use of the soap formulations in terms of cost-effectiveness, safety and overall vector control strategy for some tropical diseases is discussed.