Toxoplasmosis was found not to be an important cause of intrauterine infection in Malaysia as the rate of toxoplasma-specific IgM in 1,060 congenitally defective Malaysian children, 0 to 4 months old (0.4%) was lower than that in 405 normal children of the same age group (2.0%). A total of 8.2 intra-uterine toxoplasmic infections per 1,000 live births was detected of which one-third (2.7 per 1,000 live births) was overt, manifesting symptoms more of liver damage, than eye or brain damage. A comparison was made with the rates in U.S.A. and Europe. The role of toxoplasmosis in abortion needs to be studied.
The pathogenicity of Bacillus sphaericus strain 1593 was tested against laboratory-reared larvae of four local species of mosquitoes of public health importance in Malaysia; Aedes aegypti, Anopheles balabacensis, Mansonia uniformis and Culex quinquefasciatus. The bacteria was shake-cultured at 28 +/- 1 degrees C for three days, using Glucose-Yeast Extract Salts medium. After which, the spores and vegetative cells were harvested and stored at 4 degrees C before use. Conditions for bioassays were mean temperature of 25 +/- 1 degrees C and relative humidity 65 +/- 5.0. Twenty third-instar larvae of each species were assayed in 90 ml of diluted spore solution. Each concentration and a control were replicated three times for each bioassay. Larval mortalities at 24 hours and 48 hours were taken and analyzed through Probit Analysis using a computer (IBM 370). LC50 values after 48 hours of exposure showed an increasing order of larval susceptibility as follows: Ae. aegypti (417.70 x 10(4)), An. balabacensis (45.84 x 10(4)), Ma. uniformis (18.23 x 10(4)) and Cx. quinquefasciatus (4.14 x 10(4) spores/ml). With the ability to kill 90% of the Cx. quinquefasciatus larvae tested with just a concentration of 10(5) spores/ml, B. sphaericus (strain 1593) has shown good potential as a biocontrol agent for this species of mosquito.
Studies on the bionomics and host-parasite relationship of Robertsiella kaporensis and Malaysian Schistosoma were investigated. The study was divided into 4 parts: cultivation of snails, R. kaporensis, and maintenance of Malaysian Schistosoma life cycle, daily cercarial shedding cycle in R. kaporensis, miracidial load and cercarial shedding pattern and the infectivity of Malaysian Schistosoma cercariae. R. kaporensis were cultured in the laboratory with the use of plastic container provided with fine sand. The snails were fed with diatoms and Saraca leaves. The development period for the snail eggs was about 20-30 days, the young grew to maturity in 14-15 weeks, and the average growth rate of snails was 0.23 mm per week. The daily cercarial shedding cycle of snails had shown that the peak emergence of cercariae of Malaysian Schistosoma occurred at night, between 6-10 pm. The miracidial load which yielded the best results in terms of percentage infection rates of snails and cercarial output was the miracidial concentration of 8 miracidia per snail. The study on infectivity of Malaysian Schistosoma cercariae has shown that there was a decrease in infectivity of the cercariae to mammalian hosts as the cercariae increased in age. The percentage infection rate of mice and numbers of worms recovered were highest in mice infected with cercariae of 0-1/2 hr. old. Infection of cercariae fell rapidly after the cercariae were 16 hr. old.
Mark-release-recapture experiments were carried out in Sabah, East Malaysia on the malaria and filariasis vector, Anopheles balabacensis. Samples of wild females were marked with different colours of fluorescent pigments, released in man-baited huts fitted with exit traps. Simultaneous collections and releases were also made in night-biting catches on a water buffalo and on four men. All subsequent recaptures were made in the same situation in which the mosquitoes were marked. The same individual mosquitoes were caught biting men and buffalo on different occasions and the numbers caught showed a strong preference for man over buffalo. The length of the oviposition cycle in the field was found to be 3.0 days. After blood-feeding on man in a hut, An. balabacensis were found to exit on the night or early morning. The same individual mosquitoes were found resting in the hut or exit trap on different occasions. The results indicate that there is strong evidence for the existence of genetic variability in the tendency of An. balabacensis to rest in houses and to bite man and buffalo. The obvious existence of this phenomenon is considered discouraging for the prospects of interruption of malaria transmitted by An. balabacensis in nature.
Field surveillance of Cq. crassipes was conducted in an open housing estate near Kuala Lumpur using IMR traps baited with chicken and gerbils. Chicken bait attracted more Cq. crassipes. There was significant difference between chicken and gerbil as bait. The mosquitoes preferred to feed at canopy level. The parous rate was 20.41% and the infection rate for Cardiofilaria nilesi was 2.04%. None of the 120 chicken and 5 ducks, in a village close to the open housing estate, examined for microfilariae were positive. Ar. durhami and Ar. subalbatus did not support development of C. nilesi. However, Cq. crassipes is an extremely efficient vector of C. nilesi.
Recent studies on cytogenetics, behavioral, geographical and distinct morphological characters on adult, pupal and larval stages have revealed that "balabacensis" is a species complex. Anopheles dirus the mainland species, is distributed widely in Thailand and is renowned for its role as primary vector of human malarial parasites. Further, evidence from cytogenetic and taxonomic studies suggests that "An. dirus" is a species complex comprising at least four distinct species provisionally designated: dirus A, B, C and D. These cryptic species are distinguishable only partially morphologically, but can be separated on the basis of metaphase chromosomes using the Giemsa and Hoechst 33258 staining techniques. Apparently, these siblings show distinct patterns of geographic distribution in Thailand and Peninsular Malaysia. The recognition of dirus as a complex of species in Thailand and Peninsular Malaysia requires a re-evaluation of the role that the individual members of this complex have in the transmission of malaria parasites in this region. Cytological analysis of gene rearrangements in ovarian polytene chromosomes has shown that An. maculatus is a sibling-species complex consisting of at least four species in Thailand provisionally designated: maculatus A, B, C and G. These siblings are sympatric in some populations. Furthermore, species B is so highly polymorphic for chromosome rearrangements that four geographic forms can be recognized. It is not known whether these four forms are subspecies or yet further species within the species B complex. These sibling-species must be differentiated in order to understand any differential capabilities in their transmission of human malaria parasites. Anopheles nivipes was elevated from synonymy under An. philippinensis to full species status by Reid, a decision recently confirmed by cross mating experiments. The Thailand Malaria Division does not differentiate these two species and only identifies An. philippinensis, yet, An. nivipes is by far the most common of the two species in Thailand. Furthermore, preliminary surveys of the ovarian polytene chromosomes of several widely separated populations of An. nivipes in Thailand have revealed at least two distinct chromosomal types of nivipes based on fixed inversions on the X chromosomes.
Schistosomiasis in Southeast Asia, caused by Schistosoma japonicum, Schistosoma mekongi and Schistosoma japonicum-like, have been reported from six different countries. The S. japonicum infections are highly prevalent in the Philippines with Oncomelania hupensis quadrasi as the vector snail, and in localized areas in Indonesia with O.h. lindoensis as the snail vector. The S. mekongi infections are recent discovery in the Lower Mekong Basin in Laos and Kampuchea, with Tricula aperta as the vector snail. The S. japonicum-like infections are found as isolated cases diagnosed by the finding of S. japonicum-like eggs in the faeces, rectal biopsy, tissue biopsy or at necropsy in Thailand and Malaysia. The control measures of schistosomiasis have been implemented in the Philippines and Indonesia, while further research studies are being conducted in Thailand and Malaysia.
A seroepidemiological survey of 837 people and 383 febrile patients was performed in rural areas of Sabah. We determined that the rickettsial diseases scrub typhus and endemic typhus were uncommon causes of febrile illness, as was tick typhus, except in forest dwelling peoples. The rate of occurrence of SFGR specific antibody was 16.5% among 412 forest dwellers, indicating that tick typhus may be a frequent cause of illness in this population.
A study to identify the knowledge of infected and uninfected respondents on filariasis and epidemiologic factors in one endemic community in Malaysia to determine their role in the transmission and control of filariasis was carried out. The data were collected by non-participant observations and interviews using semi-structured schedules. The majority of respondents in both groups had knowledge of filariasis. There was no marked difference between male and female respondents, and similarly, there was fair distributions of knowledgeable respondents with and without some years of schooling. On filarial transmission, 9.2% of the infected said that filariasis was contacted through mosquito bites, while among the uninfected it was 7.4%. Within the infected, 14.8% thought that filarial worms entered the human body through the consumption of unhygenically prepared foods and drinks while, among the uninfected it was 20.4%. Both groups were aware of the presence of mosquitoes in their village. However, the majority did not associate this factor with host's susceptibility to filarial infections. Rather, they were of the opinion that personal hygiene and proper meals had something to do with filariasis. The findings showed there was general awareness of filariasis in the community which might indicate that the health campaigns had reached various levels of the population. Yet, they still lacked knowledge on disease transmission. Also, they did not make direct association between environment and exposure to mosquitoes bites though they were aware of their presence but which they regarded as not directly harmful to their health.
For any health education to succeed, the people's perception of the disease, their beliefs and cultural practices are of utmost importance as these have tremendous influence on their acceptance of new ideas. It is therefore essential to develop appropriate health education packages based on the understanding of the traditional and socio-cultural belief systems of the people. Thus on the basis of anthropological studies, health education packages were developed for the leprosy control programme in Sarawak, aimed at both adults and children. Newspaper articles, cartoon tape-slides, cartoon story books as well as posters were developed for both Chinese as well as other groups such as Malays, Ibans and Kayans. These were field tested and are now used in the Rejang Valley of Sarawak.
In 1984, in Sarawak, there were a total of 1,099 recorded cases of leprosy for a population of 1.3 million. However, for each case recorded, it is estimated that two others remain undiagnosed as a consequence of the stigmatization associated with leprosy. For the five year period, 1979-1983, an average of 29 new cases were detected each year of which 8.6 (30%) were deformed due to the late stages at which it was being reported. To increase the case-finding rate, human behavioural research was applied to the leprosy control programme so as to develop culture-specific health education packages aimed at self diagnosis and self referral in order to detect the large pool of undiagnosed cases hidden behind the veil of aversion, fear and ignorance. This was achieved through anthropological studies to identify how the various major ethnic groups perceived leprosy and their attitudes towards leprosy. Taking into account these findings, health education packages aimed at adults as well as children were developed for the Chinese as well as the non-Chinese, and consisted of newspaper articles, cartoon tape-slides, cartoon story books and posters.
Sera from one hundred and fifty nine Malaysian individuals were screened for the prevalence of delta markers. These included 15 HBsAg positive homosexuals, 16 acute hepatitis B cases, 9 chronic hepatitis B patients, 13 healthy HBsAg carriers and 106 intravenous (i.v.) drug abusers, of whom 27 were positive for HBsAg only and the rest were anti-HBc IgG positive but HBsAg negative. The prevalence of delta markers in the homosexuals was found to be 6.7%, in the HBsAg positive drug abusers 17.8%, in acute hepatitis B cases 12.5%. No evidence of delta infection was detected in healthy HBsAg carriers, chronic hepatitis B cases and HBsAg negative i.v. drug abusers. With reference to i.v. drug abusers, the prevalence of delta markers was higher in Malays (23%) than in Chinese (7%) although the latter had a higher HBsAg carrier rate. Although the HBsAg carrier rate in the homosexuals was high, their delta prevalence rate was low as compared to drug abusers. In Malaysia, as in other non-endemic regions, hepatitis delta virus transmission appeared to occur mainly via the parenteral and sexual routes. This is the first time in Malaysia that a reservoir of delta infection has been demonstrated in certain groups of the population at high risk for hepatitis B.