Citation: Manderson L. Political economy and politics of gender: maternal and child health in colonial Malaya. In: Cohen P, Purcall J (editors). The Political Economy of Primary Health Care in Southeast Asia. Canberra: Australian Development Studies Network an ASEAN Training Centre for Primary Health Care Development; 1989, p79-100
MeSH terms: Asia; Child; Child Health Services; Humans; Malaysia; Maternal Health Services; Politics; Primary Health Care
Cervix cancer is about twice as common in Asia as in the Western world and its incidence varies among different Asian ethnic groups. A study based in Singapore, the population of which comprises Chinese, Indians and Malaysians, offers the opportunity to evaluate whether the same risk factors are important in this part of the world as in the West. A total of 135 cases and an equal number of controls were interviewed and details concerning reproductive and sexual history, smoking, hygiene, socio-economic status and education were collected. Seventy-three cases had invasive cancer while 62 had micro-invasive disease or CIN III. The most important risk factors were parity and number of sexual partners. Smoking was rare in cases and controls and did not appear to be an important determinant of risk. Of the socio-economic factors, education appeared most predictive and lowered the risk. Age at first intercourse was strongly correlated with education (positively) and parity (negatively), but not with number of sexual partners. Biopsies were available for HPV DNA analysis in 38 cases and 37% were positive, mostly for HPV type 16. All these factors gave similar risks in invasive and preinvasive disease.
Eleven infants who were suspected clinically of having cows' milk protein sensitive enteropathy were fed with a protein hydrolysate formula for six to eight weeks, after which they had jejunal and rectal biopsies taken before and 24 hours after challenge with cows' milk protein. When challenged six infants (group 1) developed clinical symptoms and five did not (group 2). In group 1 the lesions developed in both the jejunal mucosa (four infants at 24 hours and one at three days), and the rectal mucosa, and the injury was associated with depletion of alkaline phosphatase activity. Infants in group 2 were normal. It seems that rectal injury that develops as a direct consequence of oral challenge with the protein in reactive infants may be used as one of the measurements to confirm the diagnosis of cows' milk protein sensitive enteropathy. Moreover, ingestion of such food proteins may injure the distal colonic mucosa without affecting the proximal small gut in some infants.
The validity of the 2-hour post-prandial (2HPP) urine glucose was determined among a Malay community in Kuala Selangor. Fifty glycosuric and 80 non-glycosuric samples had their capillary blood glucose and fasting blood sugar tested to determine their diabetic status. It was found that the test was very sensitive but less specific (sensitivity 100% and specificity 72.1%). Samples with 2HPP urine glucose of 3 + had a higher probability of being diabetic than the others.
MeSH terms: Blood Glucose; Diabetes Mellitus; Humans; Malaysia; Mass Screening; Sensitivity and Specificity