Introduction: Rectal adenocarcinoma patients are advised to increase protein intake
especially after surgery for speedy recovery. Concentrated collagen peptides might help to
improve compliance of protein prescription and ultimately muscle bulk.
Case presentation:
A 35-year-old man diagnosed with low rectal adenocarcinoma was discharged and referred
to diet clinic for continuous intervention. At the time of attending the diet clinic, patient
looked cachectic and lethargic. Patient’s height was 164cm, weight 44kg, BMI 16.4 kg/m2, muscle mass 37.6kg and body fat 9.7%. He had lost 27% of his weight (16kg within 6 months)
and had a C for SGA (Score Global Assessment). Estimated intake was 1560kcal/day and
38g/day protein. Patient reached satiety early and did not comply with oral nutritional
supplement (ONS) due to distaste and concern for his high stoma output. The nutritional
diagnosis was inadequate protein intake related to decreased ability to consume sufficient
protein as evidence by diet history. High protein high calorie diet (HPHC) and collagen
peptides supplement daily were prescribed. Patient was requested to recall diet and to
drink a bottle of collagen peptides in the diet clinic daily for a week to ensure compliance to
diet prescription. After a week, his anthropometry improved: weight reached 46.2kg, muscle
mass 38.6kg and body fat 12.7%. Patient was able to walk and to start working the following
week. Total energy intake was 1690kcal/day with 56g/day protein. As patient was able
to achieve protein requirement via food, collagen peptide was withheld. After a month,
anthropometry improved and complied to HPHC as well as ONS. Concentrated collagen
peptides were found to help the malnourished patient to achieve protein requirement in
small volumes.
Conclusion: Concentrated collagen peptides improve lean muscle mass
in patients with rectal adenocarcinoma postoperatively. It is recommended that further
investigations be conducted to provide concrete evidence on the role of collagen peptides.
Introduction: Individual differences pertaining to cognitive and affective processes toward job stress stimuli may influence food choice and intake, leading to overeating and obesity. This study was conducted to determine the relationship between job stress and abdominal obesity with anger as a personality trait and overeating as moderators among male workers in Malaysia.
Methods: This cross-sectional study involved 492 male employees from 33 private companies in various states in Malaysia. The companies and workers were approached by convenience sampling. Workers who fulfilled the study inclusion criteria completed validated questionnaires assessing job stress, anger as a personality trait and overeating, using the Oldenburg Burnout Inventory-Exhaustion, Spielberger Trait Anger Scale and Three Factor Eating Questionnaire-Uncontrolled, respectively. Weight, height and abdominal circumference were taken for each participant. Moderation effect analyses were conducted based on standard multiple regression.
Results: For two-way interaction, a significant curvilinear regression equation was found to predict overeating based on job stress as a predictor and anger as a moderator (β=0.93, SE=0.46, t=2.03, p=0.043). High anger was associated with higher overeating behaviour on exposure to high job stress level (F (7, 484) = 9.36, p
Introduction: Often considered a legitimate strategy to enhance health and
performance, the consumption of nutritional supplements (NS) has become
a common practice which frequently results in unintentional doping among
athletes. Despite a probable association between NS and doping, there are limited
studies on this topic in developing countries such as Malaysia. Thus, this study
aimed to identify the prevalence of NS usage among national elite athletes and
assess their knowledge and attitude regarding its use and doping.
Methods:
This was a cross-sectional study conducted at the Malaysian National Sports
Institute among national elite athletes (n=50) recruited via convenience sampling.
The athletes completed a self-administered questionnaire documenting their
demographic characteristics, training information, NS consumption, knowledge
and attitude related to supplement-doping. The total knowledge and attitude
scores were compared according to demography, training information, and NS
consumption.
Results: The prevalence of NS use among the athletes was 72%.
NS usage was significantly associated with training duration (p=0.029), source of
nutrition information (p=0.047) and self-exploration on supplements (p=0.045).
Supplement-doping knowledge was significantly higher among athletes with
tertiary level education (p=0.027), NS users (p=0.044), those obtaining information
from nutritionists (p=0.048) and those who had attended nutrition workshops
(p
MeSH terms: Attitude; Cross-Sectional Studies; Developing Countries; Doping in Sports; Malaysia; Surveys and Questionnaires; Sports; Prevalence; Dietary Supplements; Athletes; Nutritionists
Introduction: Physical activity has been shown to be beneficial for the prevention of
obesity and non-communicable diseases. Our contemporary way of life that is technology
dependent has significantly reduced physical activity. This study aimed to determine
accelerometer-measured physical activity (moderate-to-vigorous physical activity (MVPA))
among adults in high and low walkability neighbourhoods in Penang and Kota Bharu,
Malaysia.
Methods: Participants (n=490) were sampled using multistage sampling method
from neighbourhoods with varied levels of walkability using Geographical Information
System (GIS). Physical activity was measured objectively using Actigraph GT3X+
accelerometers, worn by the participants on their waists for a period of 5 to 7 days.
Results:
The participants had a mean of 13.5 min/day of MVPA. Total MVPA was significantly
higher among participants in high walkability neighbourhoods (19.7 min/day vs. 9.1 min/
day). Results from t-test showed that the time spent on MVPA per day was significantly
lower among participants residing in low walkability neighbourhoods. The final model
of the MIXED model statistical tests showed that total MVPA was significantly associated
with BMI, but not with WC measurements, after adjusting for covariates.
Conclusion: Most
of the participants had very low MVPA and did not achieve the current physical activity
recommendations, implying that Malaysian adults residing in these two cities were not
physically active to achieve health benefits. Results are suggestive of the importance of the
walkability concept in neighbourhoods in encouraging physical activity and healthy body
weight among Malaysians.
MeSH terms: Adult; Body Weight; Cities; Humans; Malaysia; Obesity; Exercise; Body Mass Index; Walking; Geographic Information Systems; Accelerometry
Introduction: Detailed clinical information is important for the Casemix System to
generate valuable Case Based Group (CBG) for malnourished geriatric patients. Clinical
coding for malnutrition provides useful information on the nutritional health of patients
for treatment purposes.
Methods: This cross-sectional study with purposive sampling
involved a total of 130 geriatric patients (>60 years) at Hospital Universiti Sains Malaysia
(USM). Nutritional assessments were performed such as anthropometrics measurement,
Subjective Global Assessment (SGA), and biochemical assessment. The patients’ medical
records and coded data were systematically reviewed to observe the documentation of
nutritional information and coding criteria based on the International Classification for
Diseases (ICD-10).
Results: The prevalence of malnutrition among the geriatric patients
was 35.4%. Proper documentation of required nutritional information was found in less
than 50% of the cases. None of the malnourished patients were documented and coded
with malnutrition diagnosis, despite being given nutritional interventions. The reasons
given for this omission were related to the lack of awareness (50%) and incomplete
medical documentation (50%). Further analysis revealed that uncoded diagnosis,
miscoding, missing, and unavailable codes for nutritional counselling and oral nutritional
supplementation were the main contributors to the incomplete records.
Conclusion:
The quality of clinical coding for malnourished geriatric patients in the hospital should
be improved. A structured assessment and standard documentation is recommended to
improve the quality of healthcare provision for malnourished geriatric patients.
Introduction: Malnutrition is associated with poorer outcomes following treatment for colorectal cancer (CRC). This study evaluates the relationship between nutritional status using scored Patient Generated-Subjective Global Assessment (PG-SGA) with the validated European Organisation for Research and Treatment of Cancer questionnaire (EORTC-QLQ C30) which consists of five functional scales, three symptoms scales and one item of global health/quality of life (QOL).
Methods: A total of 42 CRC patients at oncology outpatient clinics from two hospitals in Malaysia participated in the study from March 2011 to March 2012. The participants were classified as either well-nourished (PG-SGA A) or malnourished (PG-SGA B and C).
Results: The majority of patients were Chinese, male, with a mean age of 57.1 ± 9.8 years and had been diagnosed with stage 2 CRC. Well-nourished patients had statistically significantly better QOL scores on symptom scales: fatigue (p<0.001), nausea and vomiting (p<0.05), and pain (p<0.001) compared to malnourished patients. PG-SGA was strongly correlated with the main domains of the QOL: global health status (r = -0.395, p<0.05), fatigue (r = 0.816, p<0.001), nausea and vomiting (r = 0.730, p<0.001) and pain (r= 0.629, p<0.001). The better the nutritional status (lower total mean score of PG-SGA), the higher the QOL (high mean score of global health status).
Conclusion: The scored PG-SGA is suitable for use as a nutrition assessment tool to identify malnutrition and it is associated
with QOL among this population.
Key words: Chemotherapy, colorectal cancer patient, malnutrition, nutritional status, PGSGA score, quality of life
Study site: Oncology clinics, Hospital Kuala Lumpur, Hospital Selayang, Kuala Lumpur, Malaysia
Introduction: Malnutrition among cancer patients is associated with a higher risk of
gastrointestinal toxicity which develops during treatment and may affect quality of life (QOL).
Thus, this cross-sectional study aimed to determine the nutritional status and QOL of 30
oncology patients (mean age 50.0+10.7 years) prior to pelvic radiotherapy at Hospital Sultan
Ismail, Johor Bahru.
Methods: Patients were assessed for anthropometry measurements,
24-h diet recall and nutritional status using Scored Patient-Generated Subjective Global
Assessment (PG-SGA) questionnaire while the European Organization for Research and
Treatment of Cancer Care Quality of Life Questionnaire (EORTC QLQ-C30) was used to
assess QOL two weeks prior to the initiation of pelvic radiotherapy.
Results: Mean Body
Mass Index (BMI) of patients was 23.3+3.3kg/m2
and 33% of patients experienced weight
loss prior to pelvic radiotherapy. The PG-SGA rating indicated that 63% of patients were at
Stage A (well-nourished) and 37% were in Stage B (moderate malnutrition). The PG-SGA
numerical score was a significant predictor of QOL, after adjusting for socio-demographic
factors (R2
=0.861, p
MeSH terms: Adult; Body Weight; Cross-Sectional Studies; Diet; Eugenol; Humans; Middle Aged; Nutritional Status; Quality of Life; Surveys and Questionnaires; Zinc Oxide; Body Mass Index; Malnutrition
Introduction: This is a preliminary result of an on-going randomised cross-over trial to
compare the effects of consuming yellowstripe scad (YSS) and salmon, both rich in omega-3
fatty acids, on lipid profile, fasting glucose, body weight status, and blood pressure among
healthy overweight adults.
Methods: Fifty healthy overweight Malaysians aged 21-55 years
were recruited voluntarily through advertisements. During the first period of intervention,
subjects were randomised equally to receive eight weeks of either steamed whole YSS fish
(YSS group) or salmon fillet (salmon group), three days per week, obtaining approximately
7000 mg EPA+DHA per week. The diets were switched after an eight-week washout
period. Lipid profile, fasting glucose, body mass index, and blood pressure were evaluated
before and after each intervention period.
Results: The mean ages of YSS group (n=25)
and salmon (n=25) group were 30.6±9.1 and 27.9±7.1 years respectively. Both groups had
no statistically significant differences on socio-demographic characteristics (p>0.05). After
the first intervention period, there was a significant increase in total cholesterol within
the YSS group (p0.05). Both YSS and salmon
groups had significantly higher HDL-cholesterol levels after 8 weeks compared to baseline
(p0.05). However, there was a significant effect of time on
diastolic blood pressure (p
Introduction: Probiotic microbial cell preparation (MCP) supplementation is one of the
approaches to modulate alterations in gut microbiota (GM). This double-blind randomised
controlled trial investigated the effect of 4 weeks of MCP supplementation on fasting blood
glucose levels (FBG), body weight (BW), waist circumference (WC), and faecal short chain
fatty acids (SCFA) among 24 healthy and overweight (with BMI ≥ 23 kg/m2) Malaysian
adults.
Methods: Twenty-six subjects were randomised to receive either MCP (n= 12) or
placebo (n=14), twice daily, for 4 weeks. The probiotic powder contained a mix of six
strains namely, Lactobacillus acidophilus, Lactobacillus lactis, Lactobacillus casei,Bifidobacterium
longum, Bifidobacterium bifidum and Bifidobacterium infantis (3.0 x 1010 cfu). FBG, BW, WC,
WHR, faecal SCFA, physical activity levels and dietary intake were measured and changes
were determined using repeated measures ANOVA.
Results: Twenty-four subjects
successfully completed the 4-week study period. Changes in FBG, BW, WC and SCFA were
not significantly different between the groups. Only subjects in the MCP group significantly
reduced their energy intake compared to baseline (1671±476 vs 1386±447 kcal, P=0.045).
Conclusion: A 4-week supplementation of the MCP mix powder did not have significant
effects on the variables studied. However, the significant reduction in dietary energy intake
in the MCP group suggests the potential of probiotics as an adjuvant to dietary therapy for
weight loss.
Objectives: Chromosomal abnormalities especially aneuploidies are the most common etiology for pregnancy loss. Trisomy 13, trisomy 18 and trisomy 21 are the most common chromosome autosomal aneuploidies with trisomy 21 (Down syndrome) being the most common chromosomal abnormality among liveborn infants. In previous reports, we noted that the recurrence of these aneuploidies in some families may not occur by chance alone.
Methods: Extraction of relevant data from review of medical case notes of a young couple with two offspring with Down syndrome (DS) and Patau syndrome.
Results: A family history of DS is a predisposing factor for both DS and other types of aneuploidy. Certain instances of non-disjunction error are not random.
Conclusion: As the maternal age was not advanced in both pregnancies, there is a possibility that the recurrent aneuploidy in this family may not be accounted by chance alone. The risk of having subsequent affected pregnancy cannot be ignored in this family and prenatal diagnosis is strongly recommended in the subsequent pregnancy.
Progression to AIDS is more rapid in HIV-infected children. Objective: Our study aimed to investigate the effect of HIV status disclosure in children in terms of their perception of the illness, knowledge on their disease and medications and the overall impact on their quality of life.
Methods: A qualitative study was conducted from 1st June 2017 till 8th September 2017 involving face-to-face interviews with HIV-positive children receiving combination anti-retroviral therapy (cART) under paediatric HIV clinic follow-up, Hospital Tuanku Fauziah, Kangar, Perlis. Transcribed interview dialogues were subsequently coded for analysis.
Results: Data were collected from 6 out of 8 HIV-positive children on cART in Hospital Tuanku Fauziah, Perlis. Participants’ mean age was 12.2 years (standard deviation [SD] 2.11); 3 with disease disclosure. Disease-disclosed participants with ironically poor knowledge on their disease emerged as the key theme in the study. Disease-disclosed participants were also noted to be more withdrawn with very few friends, if any. Disease disclosure status did not affect the patients’ knowledge and compliance to medication.
Conclusion: Assessment of patients’ understanding after disease-disclosure session is crucial to encourage therapy adherence and prevention of future transmission. Re-appraisal of the healthcare policy with regards to holistic management of children living with HIV is warranted to attain positive social and developmental goal throughout their lives.
Study site: paediatric HIV clinic follow-up, Hospital Tuanku Fauziah, Kangar, Perlis
MeSH terms: Child; Hospitals, General; Humans; Health Knowledge, Attitudes, Practice; Malaysia; Outpatient Clinics, Hospital; HIV Infections; Disclosure; Qualitative Research
Introduction: Vaccine-preventable diseases such as pertussis are re-emerging in Malaysia during recent years.
Objective: This research aims to study the local incidence of clinical pertussis among paediatric patients admitted to Hospital Tuanku Fauziah, Perlis over two-year period.
Method: A cross-sectional study was designed in Department of Paediatrics, Hospital Tuanku Fauziah, Perlis from 1 January 2013 till 31 January 2015. Data were collected from medical and laboratory record of cases admitted for clinical pertussis. Analyses for descriptive data were done using frequency and percentage; Pearson chi-square or Fisher exact was used to test association.
Results: 81 cases of clinical pertussis were included in the study. Out of this, there were a total of 28 confirmed cases of pertussis. There was a steady increment in the incidence of pertussis throughout the study period. Cyanosis emerged as the only clinical sign significantly associated with pertussis (p = 0.011). Majority of the confirmed pertussis cases were too young to be immunized (n = 13, 46.4%).
Conclusion: Reappraisal of local health system to strengthen herd immunity in the community is warranted to control disease spread.
Music therapy is rarely available within the medical services in Malaysia. Hospitalized children experience a great deal of stress, anxiety, and pain due to unfamiliar environment, separation from the family, a variety of medical procedures and treatments, and the uncertainties of the illnesses. Music is often used to cope with both physical and psychological distress clinically because of its pervasiveness and familiarity. The purpose of this article is to elaborate the effectiveness of music therapy in addressing both physical and psychosocial needs of hospitalized children. The three case studies demonstrated how a variety of music therapy interventions are used to facilitate individualized goals and to improve the quality of life.
Introduction and Objective: Pneumococcal disease is a leading cause of morbidity and mortality worldwide. There were limited publications on invasive pneumococcal infection (IPD) in Malaysia. The aim of this study is to describe restrospectively cases of IPD in hospitalised children of less than 12 years old and highlighting the unusual cases.
Methodology: A retrospective review of children with IPD from March 2002 to November 2005 at a tertiary paediatric hospital. IPD cases were defined as isolates of Streptococcus pneumoniae from a normally sterile body fluid site.
Results: Twenty-four patients were identified with a male preponderance. Two-thirds of patients were below 1-year-old; with three cases presenting in the premature newborn. Thirty-seven percent of cases had underlying conditions. Sepsis and pneumonia were the commonest manifestation, followed by meningitis. The unusual manifestations were in a form of postinfectious glomerulonephritis and overwhelming purpura fulminans. There were two mortalities; both infants had meningitis. Antibiotic susceptibility pattern showed that more than half of the isolates were sensitive towards penicillin and erythromycin. Penicillin resistance was found in 6 (25%) isolates. Conclusion: IPD results in significant morbidity and mortality, especially in young children below 2 years of age and justifies further evaluation of preventive strategies including the implementation of pneumococcal vaccine in the national immunisation programme.
Objective: To compare the mean duration of diarrhea between children taking yogurt and with the group taking commercial probiotics, containing lactobacillus in acute watery diarrhea. Materials and
Methods: This descriptive study was conducted in the Department of Pediatrics, Services Hospital, Lahore. The duration of this cross sectional study was 6 months, from June 2013 to November 2013. A total of 200 children suffering from acute watery diarrhea were involved in the study after the informed consent under the said hospital. Their demographic information was recorded and later divided in two groups of 100 each; group A received yogurt and group B was given commercial probiotic. The duration of diarrhea was observed in both groups. The results were compared by using independent sample t-test.
Results: The average duration of diarrhea in group A, was 1.98 + 1.31 day while that in group B was 3.09 + 1.64 days. Student's t-test was applied and the difference between the two groups was found to be statistically significant (p< 0.05).
Conclusions: Treatment with yogurt significantly decreases the mean duration of diarrhea as compared to probiotic among patients with acute watery diarrhea.
Introduction: Parents of children with chronic illness such as thalassaemia, experience parental anxiety as a result of multiple stressors; these parents will consequently undergo the process of coping and adjustment in order to overcome the situation. Identifying families who may require psychosocial intervention is an important step towards providing holistic management for these children.
Methodology: A cross-sectional study was conducted to determine the level of parenting stress amongst parents of children with thalassaemia. Risk factors associated with high parenting stress score were identified. Research instruments used were the Parenting Stress Index/Short Form and Coping Inventory for Stressful Situations.
Results: A total of 54 subjects were recruited. High total parenting stress score (TPSS, defined at 75th centile) for this cohort was 99.5 whereas the mean TPSS was 86.18. Overall, 24% of these parents have high TPSS. Chinese ethnicity, number of children, monthly income, task-oriented and emotion-oriented coping mechanisms were significantly associated with a high TPSS. Logistic regression analysis revealed that low task-oriented but high emotion-oriented scores were risk factors with the greatest predictive power.
Conclusion: Early recognition of parenting stress is important to identify at risk parents so that interventions such as counseling and social support may be given.
Application of genome editing have garnered a lot of attention in the scientific world. Its ability to make permanent and precise modification or ‘edits’ in the genomic DNA sequences have open up the possibility of probing the functionality of genes and correcting abnormal genes to treat genetic diseases. The CRISPR/Cas9 which was adapted from Type II bacterial adaptive immune system is the most applied genome editing system due to the ease and efficiency of the system in customising the nucleases needed in editing the targeted sequences. However, the downside of this system is the high frequency of ‘off-target’ editing caused by the nature of the Cas9 protein that can tolerate mismatches between customised nucleases; sgRNA, and the genomic sequences. Despite the set-back, researchers continue applying CRISPR/Cas9 system to edit the genome by minimising the frequency of ‘off-target’ edits. Application of the improved system had successfully produced numerous results in the initial treatment of genetic diseases such as cystic fibrosis, β-thalassemia, and Duchenne Muscular Dystrophy. The fast-paced development and improvement made to this system will continue to be utilised by the researchers around the world for the treatment of human diseases, a progress much needed and awaited.
Thalassaemia is a hereditary blood disorder that is becoming a major health problem all over the world. This chronic illness harms the quality of life of the sufferers by interrupting their physical activities, school performance and social life. Hence, this review takes aim to assess the factors affecting the quality of life of thalassaemia among paediatrics patients. A comprehensive electronic search was conducted by using PubMed, Google Scholar and Science Direct. The search was limited to those articles written in English language and by using Pediatrics Quality of Life Inventory (PedsQLTM) 4.0 generic core scale questionnaire only. This review notifies emerging knowledge regarding the factors affecting the quality of life among thalassaemia patients and its implications in the essential core domains for paediatrics health-related quality of life measurements: physical, emotional, social and school functioning. It also empowers a better understanding regarding thalassaemia and assists as a foundation for the development of the effective preventive strategies for it.
MeSH terms: Child; Chronic Disease; Humans; Quality of Life; Surveys and Questionnaires; Thalassemia
Pre-implantation genetic diagnosis (PGD) became well known in Malaysia after the birth of the first Malaysian 'designer baby', Yau Tak in 2004. Two years later, the Malaysian Medical Council implemented the first and only regulation on the use of Pre-implantation Genetic Diagnosis in this country. The birth of Yau Tak triggered a public outcry because PGD was used for non-medical sex selection thus, raising concerns about PGD and its implications for the society. This study aims to explore participants' perceptions of the future implications of PGD for the Malaysian society. We conducted in-depth interviews with 21 participants over a period of one year, using a semi-structured questionnaire. Findings reveal that responses varied substantially among the participants; there was a broad acceptance as well as rejection of PGD. Contentious ethical, legal and social issues of PGD were raised during the discussions, including intolerance to and discrimination against people with genetic disabilities; societal pressure and the 'slippery slope' of PGD were raised during the discussions. This study also highlights participants' legal standpoint, and major issues regarding PGD in relation to the accuracy of diagnosis. At the social policy level, considerations are given to access as well as the impact of this technology on families, women and physicians. Given these different perceptions of the use of PGD, and its implications and conflicts, policies and regulations of the use of PGD have to be dealt with on a case-by-case basis while taking into consideration of the risk-benefit balance, since its application will impact the lives of so many people in the society.
MeSH terms: Attitude*; Female; Disabled Persons; Humans; Malaysia; Male; Morals; Perception; Pregnancy; Public Opinion*; Public Policy*; Surveys and Questionnaires; Social Justice; Social Values*; Preimplantation Diagnosis*; Government Regulation; Dissent and Disputes
Non-human primates of South-East Asia remain under-studied concerning parasite epidemiology and co-infection patterns. Simultaneously, efforts in conservation demand knowledge of parasite abundance and biodiversity in threatened species. The Endangered proboscis monkey, Nasalis larvatus, a primate flagship species for conservation in Borneo, was investigated in the present study. Habitat loss and fragmentation are among the greatest threats to bachelor and harem groups of this folivorous colobine. Designed as a follow-up study, prevalence and co-infection status of intestinal parasites from N. larvatus in a protected area in Malaysian Borneo were analyzed from fecal samples using a flotation method. For the first time, the intestinal parasite co-infection patterns were examined using quantitative analyses. Overall, 92.3% of fecal samples (N = 652) were positive for helminth eggs. Five helminth groups were detected: (1) trichurids (82.7% prevalence) including Trichuris spp. (82.1%) and Anatrichosoma spp. (1.4%), (2) strongyles (58.9%) including Trichostrongylus spp. (48.5%) and Oesophagostomum/Ternidens spp. (22.8%), (3) Strongyloides fuelleborni (32.7%), (4) Ascaris lumbricoides (8.6%), and (5) Enterobius spp. (5.5%). On average, an individual was co-infected with two different groups. Significant positive associations were found for co-infections of trichurids with strongyles and S. fuelleborni as well as S. fuelleborni with A. lumbricoides and strongyles. This study shows a high prevalence of various gastrointestinal helminths with potential transmission pathways primarily related to soil and with zoonotic relevance in wild proboscis monkeys in their remaining natural habitats. Observed positive associations of trichurids with strongyles and Strongyloides spp. may result from the high prevalence of trichurids. Similarly, positive associations between Strongyloides and Ascaris were found, both of which typically occur predominantly in juvenile hosts. These findings should be considered when proposing conservation actions in altered habitats nearby human settlements and when managing captive populations.