Hartmannella sp is one of the free-living amoebae that have the ability to infect
animal tissues because it has been found in human’s nasal mucosa, dog’s bronchial and
turkey‘s intestine. Treatment for diseases inflicted by free-living amoebae is difficult
because most of them infect and damage the host’s tissues, so preventive measures are
better to take rather than to cure the diseases. In this study, water taken from several
stations namely Kampung Padang, Kampung Besut, Ibu Bekalan Setiu, Kampung Tasik,
Kampung Guntung, Kampung Nyatoh, Kampung Penarik and Kampung Mangkok) along
Sungai Setiu, Terengganu was examined for the presence of Hartmannella sp. The results
of this study indicated that only Ibu Bekalan Setiu station was found positive to have the
amoeba. Detail results on the water quality and nutrient contents measured in relation to the
distribution of the amoeba at Ibu Bekalan Setiu station are presented and discussed.
MeSH terms: Amoeba; Animals; Dogs; Food; Hartmannella; Health Services; Humans; Intestines; Nasal Mucosa; Water; Life; Water Quality
Forensic entomological specimens received by the Unit of Medical
Entomology, IMR., from hospitals and the police in Malaysia in the last 3 decades
(1972 – 2002) are reviewed. A total of 448 specimens were received. From these,
538 identifications were made with the following results: Eighteen species of
cyclorrphaga flies were identified consisting of Chrysomya megacephala (Fabricius)
215 cases (47.99%), Ch. rufifacies (Masquart) 132 (29.46%), Ch. villeneuvi Patton
10 (2.23%), Ch. nigripes Aubertin 7 (1.56%), Ch. bezziana Villeneuve 4 (0.89%), Ch.
pinguis (Walker) 1 (0.22%), Chrysomya sp. 47 (10.49%), Sarcophaga sp. 28
(6.25%), Lucilia sp. 21 (4.69%), Hermetia sp. 15 (3.35%), He. illucens (Linnaeus) 1
(0.22%), Hemipyrellia ligurriens (Wiedemann) 3 (0.67%), Hemipyrellia sp. 2 (0.45%),
Ophyra spinigera 1 (0.22%), Ophyra sp. 6 (1.34%), Calliphora sp. 24 (5.36%),
Synthesiomyia nudiseta (Wulp) 1 (0.22%) and Eristalis sp. 1 (0.22%). Other non – fly
insect specimens are Pthirus pubis (Linnaeus) (Pubic louse) 2 (0.45%) and
Coleoptera (Beetles) 1 (0.22%). Ch. megacep hala and Ch. rufifacies were the
commonest species found in cadavers from different ecological habitats. Sy.
nudiseta is an uncommon species, thus far found only on cadavers from indoors.
Sy. nudiseta is reported for the second time in Peninsular Malaysia. A total of 329
cases (73.44%) had a single fly infestation, 109 cases (24.33%) had double fly
infestation and 10 cases (2.23%) had triple fly infestation. Five cases (1.12%) had
eggs and 3 cases (0.67%) had larval stages that were not identifiable. No arthropods
were retrieved from cadavers in 8 cases (1.79%). In conclusion, although large
number of fly species were found on human cadavers, the predominant species are
still those of Chrysomya.
The adulticidal activity of methanol extracts from three Malaysian plants namely Acorus calamus Linn., Litsea elliptica Blume and Piper aduncum Linn. against adult of Aedes aegypti (L.) were
studied. Standard WHO bioassay tests were used to evaluate the
effectiveness of these plant extracts. The hexane fraction from methanol
extract of Acorus calamus rhizome was the most effective, exhibiting
LC50 and LC90 values of 0.04 mgcm-2 and 0.09 mgcm -2
respectively. For L. elliptica, the methanol fraction also displayed good adulticidal
property with the LC50 and LC90 values of 0.11 mgcm-2
and 6.08 mgcm-2 respectively. It is found that hexane fraction of the P. aduncum crude
extract was the least effective among the three plants showing LC50 and
LC90 values of 0.20 mgcm -2 and 5.32 mgcm-2, respectively. However,
although A. calamus showed lowest LC values, the LT50 results indicated
that the methanol fraction of L. elliptica was most potent extract among the extracts tested.
Naegleria fowleri is a free-living amoeba, known as a causative agent for a fatal disease
of the central nervous system (CNS) in man such as Primary amoebic
meningoencephalitis (PAM). Factors contributing to its pathogenicity and its distribution
in the environment have been investigated by previous researchers. In case of its
pathogenicity, several enzymes such as phospolipase A and sphingomyelinase, have been
proposed to probably act as aggressors in promoting PAM but no study so far have been
conducted to investigate the presence of proteinase enzyme in this amoeba although a
56kDa cystein proteinase enzyme has been identified in Entamoeba histolytica as an
important contributing factor in the amoeba’s virulence. In this preliminary study, a
pathogenic amoeba, Naegleria fowleri (strain NF3) was examined for the presence of
proteinases. Samples of enzymes in this amoeba were analysed by electrophoresis using
SDS-PAGE-gelatin gels. The results showed that this amoeba possesses at least two high
molecular weight proteinases on gelatin gels; their apparent molecular weights are ~128
kDa and ~170 kDa. Band of ~128 kDa enzyme is membrane-associated and its activity is
higher at alkaline pH compared wit h lower pH; at lower pH, its activity is greatly
stimulated by DTT. The ~170 kDa band enzyme appears to be inactivated at pH 8.0, atlower ph its activity is higher and DTT-dependance. The activity of this enzyme is
partially inhibited by inhibitor E-64 but markedly inhibited to antipain suggesting it
belongs to the cysteine proteinase group.
Intestinal protozoa are increasingly being studied because of their association with
acute and chronic diarrhoea in immunocompromised as well as immunocompetent patients.
Various community outbreaks due to contamination of water or food with these protozoa have
further highlighted their importance in public health. Among these important pathogens are
Giardia duodenalis, Entamoeba histolytica, Cryptosporidium parvum, Cyclospora cayetanensis,
Isospora belli, and microsporidia. Except for the cyst-forming G. duodenalis and E. histolytica,
the others are intracellular and form spores which are passed out with the faeces. These organisms
are also found in various animals and birds and zoonotic transmission is thought to occur. These
infections are distributed worldwide, with a higher prevalence in developing compared to
developed countries. However, the relative importance of zoonotic infections especially in
developing countries has not been studied in detail. The prevalence rates are generally higher in
immunodeficient compared to immunocompetent patients. Higher prevalence rates are also seen
in rural compared to urban communities. Most studies on prevalence have been carried out in
developed countries where the laboratory and other health infrastructure are more accessible than
those in developing countries. This relative inadequacy of laboratory diagnosis can affect
accurate estimates of the prevalence of these infections in developing countries. However, reports
of these infections in travellers and workers returning from developing countries can provide
some indication of the extent of these problems. Most studies on prevalence of amoebiasis in developing countries were based onmorphological identification of the parasite in faecal smears. As the pathogenic E. histolytica is morphologically indistinguishable from that of non-pathogenic E. dispar, estimates of amoebiasis may not be accurate. The epidemiology of human microsporidia infections is not completely
understood. Two species, Enterocytozoon bieneusi and Encephalitozoon intestinalis, are
associated with gastrointestinal disease in humans and it is believed that human to human as well
as animal to human infections occur. However, the importance of zoonotic infections has not
been fully characterised. G. duodenalis cysts, microsporidia and Cryptosporidium oocysts have
been detected in various ground water resources, but their role in community outbreaks and
maintenance of the infection has not been fully characterised. The taxonomic classification and
pathogenic potential of B. hominis are still controversial. While considered by many as yeast,
fungi or protozoon, recent sequence analysis of the complete SSUrRNA gene has placed it within
an informal group, the stramenopiles. This review covers recent published data on these zoonotic
infections and examines their public health importance in Asian countries.
Diethylcarbamazine citrate (DEC) has been used for treatment and control of lymphatic
filariasis since the 1950s. Although this remarkable drug is still useful and modified strategies in its
usage have been developed, a number of newer antifilarial compounds are now available. Numerous
field trials evaluatin g their efficacy in the control of lymphatic filariasis have been conducted. In
particular, ivermectin (IVM), albendazole (ALB), and DEC have been tested singly and in
combinations and the results of such field studies should be evaluated. While most of the studies were
based on efficacy in the clearance of microfilaraemia, a few clinical trials evaluated the adulticidal
activity of these compounds. Some antibiotics are effective in killing Wolbachia bacteria symbionts of
filarial worms, but their role in the chemotherapy of lymphatic filariasis is still undefined. This review
of randomised controlled field studies and randomised controlled clinical trials with these compounds
will summarise the findings and give recommendations on their appropriate use for the control and
treatment of lymphatic filariasis. Randomised controlled studies have shown the superiority of the combination of single dose IVM at 200-400 µg/kg and ALB at 400 mg in clearing Wuchereria bancrofti microfilariaemia in children 4 months post-treatment compared to those given IVM or ALB alone. At 1 year post-treatment IVM and its combination with ALB were effective but the difference in efficacy between these two treatments was minimal. An interesting finding was that DEC at a single dose of 6 mg/kg was as effective as a total dosage of 72 mg/kg given over 12 days. Amicrofilaraemia achieved was only 40-
42% at 1 year of follow -up. In one study it was also found that co-administration of IVM with DEC
interfered with the macrofilaricidal action of DEC. This conclusion needs urgent confirmation as it
will have serious implications in control programmes utilising both drugs.Various combinations of DEC, IVM and ALB were found to be safe and well tolerated. The combination of a single dose of ALB 400 mg + DEC 6 mg/kg is safe and effective for the control of filariasis. Randomised mass treatment studies with either DEC (6 mg/kg) alone or in combination with IVM (400 µg/kg) annually for four years resulted in reduction of microfilaria rates > 95%. With 5 single annual doses of DEC at 6 mg/kg, there was a total reduction of 90% in positive microfilaria rate from the initial level. However, in other studies, with single-dose DEC or IVM annually over 4 years, the microfilarial rate fell only by 49% and 60% for the DEC and IVM groups respectively, compared to an increase by 28% in the placebo group. Microfilarial levels were also significantly decreased from pre-treatment levels. The combination of IVM 400 µg/kg + DEC 6 mg/kg or 3 mg/kg was superior to that of single dose treatment with DEC or IVM alone. A single or 6 doses of DEC 6 mg/kg were also equivalent in reducing the microfilaria prevalence rate and mean microfilarial densities significantly at 1 year posttreatment in brugian filariasis. Microfilaraemic patients treated with DEC or the newer antifilarial compounds commonlyexperience mild to severe side reactions within a few to 24 hours after the start of treatment. Wolbachia symbionts have been implicated in the pathogenesis of filariasis and adverse reactions associated with chemotherapy. Antibiotics which are effective against these bacteria may have an important role in the treatment and control of lymphatic filariasis. It is considered desirable to achieve death of the adult worms in the treatment of lymphatic filariasis. DEC is presumed to have both microfilaricidal as well as macrofilaricidal activities. Arecent study on its macrofilaricidal action on W. bancrofti has raised some concerns. While the macrofilaricidal effect of DEC was confirmed, a significant proportion of the worms were not killed even at doses in excess of 6 mg/kg. Ivermectin, even at a single dose of 400 µg/kg had no macrofilaricidal effect on adult worms.
A survey was carried out to determine the prevalence of Toxoplasma gondii
antibodies among cattle farmers and cattle in the Gombak District, Selangor. A total
of 79 human and 73 cattle serum samples were tested for Toxoplasma gondii
antibodies by the immunofluorescent technique (IFAT). Results of the survey showed
that anti-Toxoplasma gondii antibodies were found in 27.8% of the farmers, while in
cattle the positive rate was only 3.8%. The prevalence rate obtained in this study did
not differ much from the prevalence reported in previous studies. This suggests that
the same degree of risk to this infection exists in the community. In view of the
relatively low antibody prevalence in cattle, the risk of acquiring this infection from
consuming undercooked beef is realtively low. Further survey on larger sample sixe is
needed to validate the observation.
MeSH terms: Farmers; Red Meat; Animals; Antibodies, Protozoan; Cattle; Humans; Surveys and Questionnaires; Toxoplasma; Prevalence
Tick-borne encephalitis (TBE) is a viral infection of the central nervous system
and is caused by tick bites, usually after travel to rural or forested areas. The disease is
prevalent in Scandinavia, Western Europe, Central Europe and the former Soviet Union
and East Asia including Japan. In Malaysia, so far there are no reported cases of TBE. In
the present time, many illnesses have been attributed to traveling to other parts of the
world. Thus it is important to carry out TBE prevalence study to determine whether the
virus is present among Malaysian population. Samples (sera and CSF) from patients
admitted to major MOH hospitals in Peninsular Malaysia and Sabah with a clinical
diagnosis of encephalitis but is IgM negative for JE, were tested for TBEV IgM ELISA
and TBEV IgG ELISA (DRG, Germany).Out of the 600 samples screened for TBEV
IgG, all were non-reactive. In addition, out of the 100 samples screened for TBEV IgM,
all the samples were also non-reactive. Our results indicate that currently TBE is not
present in the Malaysian population. Among the reasons for this could be lack of the
infection agent, absence of the suitable vector or subjects selected for the study did not fit
the criteria of possible exposure to TBE infections. Hence we recommend that for any
future study, the selection of subjects should include those who returned from tickinfested forested areas.
Pseudorabies (Aujeszky’s disease) is an economically significant disease
of swine known to cause central nervous disorders, respiratory disease,
reproductive failure and mortality in infected pigs. In attempts to eradicate the
disease from becoming endemic, early detection is important to prevent further
economic losses and to allow for detection and removal of infected pigs in
domestic herds. Thus, a rapid and sensitive technique is necessary for the
detection of the virus. For rapid and simple examination, an immuno –
chromatographic lateral – flow assay system based on immunologic recognition
of specific pseudorabies virus antigen was developed by utilising, as signal
generator, colloidal gold conjugated to secondary antibody to detect primary or
sample antibody in the sera of pseudorabies infected animals. The pseudorabies
virus used as a capture antigen in the test strip was first cultivated in VERO cell
culture and then purified by sucrose gradient separation to produce the viral
protein concentration of 3.8 mg/ml. The standard pseudorabies antigens reacted
well with the hyperimmune serum (HIS). The antibody detection system is
basically composed of colloidal gold – labelled antibodies fixed on a conjugate
2
pad, and the complementary pseudorabies antigen immobilised onto a
nitrocellulose membrane forming capture zone. If the target antibody is present in
a specimen, the colloidal gold-labelled antibody will form a complex with the
antibody sample. Subsequently, the formed complex will migrate to the capture
zone and is then bound to the solid phase via antigen – antibody interaction. As a
result, a signal marker is generated by the accumulation of colloidal gold for
detection confirmation. The results obtained demonstrated that the optimum
combination of pseudorabies antigen needed as the capture reagent and gold
conjugate as secondary antibody recognition marker was at a concentration of
0.38mg/ml and at 1:10 dilution factor respectively. The sensitivity of the solid –
based test strip towards pseudorabies antibodies was high with a detection limit
of 1 to 10,000 – dilution factor. The specificity of the assay was 100% with no
cross – reaction being observed with other sera or antibodies. Accurate reading
time needed for confirmation of the assay can be completed in 5 min with a
whole blood sample of 25 ml. The colloidal gold – labelled antibody is stable at
room temperature for 6 months or more (data not shown). Findings from this
study indicated that the solid – based test strip assay system provided high
sensitivity and specificity for the detection of pseudorabies at low levels of
antibody concentration. The assay was rapid, simple, cheap, and does not require
any sophisticated equipment. Thus, the solid based test strip will be a useful
serological screening technique or for rapid diagnosis of an infectious disease in
target populations of animals characterised by heterogeneous antibody responses.
MeSH terms: Animals; Antibodies; Antibody Formation; Antigens; Cercopithecus aethiops; Collodion; Gold; Health Services Needs and Demand; Pseudorabies; Herpesvirus 1, Suid; Reading; Sensitivity and Specificity; Sucrose; Swine; Temperature; Vero Cells; Gold Colloid; Limit of Detection
Blood lead concentration and 6»aminolevulinic acid in urine were used as indicator for lead exposure among school children in an industrial area south of the peninsular Malaysia. A group of 1 00 Malay children which consist of 48 boys and 52 girb with the age range of 61/2 to 81/2 years from a primary school were selected as chiMren. Blood samples were collected and analyzed with Graphite Furnace Atomic Absorption Spectrophotometer. The urine 6-aminolevulinic acid concentrations were measured with UV/VIS Spectrophotometer. The mean blood lead was 3.75ug/dl. Based on the biological index, 76% of the children are in the “normal range" (
Functional dependence is common in hte life and may be due to the normal process of ageing or associated with physical disorders. This study was done to determine the prevalence and factors affecting functional dependence among the elderly in a rural community setting. A cross sectional study design using stratifed proportionate cluster sampling method was used in this study. All elderly residents aged 60 years old and above in the selected kampungs in Mukim Sepang were selected as respondents. The Barthel`s Index ( B1) was used to screen for functional dependence among the respondents. Functional dependence in basic Activities of Daily Living (ADL) implies that the respondent needs assistance in one or more of these tasks. Out of the 263 elderly residents, 223 agreed to participate givinga response rate 84.8%. The mean age was 69.7 years with a SD of 6.8 years. Age ranged from 60-99 years. Thirtyyfive (15.7%) of the respondents were dependent in at kast one function of the ADL. The most common problem identifed was urinary incontinence (9.9%). Functional dependence is common among our elderly population. This problem needs to be addressed by the health care personnel to improve the quality of life of the elderly.
MeSH terms: Activities of Daily Living; Aged; Aging; Cross-Sectional Studies; Humans; Quality of Life; Surveys and Questionnaires; Rural Population; Urinary Incontinence; Prevalence
A cross sectional study was carried amongst adolescent school children in Barat Daya, in 2000. This was to determine the characteristic features of adolescents in the district and to look into their sexual activities, substance use and psychosocial problems with the aim to plan an appropriate adolescent health program. Some 400 students from Form 2 and Form 4 were selected by purposive stratifed and systematic sampling. The study was carried out by trained nurses with an interview using a structured questionnaire. The majority of the respondents were Malays (78.8%) with a household income of less than RM2, 000.00 per if month. Family relations and parental influence were found to be strong. Mental health characteristics scored negatively significantly in this study and those particularly at risk were those who performed poorly in schools. Most claimed not to be involved in high risk behaviour though they knew of friends who did so. Adolescent health services in the district should take an integrated approach with other stakeholders. Health information should be easily available and focus should be given to poor achievers in school.
MeSH terms: Adolescent Health; Adolescent; Child; Cross-Sectional Studies; Family Relations; Humans; Mental Health; Surveys and Questionnaires; Risk-Taking; Schools; Sexual Behavior; Students; Adolescent Health Services; Friends
Cigarette smoking is so widespread that even medical workers are not exempted. A cross sectional survey was conducted among health care workers of the Institute of Respiratory Medicine, Hospital Kuala Lumpur to determine the prevalence of smoking and to assess readiness among the current smokers to quit. A total of 165 workers from all categories was surveyed using a pre-tested self-administered questionnaire, The survey began in Mac 2002 and ended in April 2002, The survey showed that 24.8% of the workers surveyed were current smokers. Only male workers were found to smoke and the prevalence among them was 60.3%. Majority were moderate smokers, smoking between 10 to 20 cigarettes a day and were mainly lower category of workers, Median age of starting to smoke was 17.6 years, There were 20 smokesr ( 52.6%) who were ready to quit. This study found the prevalence of smoking among male health care workers to be higher than males in the general population. The low level of education of these workers seemed to influence smoking status.
MeSH terms: Adult; Cross-Sectional Studies; Health Personnel; Hospitals, General; Humans; Malaysia; Male; Surveys and Questionnaires; Smoking; Tobacco; Prevalence; Smoking Cessation
An outbreak of pneumonia occurred among 1,491 recruits undergoing training at the Army Recruit Training Center, Port Dickson, Negeri Sembihxn, between july to August 2000. They had reported for training 2 weeks before and were placed in new modern concrete 4 floors buiMing with well ventilated dorm. A total of 70 recruits were ajjfected and one died. The attack rate was 4.7% and the case fatality rate was 1.4%. The outbreak ajfected recruits from all the jive companies; J (21/299,
30.0%) , G (19/298, 27.1 %), I (14/298, 20.0%), H (13/298, 18.6%) and F (3/298, 4.3%) . The main presenting symptoms were fever (68/70, 97.1%), cough (62/70, 88.6%), and chest pain (35/70, 50 .0%) . This was a common site outbreak with the mode of spread from person to person through infected droplet. The outbreak has three peaks, which was at lst, 4th and 6th week respectively and lasted for eight weeks. The organisms isobted through blood culture were Streptococcal pneumoniae and Klebsiella pneumoniae. All the cases were managed and treated as in-patients at four dijjferent hospitals depending on the severity of the illness. The main control activities carried out were separation of ill recruits from the healthy, reducing the number of recruits in the dormitories and encourage recruits to drink a lot of water while in training.
An outbreak of dengue and dengue haemorrhagic fever was studied in Bandar Baru Bangi, Hulu Langat District which started from epidemiological week 51 of December 2001 until ]anuary 2002. Altogether, 53 cases were reported to the Hulu Langat District Health Office with 24 cases detected in Section I and Section 6, and 5 cases in Section 4 of Bandar Baru Bangi respectively. Two cases were confirmed as dengue haernorrhagic fever (DHF). The majority of the cases were female Malays. The age of the cases ranged from 3 to 60 years with a mean of 29.17 : 13.18 years old. The majority of patients were mainly private sector workers from factories or companies with 29 cases (54.7%) and university students with 14 cases (26.4%). No deaths were reported in this outbreak. On the average, the duration taken for a patient to be admitted from the date of onset was about 4.4 - 2.0 days and the duration taken for notification from the date of admission was about 2.0 - 1.7 days. The majority of cases reported were based on classical clinical features of dengue fever. Only 18 cases (34%) were IgM positive for dengue. The statistical analysis showed that the majority were male (P>0.05), Malays (P>0.05) , age group of 21»30 years (P>0.05), platelets level < 100,000 per mm3 (p>0.05) and the serological specimens obtained 5 days after the date of onset (p2.0%) within residential premises in this locality with 46 Aedes mosquito breeding places identified and a total amount of RM 6500 of fines imposed.
A cross sectional survey on the assessment of coronary heart disease risks was conducted on a group of security guards in a public university. The objectives were to assess the risk of coronary heart disease (CHD) among the security staff and to provide advice on CHD prevention and practice of a healthy lifestyle. A face»t0»face questionnaire was used to conduct the survey. The main outcome measure was the coronary heart disease (CHD) risk score estimates. The handings showed that 61 participants ( 5 3 .0%) have very high CHD risk factors, while the rest, 38.3% and 8.7% have moderate and low CHD risk factors respectively. With increasing age, there is an increase in total risk score among the target groups. The percentage increases almost 2-fold between the 21-30 and the 31-40 age groups. Majority of the security staff had high CHD risk factors and more efforts and preventive measures must be taken to overcome this situation. Personalised advice was given to participants based on their CHD risks estimates.
MeSH terms: Coronary Artery Disease; Cross-Sectional Studies; Life Style; Surveys and Questionnaires; Risk Factors; Universities; Outcome Assessment (Health Care)
A cross-sectional study to determine the prevalence of malnutrition and some associated factors among primary one schoolchildren, aged 7 years from rural areas of Tumpat and Bachok in Kelantan was carried out. A total of 922 chiMren from 18 primary schools were examined. The parents completed self-administered questionnaires eliciting demographic and socio-economic information. The weight and height of each child was taken. The nutritional status was assessed by the z-scores of weight-for-age (WAZ) , height- or-age (HAZ) and weight-for-height (WHZ). The prevalence of underweight was 25 .2% , stunting was 21 .1% and wasting was 6 .2%. Less than 1 .0% ofthe children were overweight. Risk factors of underweight were lueinga male (OR=l .4),
having an unemployed father (OR=2 .6) and a monthly family income of RM 251 -500 (OR=2 .0) . Being a male (OR=1 .6) was the only risk factor for stunning and working mother (OR=2 .0) was the only risk factor of wasting. In conclusion, there is still a high prevalence of undemutrition among primary one schoolchildren in rural areas of Tumpat and Bachok. This may be due to the poor socioeconomic status of the rural community and the lack of emphasis ofthe supplementary feeding program on the late preschool children. A comprehensive nutrition support program is essential, especially targeting the preschool children in these rural communities
HIV/AIDS is a global issue and the fourth biggest killer worldwide. Report from Ministry Of Health Malaysia showed factory workers are among the social group that are mostly infected (10.4%). A cross~sectional study was carried out to determine the socio-demographic factor and its relationship with knowledge, attitude and HIV-related risk behavior among factory workers in Selangor, Negeri Sembilan and MaIacca. This study involved 3300 factory workers selected randomly and were given self-guided questionnaire. With response rate about 95.4% (3148), the level of knowledge was high (97.3%) and the attitude was positive (81 %). However there was still an amount of fear towards HIV/AlDS patient. Logistic regression showed significant difference (p<0.05) between level of knowledge and ethnic group, income and level of education and between attitude and income and level of knowledge. About 27.7% of respondents smoked cigarette. 4.2% involved with drugs of which 0.7% administered intravenously, 2.3% were homosexuals, 2.5% were bisexuals and 3.1% were hererosexuals. HIV/AIDS prevention and control intervention should take into consideration the local socio-cultural factors and commitment from the top level management in the factory·
The aim of this study was to describe the sociodemographic aspect, clinical presentation and laboratory support, behaviour factor and vector situation of dengue outbreak. Data was obtained from standard investigation format of 84 cases of suspected dengue fever in two main outbreaks localities in Temerloh District from December 2001 to January 2002. The result showed that most of the cases occurred among 11 years old and above, especially in the age group of 11 to 20 years old. Students and female were the most high risk groups. Rashes and petechiae were more prevalent in Taman Sri Semantan which reflect the case incidence there. Serological result showed that seroprevalence for IgM was 66.1 %. Based on dengue rapid test, secondary infection was more prevalent in Taman Sri Kemuning whereas those in Taman Sri Semantan had more primary infection. About 25% of the cases came late to hospital for treatment. Both localities had different mosquito breeding areas. Further studies are needed to identify behaviour aspect of the population with regard to dengue fever in previous main outbreak localities. A more valid and rapid serological test is required for better case identification.
Keywords: Dengue outbreak, risk factors, patient factor, clinical finding, serological test
MeSH terms: Dengue*; Disease Outbreaks*; Humans; Malaysia
The aim of this study was to determine the pattern of health care utilization amongst the rural community and the prevalence of complementary health care in Kampung Giching, Sepang, Selangor, A cross sectional study was conducted in 2001. Out of the 154 respondents selected by universal sampling, only 131 completed the questionnaires giving a response rate of 85.1 %. The
respondents were asked to recall the presence of any illness during the past 6 months and their use of health care, Twenty-four respondents claimed to be healthy without having any illness (18,3%), 33 respondents (25,2%) reported that they had chronic illnesses, while the rest (n=74) reported having acute illnesses. There were 54.2% of the respondents admitted trying self-medication and 10.3% seelced traditional medication for their respective illnesses. Among the self»medicated respondents, 48,3% used modem medicine, 48 .3% used traditional medicine, 1.7% used both modern and traditional medicines and 1 .7% respondent used home remedies. The results of this study show that both modern and traditional practitioners play important roles in giving information on self-medication, These practitioners as well as the public should be advised on the benejits and side»e]j"ects of both types of medication (modern and traditional).
MeSH terms: Chronic Disease; Cross-Sectional Studies; Modems; Medicine, Traditional; Patient Acceptance of Health Care; Surveys and Questionnaires; Rural Population; Self Medication; Prevalence