Displaying publications 1 - 20 of 231 in total

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  1. Antinori S, Galimberti L, Milazzo L, Corbellino M
    Acta Trop, 2013 Feb;125(2):191-201.
    PMID: 23088834 DOI: 10.1016/j.actatropica.2012.10.008
    Plasmodium knowlesi was initially identified in the 30s as a natural Plasmodium of Macaca fascicularis monkey also capable of experimentally infecting humans. It gained a relative notoriety in the mid-30s as an alternative to Plasmodium vivax in the treatment of the general paralysis of the insane (neurosyphilis). In 1965 the first natural human infection was described in a US military surveyor coming back from the Pahang jungle of the Malaysian peninsula. P. knowlesi was again brought to the attention of the medical community when in 2004, Balbir Singh and his co-workers reported that about 58% of malaria cases observed in the Kapit district of the Malaysian Borneo were actually caused by P. knowlesi. In the following years several reports showed that P. knowlesi is much more widespread than initially thought with cases reported across Southeast Asia. This infection should also be considered in the differential diagnosis of any febrile travellers coming back from a recent travel to forested areas of Southeast Asia. P. knowlesi can cause severe malaria with a rate of 6-9% and with a case fatality rate of 3%. Respiratory distress, acute renal failure, shock and hyperbilirubinemia are the most frequently observed complications of severe P. knowlesi malaria. Chloroquine is considered the treatment of choice of uncomplicated malaria caused by P. knowlesi.
    Matched MeSH terms: Communicable Diseases, Emerging/parasitology
  2. Raza A, Ahmadian A, Rafiq M, Salahshour S, Naveed M, Ferrara M, et al.
    Adv Differ Equ, 2020;2020(1):663.
    PMID: 33250928 DOI: 10.1186/s13662-020-03116-8
    In this manuscript, we investigate a nonlinear delayed model to study the dynamics of human-immunodeficiency-virus in the population. For analysis, we find the equilibria of a susceptible-infectious-immune system with a delay term. The well-established tools such as the Routh-Hurwitz criterion, Volterra-Lyapunov function, and Lasalle invariance principle are presented to investigate the stability of the model. The reproduction number and sensitivity of parameters are investigated. If the delay tactics are decreased, then the disease is endemic. On the other hand, if the delay tactics are increased then the disease is controlled in the population. The effect of the delay tactics with subpopulations is investigated. More precisely, all parameters are dependent on delay terms. In the end, to give the strength to a theoretical analysis of the model, a computer simulation is presented.
    Matched MeSH terms: Communicable Diseases
  3. Chan SK, Lim TS
    Adv Exp Med Biol, 2017;1053:61-78.
    PMID: 29549635 DOI: 10.1007/978-3-319-72077-7_4
    The incident of two children in Europe who died of diphtheria due to a shortage of anti-toxin drugs has highlighted the need for alternative anti-toxins. Historically, antiserum produced from immunised horses have been used to treat diphtheria. Despite the potential of antiserum, the economical and medial concerns associated with the use of animal antiserum has led to its slow market demise. Over the years, new and emerging infectious diseases have grown to be a major global health threat. The emergence of drug-resistant superbugs has also pushed the boundaries of available therapeutics to deal with new infectious diseases. Antibodies have emerged as a possible alternative to combat the continuous onslaught of various infectious agents. The isolation of antibodies against pathogens of infectious diseases isolated from immune libraries utilising phage display has yielded promising results in terms of affinities and neutralizing activities. This chapter focuses on the concept of immune antibody libraries and highlights the application of immune antibody libraries to generate antibodies for various infectious diseases.
    Matched MeSH terms: Communicable Diseases/drug therapy*; Communicable Diseases/immunology
  4. Chan SK, Rahumatullah A, Lai JY, Lim TS
    Adv Exp Med Biol, 2017;1053:35-59.
    PMID: 29549634 DOI: 10.1007/978-3-319-72077-7_3
    Many countries are facing an uphill battle in combating the spread of infectious diseases. The constant evolution of microorganisms magnifies the problem as it facilitates the re-emergence of old infectious diseases as well as promote the introduction of new and more deadly variants. Evidently, infectious diseases have contributed to an alarming rate of mortality worldwide making it a growing concern. Historically, antibodies have been used successfully to prevent and treat infectious diseases since the nineteenth century using antisera collected from immunized animals. The inherent ability of antibodies to trigger effector mechanisms aids the immune system to fight off pathogens that invades the host. Immune libraries have always been an important source of antibodies for infectious diseases due to the skewed repertoire generated post infection. Even so, the role and ability of naïve antibody libraries should not be underestimated. The naïve repertoire has its own unique advantages in generating antibodies against target antigens. This chapter will highlight the concept, advantages and application of human naïve libraries as a source to isolate antibodies against infectious disease target antigens.
    Matched MeSH terms: Communicable Diseases/drug therapy*; Communicable Diseases/immunology
  5. Fix AG
    Am. J. Phys. Anthropol., 1984 Oct;65(2):201-12.
    PMID: 6507610
    A Monte Carlo simulation based on the population structure of a small-scale human population, the Semai Senoi of Malaysia, has been developed to study the combined effects of group, kin, and individual selection. The population structure resembles D.S. Wilson's structured deme model in that local breeding populations (Semai settlements) are subdivided into trait groups (hamlets) that may be kin-structured and are not themselves demes. Additionally, settlement breeding populations are connected by two-dimensional stepping-stone migration approaching 30% per generation. Group and kin-structured group selection occur among hamlets the survivors of which then disperse to breed within the settlement population. Genetic drift is modeled by the process of hamlet formation; individual selection as a deterministic process, and stepping-stone migration as either random or kin-structured migrant groups. The mechanism for group selection is epidemics of infectious disease that can wipe out small hamlets particularly if most adults become sick and social life collapses. Genetic resistance to a disease is an individual attribute; however, hamlet groups with several resistant adults are less likely to disintegrate and experience high social mortality. A specific human gene, hemoglobin E, which confers resistance to malaria, is studied as an example of the process. The results of the simulations show that high genetic variance among hamlet groups may be generated by moderate degrees of kin-structuring. This strong microdifferentiation provides the potential for group selection. The effect of group selection in this case is rapid increase in gene frequencies among the total set of populations. In fact, group selection in concert with individual selection produced a faster rate of gene frequency increase among a set of 25 populations than the rate within a single unstructured population subject to deterministic individual selection. Such rapid evolution with plausible rates of extinction, individual selection, and migration and a population structure realistic in its general form, has implications for specific human polymorphisms such as hemoglobin variants and for the more general problem of the tempo of evolution as well.
    Matched MeSH terms: Communicable Diseases/genetics
  6. Ten DCY, Jani R, Hashim NH, Saaban S, Abu Hashim AK, Abdullah MT
    Animals (Basel), 2021 Apr 06;11(4).
    PMID: 33917373 DOI: 10.3390/ani11041032
    The critically endangered Malayan tiger (Panthera tigris jacksoni), with an estimated population of less than 200 individuals left in isolated rainforest habitats in Malaysia, is in an intermediate population crash leading to extinction in the next decade. The population has decreased significantly by illegal poaching, environmental perturbation, roadkill, and being captured during human-wildlife conflicts. Forty-five or more individuals were extracted from the wild (four animals captured due to conflict, one death due to canine distemper, one roadkilled, and 39 poached) in the 12 years between 2008-2019. The Malayan tigers are the first wildlife species to test positive for COVID-19 and are subject to the Canine Distemper Virus. These anthropogenic disturbances (poaching and human-tiger conflict) and environmental perturbation (decreasing habitat coverage and quality) have long been identified as impending extinction factors. Roadkill and infectious diseases have emerged recently as new confounding factors threatening Malayan tiger extinction in the near future. Peninsular Malaysia has an existing Malayan tiger conservation management plan; however, to enhance the protection and conservation of Malayan tigers from potential extinction, the authority should reassess the existing legislation, regulation, and management plan and realign them to prevent further population decline, and to better enable preparedness and readiness for the ongoing pandemic and future threats.
    Matched MeSH terms: Communicable Diseases
  7. Chai WL, Yong CK, Ngeow WC
    Ann Dent, 2003;10(1):22-26.
    MyJurnal
    Most prosthetic joint infections originate from wound contamination or haematogenous seeding from distant sites of infection. Bacteraemia may follow dental treatment but there is little evidence of it related to prosthetic joint infection. Nevertheless, controversy continues with regards to the effect of dental treatment in patients with prosthetic joints. This article reviews current English literature regarding the use of antibiotic prophylaxis in the dental management of patients with prosthetic joints. Routine antibiotic prophylaxis is not recommended for every patient with prosthetic joints when receiving dental treatments. However, antibiotic prophylaxis may be prescribed for high-risk groups with predisposing factors to infection when undergoing dental treatment with high risk of bacteraemia.
    Matched MeSH terms: Communicable Diseases
  8. Bosco J
    Ann Acad Med Singap, 1988 Apr;17(2):251-3.
    PMID: 3044263
    Immunology is a discipline that traverses all branches of clinical medicine. Thus since about ten years ago major hospitals in Malaysia established routine clinical immunology services particularly in the diagnosis of autoimmune/connective tissue disorders. More recently these laboratories have ventured into basic research in Dengue Haemorrhagic Fever, Leukaemia Immunology, Nasopharyngeal Cancer and Leprosy. The rationale for these projects together with early results from them are discussed.
    Matched MeSH terms: Communicable Diseases/immunology
  9. Daszak P, Tabor GM, Kilpatrick AM, Epstein J, Plowright R
    Ann N Y Acad Sci, 2004 Oct;1026:1-11.
    PMID: 15604464
    The last three decades have seen an alarming number of high-profile outbreaks of new viruses and other pathogens, many of them emerging from wildlife. Recent outbreaks of SARS, avian influenza, and others highlight emerging zoonotic diseases as one of the key threats to global health. Similar emerging diseases have been reported in wildlife populations, resulting in mass mortalities, population declines, and even extinctions. In this paper, we highlight three examples of emerging pathogens: Nipah and Hendra virus, which emerged in Malaysia and Australia in the 1990s respectively, with recent outbreaks caused by similar viruses in India in 2000 and Bangladesh in 2004; West Nile virus, which emerged in the New World in 1999; and amphibian chytridiomycosis, which has emerged globally as a threat to amphibian populations and a major cause of amphibian population declines. We discuss a new, conservation medicine approach to emerging diseases that integrates veterinary, medical, ecologic, and other sciences in interdisciplinary teams. These teams investigate the causes of emergence, analyze the underlying drivers, and attempt to define common rules governing emergence for human, wildlife, and plant EIDs. The ultimate goal is a risk analysis that allows us to predict future emergence of known and unknown pathogens.
    Matched MeSH terms: Communicable Diseases, Emerging/diagnosis; Communicable Diseases, Emerging/epidemiology; Communicable Diseases, Emerging/therapy*
  10. Amaya M, Broder CC
    Annu Rev Virol, 2020 09 29;7(1):447-473.
    PMID: 32991264 DOI: 10.1146/annurev-virology-021920-113833
    Hendra virus (HeV) and Nipah virus (NiV) are bat-borne zoonotic para-myxoviruses identified in the mid- to late 1990s in outbreaks of severe disease in livestock and people in Australia and Malaysia, respectively. HeV repeatedly re-emerges in Australia while NiV continues to cause outbreaks in South Asia (Bangladesh and India), and these viruses have remained transboundary threats. In people and several mammalian species, HeV and NiV infections present as a severe systemic and often fatal neurologic and/or respiratory disease. NiV stands out as a potential pandemic threat because of its associated high case-fatality rates and capacity for human-to-human transmission. The development of effective vaccines, suitable for people and livestock, against HeV and NiV has been a research focus. Here, we review the progress made in NiV and HeV vaccine development, with an emphasis on those approaches that have been tested in established animal challenge models of NiV and HeV infection and disease.
    Matched MeSH terms: Communicable Diseases, Emerging/immunology; Communicable Diseases, Emerging/prevention & control*; Communicable Diseases, Emerging/virology
  11. Iskandar K, Molinier L, Hallit S, Sartelli M, Hardcastle TC, Haque M, et al.
    Antimicrob Resist Infect Control, 2021 03 31;10(1):63.
    PMID: 33789754 DOI: 10.1186/s13756-021-00931-w
    Data on comprehensive population-based surveillance of antimicrobial resistance is lacking. In low- and middle-income countries, the challenges are high due to weak laboratory capacity, poor health systems governance, lack of health information systems, and limited resources. Developing countries struggle with political and social dilemma, and bear a high health and economic burden of communicable diseases. Available data are fragmented and lack representativeness which limits their use to advice health policy makers and orientate the efficient allocation of funding and financial resources on programs to mitigate resistance. Low-quality data means soaring rates of antimicrobial resistance and the inability to track and map the spread of resistance, detect early outbreaks, and set national health policy to tackle resistance. Here, we review the barriers and limitations of conducting effective antimicrobial resistance surveillance, and we highlight multiple incremental approaches that may offer opportunities to strengthen population-based surveillance if tailored to the context of each country.
    Matched MeSH terms: Communicable Diseases/epidemiology
  12. Mukheem A, Shahabuddin S, Akbar N, Anwar A, Sarih NM, Sudesh K, et al.
    Appl Microbiol Biotechnol, 2020 Apr;104(7):3121-3131.
    PMID: 32060693 DOI: 10.1007/s00253-020-10416-2
    Antibiotic resistance in pathogenic bacteria is a major health challenge, as Infectious Diseases Society of America (IDSA) has recognized that the past simply drugs susceptible pathogens are now the most dangerous pathogens due to their nonstop growing resistance towards conventional antibiotics. Therefore, due to the emergence of multi-drug resistance, the bacterial infections have become a serious global problem. Acute infections feasibly develop into chronic infections because of many factors; one of them is the failure of effectiveness of antibiotics against superbugs. Modern research of two-dimensional nanoparticles and biopolymers are of great interest to attain the intricate bactericidal activity. In this study, we fabricated an antibacterial nanocomposite consisting of representative two-dimensional molybdenum disulfide (2D MoS2) nanoparticles. Polyhydroxyalkanoate (PHA) and chitosan (Ch) are used to encapsulate MoS2 nanoparticles into their matrix. This study reports the in vitro antibacterial activity and host cytotoxicity of novel PHA-Ch/MoS2 nanocomposites. PHA-Ch/MoS2 nanocomposites were subjected to time-dependent antibacterial assays at various doses to examine their antibacterial activity against multi-drug-resistant Escherichia coli K1 (Malaysian Type Culture Collection 710859) and methicillin-resistant Staphylococcus aureus (MRSA) (Malaysian Type Culture Collection 381123). Furthermore, the cytotoxicity of nanocomposites was examined against spontaneously immortalized human keratinocyte (HaCaT) cell lines. The results indicated significant antibacterial activity (p value
    Matched MeSH terms: Communicable Diseases
  13. Sayuti, R., Baharudin, A., Amran, M.
    MyJurnal
    Submasseteric abscess is unusual in the head and neck region. Patients with this condition may be misdiagnosed as a parotid abscess due to the similarities in their presentation. Awareness and due recognition should be given to this unusual problem.
    Matched MeSH terms: Communicable Diseases
  14. Wan Salina, W.S., Nizam, A., Naing, L.
    MyJurnal
    Sociodemographic factors have received considerable attention in the literature with regards its relationship with caries. However, the related information among children ages 12-17 is fairly limited. Birth order has been consistently found to be associated with diseases hypothesized to have an infectious aetiology but only few studies have examined its relationship with dental caries. The aims of this study were to determine the association of birth order and the sociodemographic background of subjects with caries and high caries experience among 16-year-old schoolchildren in Tumpat district, Kelantan. This was a case-control study. A total of 1087 16-year-old schoolchildren were examined intraorally for their caries status. They were categorized into three groups namely caries free (DMFS=0) mild caries (DMFS= 1-7) and high caries (DMFS ≥8) group based on DMFS score. Cases were the caries group and the controls were the caries free group. In each group, 163 subjects were selected by using simple random sampling. A questionnaire was used to obtain personal information of the subjects, birthweight and sociodemographic background. Analysis involved was ordinal logistic regression. The factor that was found to have association with caries and high caries experience determined using multiple ordinal logistic regression analysis was educational level of parents (OR=1.55, 95% CI: 1.06; 2.28). This study showed that birth order was not a significant factor associated with caries experience. Among the sociodemographic factors, only parent’s educational level was found to be associated with caries and high caries experience.
    Matched MeSH terms: Communicable Diseases
  15. Lam SK
    Asia Pac J Public Health, 2002;14(1):6-8.
    PMID: 12597511 DOI: 10.1177/101053950201400103
    Emerging and re-emerging infectious diseases have become a major global problem. Malaysia appears to be an epicenter for such infections and in recent years, several outbreaks have occurred resulting in loss of lives and economic hardships. In this paper, we discussed the outbreaks of leptospirosis, enterovirus 71 encephalitis, chikungunya polyarthritis and Nipah encephalitis and how a developing country such as Malaysia managed the situation with the help of international agencies and organisations. Many valuable lessons were learned and by sharing our experience, it is hoped that we will be in a better position to handle future outbreaks and prevent their spread to countries in the region.
    Matched MeSH terms: Communicable Diseases, Emerging/epidemiology*
  16. Osman HA, Hasan H, Suppian R, Bahar N, Hussin NS, Rahim AA, et al.
    Asian Pac J Cancer Prev, 2014;15(13):5245-7.
    PMID: 25040982
    BACKGROUND: Helicobacter pylori (H. pylori) is one of the most important causes of dyspepsia and gastric cancer and diagnosis can be made by invasive or non-invasive methods. The Atlas Helicobacter pylori antigen test is a new rapid non-invasive method which is simple to conduct. The aim of this study was to determine its sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and accuracy.

    MATERIALS AND METHODS: This prospective study was conducted between July 2012 and December 2013. Stool samples of 59 dyspeptic patients who underwent upper endoscopy were evaluated for H. pylori stool antigen.

    RESULTS: From the 59 patients who participated in this study, there were 36 (61%) males and 23 (39%) females. H. pylori was diagnosed in 24 (40.7%) gastric biopsies, 22 (91.7 %) of these being positive for the Atlas H. pylori antigen test. The sensitivity, specificity, PPV, NPV and accuracy were 91.7%, 100%, 100%, 94.6% and 96.6% respectively.

    CONCLUSIONS: The Atlas H. pylori antigen test is a new non-invasive method which is simple to perform and avails reliable results in a few minutes. Thus it can be the best option for the diagnosis of H. pylori infection due to its high sensitivity and specificity.

    Matched MeSH terms: Communicable Diseases/diagnosis; Communicable Diseases/immunology; Communicable Diseases/microbiology
  17. Tong SF, Low WY, Ng CJ
    Asian J Androl, 2011 Jul;13(4):526-33.
    PMID: 21358664 DOI: 10.1038/aja.2010.125
    Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men's unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men's health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men's health behaviour must be addressed. A national men's health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.
    Matched MeSH terms: Communicable Diseases/epidemiology
  18. Hassan MR, Pani SP, Peng NP, Voralu K, Vijayalakshmi N, Mehanderkar R, et al.
    BMC Infect Dis, 2010;10:302.
    PMID: 20964837 DOI: 10.1186/1471-2334-10-302
    Melioidosis, a severe and fatal infectious disease caused by Burkholderia pseudomallei, is believed to an emerging global threat. However, data on the natural history, risk factors, and geographic epidemiology of the disease are still limited.
    Matched MeSH terms: Communicable Diseases, Emerging/mortality; Communicable Diseases, Emerging/epidemiology*; Communicable Diseases, Emerging/pathology
  19. Chong ZL, Sekaran SD, Soe HJ, Peramalah D, Rampal S, Ng CW
    BMC Infect Dis, 2020 Mar 12;20(1):210.
    PMID: 32164538 DOI: 10.1186/s12879-020-4911-5
    BACKGROUND: Dengue is an emerging infectious disease that infects up to 390 million people yearly. The growing demand of dengue diagnostics especially in low-resource settings gave rise to many rapid diagnostic tests (RDT). This study evaluated the accuracy and utility of ViroTrack Dengue Acute - a new biosensors-based dengue NS1 RDT, SD Bioline Dengue Duo NS1/IgM/IgG combo - a commercially available RDT, and SD Dengue NS1 Ag enzyme-linked immunosorbent assay (ELISA), for the diagnosis of acute dengue infection.

    METHODS: This prospective cross-sectional study consecutively recruited 494 patients with suspected dengue from a health clinic in Malaysia. Both RDTs were performed onsite. The evaluated ELISA and reference tests were performed in a virology laboratory. The reference tests comprised of a reverse transcription-polymerase chain reaction and three ELISAs for the detection of dengue NS1 antigen, IgM and IgG antibodies, respectively. The diagnostic performance of evaluated tests was computed using STATA version 12.

    RESULTS: The sensitivity and specificity of ViroTrack were 62.3% (95%CI 55.6-68.7) and 95.0% (95%CI 91.7-97.3), versus 66.5% (95%CI 60.0-72.6) and 95.4% (95%CI 92.1-97.6) for SD NS1 ELISA, and 52.4% (95%CI 45.7-59.1) and 97.7% (95%CI 95.1-99.2) for NS1 component of SD Bioline, respectively. The combination of the latter with its IgM and IgG components were able to increase test sensitivity to 82.4% (95%CI 76.8-87.1) with corresponding decrease in specificity to 87.4% (95%CI 82.8-91.2). Although a positive test on any of the NS1 assays would increase the probability of dengue to above 90% in a patient, a negative result would only reduce this probability to 23.0-29.3%. In contrast, this probability of false negative diagnosis would be further reduced to 14.7% (95%CI 11.4-18.6) if SD Bioline NS1/IgM/IgG combo was negative.

    CONCLUSIONS: The performance of ViroTrack Dengue Acute was comparable to SD Dengue NS1 Ag ELISA. Addition of serology components to SD Bioline Dengue Duo significantly improved its sensitivity and reduced its false negative rate such that it missed the fewest dengue patients, making it a better point-of-care diagnostic tool. New RDT like ViroTrack Dengue Acute may be a potential alternative to existing RDT if its combination with serology components is proven better in future studies.

    Matched MeSH terms: Communicable Diseases, Emerging/diagnosis; Communicable Diseases, Emerging/virology
  20. Wong LP, Atefi N, AbuBakar S
    BMC Public Health, 2016 08 12;16:780.
    PMID: 27520825 DOI: 10.1186/s12889-016-3409-y
    BACKGROUND: As there is no specific treatment for dengue, early detection and access to proper treatment may lower dengue fatality. Therefore, having new techniques for the early detection of dengue fever, such as the use of dengue test kit, is vitally important. The aims of the study were: 1) identify factors associated with acceptance of a home self-test kit for dengue fever if the dengue test is available to the public and 2) find out the characteristics of the test kits that influence the use of the dengue test kit.

    METHODS: A national telephone survey was carried out with 2,512 individuals of the Malaysian public aged 18-60 years old. Individuals were contacted by random digit dialling covering the whole of Malaysia from February 2012 to June 2013.

    RESULTS: From 2,512 participants, 6.1 % reported to have heard of the availability of the dengue home test kit and of these, 44.8 % expressed their intention to use the test kit if it was available. Multivariate logistic regressions indicated that participants with primary (OR: 0.65; 95 % CI: 0.43-0.89; p = 0.02, vs. tertiary educational level) and secondary educational levels (OR: 0.73; 95 % CI: 0.57-0.90; p = 0.01, vs. tertiary educational level) were less likely than participants with a tertiary educational level to use a home self-testing dengue kit for dengue if the kit was available. Participants with lower perceived barriers to dengue prevention (level of barriers 0-5) were less likely (OR: 0.67, 95 % CI: 0.53-0.85, p 

    Matched MeSH terms: Communicable Diseases/diagnosis
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