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Intestinal Myiasis in a Malaysian Patient Caused by Larvae of Clogmia albipunctatus (Diptera: Psychodidae)

Mokhtar AS, Braima KA, Peng Chin H, Jeffery J, Mohd Zain SN, Rohela M, et al.

J Med Entomol, 2016 Apr 25.
PMID: 27113101 DOI: 10.1093/jme/tjw014

We report a case of human intestinal myiasis in a 41-yr-old female patient presented at a clinic in Seri Kembangan, Selangor, Malaysia. Larvae passed out in the patient's feces were sent to the Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. DNA barcoding confirmed the second case of intestinal myiasis in Malaysia involving the larvae of Clogmia albipunctatus (Duckhouse) (Diptera: Psychodidae). We review reported cases of myiasis and discuss the present case of intestinal myiasis in an urban patient.
Patterns and Risk Factors of Soil-Transmitted Helminthiasis Among Orang Asli Subgroups in Peninsular Malaysia

Ngui R, Aziz S, Chua KH, Aidil RM, Lee SC, Tan TK, et al.

Am J Trop Med Hyg, 2015 Aug;93(2):361-70.
PMID: 26055746 DOI: 10.4269/ajtmh.13-0677

A cross-sectional study was conducted to provide comprehensive data on the patterns and associated risk factors of soil-transmitted helminth (STH) infections among five Orang Asli subgroups in Peninsular Malaysia. The overall prevalence of STH infections was 59.9% (95% confidence interval [CI] = 56.1-63.7%). Trichuris trichiura (54.3%; 95% CI = 50.4-58.2%) was the predominant species followed by Ascaris lumbricoides (26.7%; 95% CI = 23.3-30.1%) and hookworm (9.1%; 95% CI = 6.9-11.3%). This study showed diversity for STH infections by subgroup with poverty and personal sanitary behavior as important risk factors for infection. Risk profile analyses indicating that Orang Kuala subgroup who has a generally well-developed infrastructure and better quality of life had a low rate of infection. There is a need for poverty reduction and promotion of deworming programs along with mass scale campaigns to create awareness about health and hygiene to reduce STH infections.
Fulltext Distribution of mosquito larvae in various breeding sites in National Zoo Malaysia

Muhammad-Aidil R, Imelda A, Jeffery J, Ngui R, Wan Yusoff WS, Aziz S, et al.

Trop Biomed, 2015 Mar;32(1):183-6.
PMID: 25801269 MyJurnal

Mosquitoes are principal vectors of major vector-borne diseases. They are widely found throughout urban and rural areas in Malaysia. They are responsible for various vector-borne diseases such as dengue, malaria, filariasis and encephalitis. A total of 158 mosquito larvae specimens were collected from the National Zoo, Malaysia, from 11 types of breeding habitats during the study period from end of May 2007 to July 2007. Aedes albopictus was the predominant species (35.4%), followed by Tripteroides aranoides (26.6%), Lutzia halifaxii (11.4%), Aedes alboscutellatus (10.1%), Aedes caecus (8.9%), Armigeres spp. (4.4%), Malaya genurostris (2.5%) and Culex vishnui (0.6%). It is important to have a mosquito free environment in a public place like the zoo. Routine larval surveillance should be implemented for an effective mosquito control program in order to reduce mosquito population.
Fulltext First report of brown widow spider sightings in Peninsular Malaysia and notes on its global distribution

Muslimin M, Wilson JJ, Ghazali AR, Braima KA, Jeffery J, Wan-Nor F, et al.

J Venom Anim Toxins Incl Trop Dis, 2015;21:11.
PMID: 25995738 DOI: 10.1186/s40409-015-0010-2

The brown widow spider (Latrodectus geometricus Koch, 1841) has colonised many parts of the world from its continent of origin, Africa. By at least 1841, the species had successfully established populations in South America and has more recently expanded its range to the southern states of North America. This highly adaptable spider has been far more successful in finding its niche around the world than its famous cousins, the black widow, Latrodectus mactans, found in the south-eastern states of North America, and the red-back, Latrodectus hasselti, found mostly in Australia, New Zealand and Japan.
Fulltext Molecular detection of Entamoeba histolytica and Entamoeba dispar infection among wild rats in Kuala Lumpur, Malaysia

Lau YL, Jamaiah I, Rohela M, Fong MY, Siti CO, Siti FA

Trop Biomed, 2014 Dec;31(4):721-7.
PMID: 25776597 MyJurnal

Entamoeba histolytica infection is the third-greatest parasitic disease responsible for death in the world. Wild rats harbouring E. histolytica can be the possible reservoir hosts for human amoebiasis. There were numerous studies on prevalence of intestinal parasites among wild rats in Malaysia but none has reported E. histolytica. Rats were captured from Sentul and Chow Kit areas, Kuala Lumpur, Malaysia. The preserved stool samples were used for microscopy examination and molecular analysis. Out of 137 samples collected, 12 were positive for E. histolytica / E. dispar / E. moshkovskii microscopically. Two E. histolytica (1.4%), 1 E. dispar (0.7%) and 6 mixed infections of E. histolytica and E. dispar (4.3%) were detected using PCR. This is the first report of molecular detection of E. histolytica/dispar infection among wild rats in Malaysia. This study provides useful information about the potential risks of zoonotic agents and the importance of developing control measures to prevent zoonotic transmission.
Fulltext Current status of parasitic infections among Pangkor Island community in Peninsular Malaysia

Ahmad AF, Ngui R, Muhammad Aidil R, Lim YA, Rohela M

Trop Biomed, 2014 Dec;31(4):836-43.
PMID: 25776610 MyJurnal

Limited data is available on the prevalence of parasitic infections among the island communities in Malaysia with most studies performed between 1960s-1980s. This study was conducted to determine the current prevalence status of parasitic infections among communities living in Pangkor Island Peninsular Malaysia. A total of 131 stool and 298 serum samples were collected and subjected to microscopic examination for intestinal protozoa and helminths and detection of Toxoplasma gondii antibodies using commercial ELISA kits respectively. In addition, thin and thick peripheral blood films were microscopically screened for the presence of Plasmodium spp. and microfilariae respectively. The overall prevalence of intestinal parasitic infections among Pangkor Island community was 9.9% (13/131) with T. trichiura (5.3%) being the most common intestinal parasite detected. Toxoplasmosis was reported in almost 60% of the community with the seroprevalence being significantly high among females (64.7%) compared to males (52.8%) (p=0.038). None of those examined samples were infected with intestinal sarcocystosis, malaria and filariasis. This study revealed that the prevalence of intestinal parasitic infections among Pangkor Island community has been greatly reduced compared to that reported 35 years ago. Massive improvements in the socioeconomic status, personal hygiene, water facilities and sanitation may have contributed to the low prevalence of parasitic infections in this community. Nevertheless, further studies still need to be performed to determine the possible risk factors for the high prevalence of toxoplasmosis in this community.
Fulltext Is there a risk of suburban transmission of malaria in Selangor, Malaysia?

Braima KA, Sum JS, Ghazali AR, Muslimin M, Jeffery J, Lee WC, et al.

PLoS One, 2013;8(10):e77924.
PMID: 24194901 DOI: 10.1371/journal.pone.0077924

BACKGROUND: The suburban transmission of malaria in Selangor, Malaysia's most developed and populous state still remains a concern for public health in this region. Despite much successful control efforts directed at its reduction, sporadic cases, mostly brought in by foreigners have continued to occur. In addition, cases of simian malaria caused by Plasmodium knowlesi, some with fatal outcome have caused grave concern to health workers. The aim of this study was to investigate the possibility of local malaria transmission in suburban regions of Selangor, which are adjacent to secondary rainforests.
FINDINGS: A malaria survey spanning 7 years (2006 - 2012) was conducted in Selangor. A total of 1623 laboratory confirmed malaria cases were reported from Selangor's nine districts. While 72.6% of these cases (1178/1623) were attributed to imported malaria (cases originating from other countries), 25.5% (414/1623) were local cases and 1.9% (31/1623) were considered as relapse and unclassified cases combined. In this study, the most prevalent infection was P. vivax (1239 cases, prevalence 76.3%) followed by P. falciparum (211, 13.0%), P. knowlesi (75, 4.6%), P. malariae (71, 4.4%) and P. ovale (1, 0.06%). Mixed infections comprising of P. vivax and P. falciparum were confirmed (26, 1.6%). Entomological surveys targeting the residences of malaria patients' showed that the most commonly trapped Anopheles species was An. maculatus. No oocysts or sporozoites were found in the An. maculatus collected. Nevertheless, the possibility of An. maculatus being the malaria vector in the investigated locations was high due to its persistent occurrence in these areas.
CONCLUSIONS: Malaria cases reported in this study were mostly imported cases. However the co-existence of local cases and potential Plasmodium spp. vectors should be cause for concern. The results of this survey reflect the need of maintaining closely monitored malaria control programs and continuous extensive malaria surveillance in Peninsula Malaysia.
Fulltext Prevalence of intestinal and blood parasites among wild rats in Kuala Lumpur, Malaysia

Siti Shafiyyah CO, Jamaiah I, Rohela M, Lau YL, Siti Aminah F

Trop Biomed, 2012 Dec;29(4):544-50.
PMID: 23202599 MyJurnal

A survey was undertaken to investigate the prevalence of intestinal and blood parasites among wild rats in urban area of Kuala Lumpur, Malaysia. A total of 137 stool and blood samples were collected from wild rats from Sentul and Chow Kit areas. Five species of rats were captured and supplied by Kuala Lumpur City Hall. The most common was Rattus rattus diardii (Malayan Black rat), 67%, followed by Rattus norvegicus (Norway rat), 10%, Rattus argentiventer (rice-field rat), 10%, Rattus tiomanicus (Malaysian field rat), 9% and Rattus exulans (Polynesian rat), 4%. Rattus rattus diardii is commonly known to live in human environment and they are normally identified as pests to human community. More male rats were captured (61%) compared to female (39%). Out of 137 samples, 81.8% samples were positive with intestinal parasites, with 86.2% from Sentul area and 78.5% from Chow Kit area. Six different parasites were detected. The most common intestinal helminth parasite detected was Nippostrongylus brasiliensis (80.3%), followed by Hymenolepis nana (23.4%), Capillaria hepatica (13.9%) and Hymenolepis diminuta (2.9%). Intestinal protozoan detected was Entamoeba histolytica/E. dispar (8.8%). Trypanosoma lewisi (1.5%) was the only blood parasite detected.
Fulltext Pneumocystis carinii (jirovecii) pneumonia (PCP): the most common opportunistic infection observed in HIV/AIDS cases at the University Malaya Medical Centre, Kuala Lumpur, Malaysia

Jamaiah I, Rohela M, Tok EL, Tan CL, Tan WH, Teo WS, et al.

Southeast Asian J. Trop. Med. Public Health, 2012 Jul;43(4):825-31.
PMID: 23077803

This retrospective study was conducted among 59 HIV/AIDS patients with opportunistic infections admitted to the University Malaya Medical Centre between 2000 and 2009. Fifty-five point nine percent of cases were Chinese, 25.4% were Malays, 11.9% were Indians and 6.8% were of unknown ethnic origin. The male:female ratio was 2.9:1 (44 males and 15 females). The highest prevalence (38.9%) occurred in the 30-39 year old age group. Men comprised 47.7% and women 53.3%; the majority of both were married. The majority of cases were Malaysians (89.8%) and the rest (10.2%) were immigrants. Most of the patients (18.6%) were non-laborers, followed by laborers (11.9%), the unemployed (5.1%) and housewives (3.4%). The most common risk factor was unprotected sexual activity (20.3%). The two most common HIV/AIDS related opportunistic infections were Pneumocystis carinii (jirovecii) pneumonia (PCP) (62.7%) and toxoplasmosis (28.8%). Seventy-two point nine percent of patients had a CD4 count <200 cells/microl and 5.1% had a CD4 count >500 cells/microl. Eleven point nine percent of cases died during study period. A low CD4 count had a greater association with opportunistic infections. Most of the patients presented with fever (44.1%), cough (42.4%) and shortness of breath (28.8%). Detection of the etiologic pathogens aids clinicians in choosing appropriate management strategies.
Fulltext Oxyspiruriasis in zoo birds

Vellayan S, Jeffery J, Oothuman P, Zahedi M, Krishnasamy M, Paramaswaran S, et al.

Trop Biomed, 2012 Jun;29(2):304-7.
PMID: 22735854 MyJurnal

Oxyspiruriasis caused by the bird eyeworm, Oxyspirura mansoni, a thelaziid nematode, in three species of pheasants, 3 Chrysolophus pictus (golden pheasant), 7 Lophura nycthemera (silver pheasant) and 9 Phasianus colchicus (common pheasant) in Zoo Negara Malaysia are reported. Birds with the disease were treated with a solution of 0.5% iodine or 0.5% lysol. Antistress powder for 4 days in water and non-strep vitamin powder in water was also provided. Control measures included removal of the cockroach intermediate host, Pycnoscelus surinamensis (Surinam cockroach) from the vicinity of the birds. The golden pheasant is a new host for O. mansoni in peninsular Malaysia.
Fulltext A case report of Hymenolepis diminuta infection in a Malaysian child

Rohela M, Ngui R, Lim YA, Kalaichelvan B, Wan Hafiz WI, Mohd Redzuan AN

Trop Biomed, 2012 Jun;29(2):224-30.
PMID: 22735844 MyJurnal

We report a case of Hymenolepis diminuta infection in a 2-year-old Malaysian child. This case was initially reported as 'normal' after the examination of proglottids shed from the anus of the child at a private laboratory on two occasions. The putative proglottids shed was then referred to the Parasite Southeast Asia Diagnostic (Para:SEAD) Laboratory, Department of Parasitology, Faculty of Medicine, University of Malaya for further examination. Microscopic examination confirmed that the child was infected with H. diminuta based on the characteristic eggs found in the proglottids. She was treated with a single dose praziquantel (20 mg/kg of body weight) and recovered well.
Fulltext Domiciliary cockroaches found in restaurants in five zones of Kuala Lumpur Federal Territory, peninsular Malaysia

Jeffery J, Sulaiman S, Oothuman P, Vellayan S, Zainol-Ariffin P, Paramaswaran S, et al.

Trop Biomed, 2012 Mar;29(1):180-6.
PMID: 22543619 MyJurnal

The following domiciliary cockroaches were collected from restaurants in five zones of Kuala Lumpur Federal Territory, Malaysia using 1L glass beaker traps baited with ground mouse-pellets: Periplaneta americana (Linnaeus) (n = 820), Periplaneta brunnea Burmeister (n = 46), Blattella germanica (Linnaeus) (n = 12504), Supella longipalpa (Fabricius) (n = 321), Symploce pallens Stephens (n = 29) and Neostylopyga rhombifolia (Stoll) (n = 5). The following bacteria were isolated from 10 cockroach specimens: Enterobacter cloacae, Klebsiella pneumoniae ssp. pneumoniae, Klebsiella pneumoniae ssp. rhinoscleromatis and Serratia liquefaciens from 5 B. germanica; Acinetobacter calcoaceticus var. anitratus, Citrobacter diversus/amalonaticus, Escherichia vulneris and K.p. pneumoniae from 3 P. brunnea; and Citrobacter freundii, Enterobacter agglomerans 4, Escherichia adecarboxylate, E. vulneris, K. p. pneumonia, K. p. rhinoscleromatis and Proteus vulgeris from 2 P. americana.
Fulltext Plasmodium knowlesi reinfection in human

Lau YL, Tan LH, Chin LC, Fong MY, Noraishah MA, Rohela M

Emerg Infect Dis, 2011 Jul;17(7):1314-5.
PMID: 21762601 DOI: 10.3201/eid1707.101295
Fulltext Seroprevalence of toxocariasis among Orang Asli (Indigenous people) in Malaysia using two immunoassays

Romano N, Nor Azah MO, Rahmah N, Lim Y AL, Rohela M

Trop Biomed, 2010 Dec;27(3):585-94.
PMID: 21399601 MyJurnal

Toxocariasis is a zoonotic helminthic infection of humans caused by the dog roundworm (Toxocara canis) or cat roundworm (Toxocara cati). There are two main human syndromes: visceral larva migrans (VLM), which are characterized by symptoms associated with major organs and ocular larva migrans (OLM), in which pathological effects on the host are restricted to the eye and the optic nerve. The present study evaluated the seroprevalence of toxocariasis among the Orang Asli with an IgG4-ELISA using recombinant antigens (rTES-26, rTES-30 and rTES-120) and an IgG-ELISA commercial kit (Cypress Diagnostic, Belgium). A total of 188 serum samples were analyzed using IgG4-ELISA recombinant antigens while 83 were tested using IgG-ELISA. Overall, 9 out of 188 (4.8%) samples were positive with the former assay: rTES-26 (2.7%) and rTES-30 (2.1%); and 63 out of 83 (75.9%) were positive with the IgG-ELISA. In general, the seroprevalence of toxocariasis among males (9.5%) was higher compared to females (1%). Children below 12 years (6.3%) have higher seroprevalence rate compared to adults (1.2%). Out of 59 IgG positive samples, 56 (94.9%) were also positive with soil-transmitted helminth (STH) infections which may indicate high false positivity. None of the IgG4- ELISA positive samples were positive with STH infections. Of 9 positive samples with IgG4-ELISA, 7 were also positive with IgG-ELISA giving the probability of true cases. The present finding indicated that exposure to Toxocara infection is not unusual among Malaysian aborigines, and it affects both sexes and all age groups. As a prevention strategy, more effective public health programmes to promote better understanding on the consequences of toxocariasis among the Orang Asli communities are deemed necessary.
Fulltext Unusual manifestation of cutaneous toxoplasmosis in a HIV-positive patient

Fong MY, Wong KT, Rohela M, Tan LH, Adeeba K, Lee YY, et al.

Trop Biomed, 2010 Dec;27(3):447-50.
PMID: 21399585 MyJurnal

We report a case of unusual cutaneous toxoplasmosis manifestation in a HIV-positive patient. He presented with hard and painful nodular lesions on the arms, hands and chest. Serology tests for anti-Toxoplasma antibody were negative. However, histopathologic examination of the lesion revealed foci of macrophages containing crescent-shaped organisms resembling the zoites of the protozoan parasite Toxoplasma gondii. Ultrastructure examination under electron microscopy and PCR confirmed the organism as T. gondii.
Fulltext Prevalence of scabies and head lice among children in a welfare home in Pulau Pinang, Malaysia

Muhammad Zayyid M, Saidatul Saadah R, Adil AR, Rohela M, Jamaiah I

Trop Biomed, 2010 Dec;27(3):442-6.
PMID: 21399584 MyJurnal

This is a survey of 120 children for scabies and head lice infestations in a welfare home in Pulau Pinang. Children from this welfare home (Rumah Kanak-Kanak Taman Bakti, Kepala Batas, Pulau Pinang) were randomly selected. Majority of them were Malays (72.5%) and the rest were Indians. The infestation rates were highest in the 10-12 years age group with 46% and 70% for scabies and head lice respectively. Head lice was more commonly seen in girls (65%) than boys (29%). Scabies was more commonly seen in boys (50%) than girls (16%). Overall prevalence rate for scabies was 31% and for head lice infestation was 49%.
Fulltext Tuberculosis: an eight year (2000-2007) retrospective study at the University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Jetan CA, Jamaiah I, Rohela M, Nissapatorn V

Southeast Asian J. Trop. Med. Public Health, 2010 Mar;41(2):378-85.
PMID: 20578521

This was an eight year (2000-2007) retrospective study of tuberculosis in patients admitted to the UMMC. A total of 131 cases were analyzed. Malays constituted the most cases, (43%), followed by Chinese (22%), Indians (17%) and others (18%). The majority of cases were within the 21-60 year old age group, which constituted 69.5% of the total. Males were more commonly affected (65%). Most cases were reported among Malaysians (83%). The majority of patients were unemployed (39%), followed by housewives (10%), laborers (9%), students (8%), shop assistants (7%), and other occupations (27%). The most common presenting complaints were prolonged productive cough, night sweats, fever, anorexia, weight loss (57%), hemoptysis (34%), and undifferentiated symptoms, such as prolonged diarrhea and dysphagia (9%). Sputum was positive for acid-fast bacilli (AFB) in 89%, but only 69% of cases had abnormal chest radiographs. The majority of patients (65%) developed no complications. The most common complications were pleural effusion, pneumothorax and pulmonary fibrosis. The majority of patients (82%) suffered either from diabetes mellitus, hypertension, ischemic heart disease or all 3 conditions. Regarding risk factors for tuberculosis, two were HIV positive and two were intravenous drug users. The majority of the patients (85%) did not complain of any side effects from their anti-tuberculosis treatment. Among those who did complain of side effects, the most common were nausea and vomiting (41%), drug induced hepatitis (37%), blurring of vision (11%) and skin rashes (11%). Two cases of death were reported.
An assay for selection of sera with circulating Toxoplasma gondii antigens

Emelia O, Zeehaida M, Sulaiman O, Rohela M, Saadatnia G, Yeng C, et al.

J Immunoassay Immunochem, 2010;31(1):79-91.
PMID: 20391020 DOI: 10.1080/15321810903405134

We have developed an ELISA that employs monoclonal anti-Toxoplasma SAG1 (p30) as the capture antibody to detect T. gondii circulating antigens in patients' serum samples. Using serum spiked with Toxoplasma soluble and with SAG1 recombinant proteins, the detection limits were 31.25 ng/mL and 62.50 ng/mL, respectively. We obtained positive results in 28% (21/75) and 11% (23/206) of probable active and chronic toxoplasmosis serum samples, respectively. Western blot analysis on pooled antigen-positive serum samples showed antigenic bands of molecular weights 25 and 75 kDa from sera of probable active infection and five antigenic bands ranging in size from 26 to 33 kDa from chronic infection sera. This assay would be useful as an initial serum selection step in developing a Toxoplasma antigen detection test and for characterization studies.
Fulltext A ten year (1999-2008) retrospective study of amoebiasis in University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia

Farhana F, Jamaiah I, Rohela M, Abdul-Aziz NM, Nissapatorn V

Trop Biomed, 2009 Dec;26(3):262-6.
PMID: 20237439 MyJurnal

This is a ten year (1999-2008) retrospective study of amebiasis in patients admitted to UMMC. A total of 34 cases were analyzed. The most common were amebic liver abscess 22(65%) and the rest were amoebic dysentery 12(35%). Majority of the cases occurred among Malaysians 29(85%), with Chinese 14(41%), followed by the Malays 9(26%) and the Indians 6(18%). Foreigners made up of one Indonesian, one Pakistani and three Myanmarese and constituted 5(15%) of the total cases. Males 24(71%) were more commonly affected. Most of the cases occurred between the age group of 40-49 years, 8(23%) and 60 years and above, 8(23%). Age group of 20-50 years constituted 20(60%) of the cases. The most common clinical presentations were fever with chills and rigors 26(76%), diarrhoea 20 (59%), right hypochondrium pain 17(50%), abdominal pain 17(50%), hepatomegaly 16 (47%) and jaundice 7(20%). All were discharged well after treatment except for one case of death in a 69-year-old Chinese male with amebic liver abscess.
Dirofilaria causing eye infection in a patient from Malaysia

Rohela M, Jamaiah I, Hui TT, Mak JW, Ithoi I, Amirah A

Southeast Asian J. Trop. Med. Public Health, 2009 Sep;40(5):914-8.
PMID: 19842373

Human dirofilariasis caused by Dirofilaria immitis and Dirofilaria repens have been reported in Malaysia. This is the fourth reported case of dirofilariasis caused by D. repens. The patient was a Chinese male from Kuching Sarawak, Malaysia who presented with a one day history of redness and itchiness over the temporal aspect of his left eye. A worm was seen and later removed from beneath the conjunctiva under local anesthesia and based on the morphological characteristics, it was identified as an immature Dirofilaria repens.

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