MyMedR

Fulltext An example of Filariasis control from West Malaysia

Wilson T

Bull World Health Organ, 1969;41(2):324-9.

Fulltext Sensitized-erythrocyte-lysis (SEL) test as an epidemiological tool for human leptospirosis serological surveys

Tan DS

Bull World Health Organ, 1969;40(6):899-902.

Epidemiological studies of human leptospirosis have generally been limited to countries with specialized laboratories employing the microscopic-agglutination (MA) test. The sensitized-erythrocyte-lysis (SEL) test is much simpler for routine hospital laboratories to carry out and it has been found valuable in the diagnosis of human leptospirosis. This paper reports the results of studies of the SEL test as an epidemiological tool in serological surveys.The results showed that the significant SEL titre was 1:80 and that the sensitivity of the test depended possibly on the antigen preparation and the amount of complement used. Most of the SEL antibodies were found to persist at significant titres for about 1 year after active infection, but less than half persisted longer than that. The SEL test is therefore useful for detecting recent infections and for indicating that stability of leptospirosis in an area.The endemicity of leptospirosis in West Malaysia was confirmed by the SEL test, based on the employment of 1:80 as the significant titre.

Immunotyping of different strains of Japanese encephalitis virus by antibody-absorption, haemagglutination-inhibition and complement-fixation tests

Okuno T, Okada T, Kondo A, Suzuki M, Kobayashi M, Oya A

Bull World Health Organ, 1968;38(4):547-63.

PMID: 5302450

The immunological characteristics of 26 strains of Japanese encephalitis virus (JEV) isolated in Japan and Malaya between 1935 and 1966 have been investigated mainly by the antibody-absorption variant of the haemagglutination-inhibition test, and to a certain extent also by conventional haemagglutination-inhibition and complement-fixation tests. The antibody-absorption technique shows promise as a routine method for the immunotyping of JEV.At present, two immunotypes can be distinguished. One comprises 2 strains, Nakayama-NIH and I-58, and is designated as the I-58 immunotype. The other immunotype, JaGAr 01, comprises 17 strains which share the characteristics of the JaGAr 01 strain, including one subline of the Nakayama strain, Nakayama-Yakken. The Nakayama-RFVL strain was found to have the characteristics of both immunotypes. The I-58 immunotype differs more markedly from related arboviruses, such as the Murray Valley encephalitis virus and the West Nile Eg101 strain, than does the JaGAr 01 immunotype.Evidence is presented which suggests that a given JEV strain can change immunotype on repeated passage through mice.

Fulltext Telemedicine to deliver diabetes care in low- and middle-income countries: a systematic review and meta-analysis

Correia JC, Meraj H, Teoh SH, Waqas A, Ahmad M, Lapão LV, et al.

Bull World Health Organ, 2021 Mar 01;99(3):209-219B.

PMID: 33716343 DOI: 10.2471/BLT.19.250068

Objective: To determine the effectiveness of telemedicine in the delivery of diabetes care in low- and middle-income countries.

Methods: We searched seven databases up to July 2020 for randomized controlled trials investigating the effectiveness of telemedicine in the delivery of diabetes care in low- and middle-income countries. We extracted data on the study characteristics, primary end-points and effect sizes of outcomes. Using random effects analyses, we ran a series of meta-analyses for both biochemical outcomes and related patient properties.

Findings: We included 31 interventions in our meta-analysis. We observed significant standardized mean differences of -0.38 for glycated haemoglobin (95% confidence interval, CI: -0.52 to -0.23; I2 = 86.70%), -0.20 for fasting blood sugar (95% CI: -0.32 to -0.08; I2 = 64.28%), 0.81 for adherence to treatment (95% CI: 0.19 to 1.42; I2 = 93.75%), 0.55 for diabetes knowledge (95% CI: -0.10 to 1.20; I2 = 92.65%) and 1.68 for self-efficacy (95% CI: 1.06 to 2.30; I2 = 97.15%). We observed no significant treatment effects for other outcomes, with standardized mean differences of -0.04 for body mass index (95% CI: -0.13 to 0.05; I2 = 35.94%), -0.06 for total cholesterol (95% CI: -0.16 to 0.04; I2 = 59.93%) and -0.02 for triglycerides (95% CI: -0.12 to 0.09; I2 = 0%). Interventions via telephone and short message service yielded the highest treatment effects compared with services based on telemetry and smartphone applications.

Conclusion: Although we determined that telemedicine is effective in improving several diabetes-related outcomes, the certainty of evidence was very low due to substantial heterogeneity and risk of bias.

Fulltext Fostering local production of essential medicines in Nigeria

Fatokun O

Bull World Health Organ, 2020 Jul 01;98(7):507-508.

PMID: 32742037 DOI: 10.2471/BLT.19.249508

Fulltext Immunological surveys of arbovirus infections in South-East Asia, with special reference to dengue, chikungunya, and Kyasanur Forest disease

Rao TR

Bull World Health Organ, 1971;44(5):585-91.

PMID: 4400821

Serological surveys have been widely used in South-East Asia to determine the presence and activity of arboviruses. The haemagglutination-inhibition test has been most frequently employed but complement-fixation and neutralization tests have also been used in some investigations.Although virus isolations provide the most conclusive evidence, they can be carried out in a few specialized centres only, and serological surveys are very important for studying the distribution of arboviruses.The surveys have shown that group B arboviruses (principally all four types of dengue, Japanese encephalitis, and West Nile) are widely prevalent. Dengue and Japanese encephalitis viruses are more widespread than West Nile virus, which was not known previously to extend east of India although recent survyes have shown that its range extends to Burma. Japanese encephalitis is frequent in most of South-East Asia but in India is found mainly in eastern and south-eastern parts of the country. Kyasanur Forest disease (KFD) and Langat viruses are the only tick-borne group B arboviruses definitely known to occur in the region, the former in India, the latter in Malaysia. KFD virus has been isolated only from a small focus in Mysore, although human and animal sera containing neutralizing antibodies to this virus have been found sporadically in widely scattered areas. Among the group A arboviruses, chikungunya and Sindbis have been detected in serological surveys, but the former has not yet been found in Malaysia.

Fulltext Studies on the relationship between fluorescent antibody response and ecology of malaria in Malaysia

Collins WE, Warren M, Skinner JC, Fredericks HJ

Bull World Health Organ, 1968;39(3):451-63.

PMID: 4882987

The fluorescent antibody (FA) technique was used to detect the presence of malarial antibody in populations living in 3 different ecological areas of Malaysia. Serum samples were tested using Plasmodium falciparum, P. vivax, P. malariae and P. fieldi antigens. An area of hyperendemic malaria had a good correlation between the antibody responses and active parasitaemias. The percentage and intensity of responses increased with the age of the individuals. In an area of hypoendemic malaria, each of 17 sites had ecological conditions which would favour or discourage the transmission of malaria. The reasons for high FA responses in some villages and low responses in others were readily apparent. The effect of even limited control programmes on the malarial ecology could be measured by an examination of the antibody responses. An aboriginal population receiving suppressive drugs had FA responses indicating both past experience and the effect of the drug programme.

Fulltext Responses of Anopheles balabacensis to various patterns of DDT-spraying of shelters in Sabah, East Malaysia

Cheng FY

Bull World Health Organ, 1968;38(3):469-77.

PMID: 5302337

In certain areas of Sabah, East Malaysia, local houses are frequently built without walls or with incomplete walls. Also, the people in these areas often refuse permission for their houses to be sprayed inside with insecticide (DDT). These special conditions are the reason for the persistence of malaria transmission under a WHO malaria eradication programme.Field trials were conducted in specially constructed huts, similar to the local houses, in which all-night collections of mosquitos were made, both those biting human baits and those resting on walls, in order to determine (1) the effectiveness of spraying DDT in houses without, or with incomplete, walls; and (2) the best way to protect people against mosquito bites with DDT-spraying where the house-owners have refused indoor spraying.The results indicate that (1) as expected, DDT-spraying inside a hut with incomplete walls is less effective than in a hut with complete walls, especially 6 months or more after spraying; (2) external spraying of walls with DDT at double the normal dose (i.e., 4 g/m(2)) greatly reduced contacts between man and mosquito and thereby limited transmission of malaria.

A survey of antibodies to Adenovirus 8 and Coxsackievirus A21 in human sera

Chapple PJ

Bull World Health Organ, 1966;34(2):243-8.

PMID: 5296130

Studies have recently been published of surveys of antibodies to common respiratory viruses in human sera from several parts of the world. The present article reports the findings of a survey of antibodies to two more viruses (adenovirus type 8 and coxsackievirus type A21) in human sera mainly collected from six widely separated geographical regions (Alaska, England, Marshall Islands, Sarawak, South-West Africa and Tunisia).A world-wide geographical distribution of infection with these two viruses was found. However, antibodies to individual viruses were not found with the same frequency in all countries; and, in marked contrast to the findings in the earlier surveys of antibodies to the common respiratory viruses, the frequency of antibodies was not the same for each virus in sera from the same country. It was not possible to draw any final conclusions as to the reasons for the observed differences.

Fulltext Kwashiorkor in Malaya

Dean RF

Bull World Health Organ, 1959;20:727-9.

PMID: 13815166

Fulltext A malaria-control experiment in the interior of Borneo

De Zulueta J, Lachance F

Bull World Health Organ, 1956;15(3-5):673-93.

PMID: 13404443

A first experiment on malaria control in the interior of Borneo by spraying with residual insecticides is described. The work was carried out in the isolated, sparsely populated valleys of the Baram River and its tributary, the Tinjar, in northern Sarawak. The experimental area was divided into three parts: a DDT test area, where a 75% suspension of wettable powder was applied at the rate of 2 g of DDT per m(2) of surface; a BHC test area, where a 50% suspension of wettable powder was applied at the rate of 0.10 g of gamma isomer per m(2); and a check area.Entomological investigations made before the spraying operations were started showed that Anopheles leucosphyrus Dönitz, 1901 was the main malaria vector in both the test and the check areas. Out of a total of 7568 A. leucosphyrus dissected, 30 gland infections were detected-a sporozoite-rate of 0.40%. A. barbirostris was found to be a secondary vector throughout the experimental area.THE RESULTS OF INSECTICIDE SPRAYING WERE SATISFACTORY: in the DDT test area, the spleen-rate fell from 51.8% to 25.1%, and the parasite-rate from 35.6% to 1.6%, in 21 months, and a similar reduction in the rates was observed in the BHC test area. In the check area, the spleen- and parasite-rates rose during the period of observations. It is considered that if such a degree of control can be obtained in 21 months, complete eradication can be expected in the near future.Although BHC spraying proved effective, the fact that it has to be repeated every three months makes it impracticable in the interior of Sarawak, where communications are very poor and difficulties of transport very great. DDT spraying, which need only be done twice a year, is therefore to be preferred. The cost of the DDT operations-US$ 0.45 per person protected per year-is comparatively high, owing to the difficulty of communications and to the necessity for spraying not only the village "longhouses", but also the temporary shelters which the semi-nomadic people in the interior of Sarawak build each year in the rice-fields.

Fulltext Present status of malaria control in Asia

Dy FJ

Bull World Health Organ, 1954;11(4-5):725-63.

PMID: 13209318

The author summarizes the information given by 13 governments-Afghanistan, Burma, Ceylon, China, India, Indonesia, Malaya, Netherlands New Guinea, Philippines, Portuguese India, Sarawak, Thailand, and Viet Nam-on their existing and proposed malaria-control programmes in response to a questionnaire prepared by WHO for discussion at the First Asian Malaria Conference, which was held in Bangkok in September 1953.Although in late 1953 nearly 46.5 million of the 271 million people living in malarious regions were protected against the disease, more than 224 million others were still unprotected.It is noted that residual-insecticide spraying-the basis of most campaigns-has significantly reduced spleen- and parasite-rates; that the minor opposition to spraying initially encountered in some places quickly disappeared as the benefits became apparent; that malaria control has resulted in general improvements in public health and has promoted socio-economic development; that anopheline resistance to the insecticides used has not been observed; that ten governments voiced the need for indoctrination of public officials concerning malaria control; and that there is a trend among governments to make financial provision for long-term malaria-control schemes.

Fulltext Respiratory virus disease in Malaysian children: a serological study

Ong SB, Lam KL, Lam SK

Bull World Health Organ, 1975;52(3):376-8.

PMID: 1084808

Paired sera from 101 Malaysian children aged up to 10 years and suffering from respiratory illnesses were examined serologically for evidence of respiratory viral infections. Of these children, 32.6% showed rising antibody titres for one or more of the test agents. Respiratory syncytial virus appeared to be the main respiratory pathogen involved, followed by Mycoplasma pneumoniae, parainfluenza viruses, adenoviruses, and influenza A virus. These findings are generally similar to those reported by others in temperate and tropical countries.

DDT-resistance in West African and Asian strains of Aedes aegypti (L.)

Inwang EE, Khan MA, Brown AW

Bull World Health Organ, 1967;36(3):409-21.

PMID: 5299673

The yellow fever mosquito Aedes aegypti has developed resistance to DDT in the Caribbean region and in South-East Asia, but not in West Africa. Therefore West African strains were compared with South-East Asian strains for their response to laboratory selection with DDT. It was found that West African strains were much slower to respond initially, but eventually could build up a high degree of DDT-resistance. By crossing and backcrossing with a susceptible marker-gene strain, it was found that this resistance was due to a single gene linked with the gene y (yellow) on chromosome 2 at a cross-over distance of approximately 35 units in an Upper Volta strain as in a Bangkok strain; interstrain crosses indicated that the gene was the same as that in a Trinidad strain and in one from Penang. Dieldrin-resistance could be readily induced in the Upper Volta strain and proved to be due to a gene also linked with y but at a crossover distance of approximately 25 units, comparable to that in Caribbean strains previously studied. Material from Karachi, West Pakistan, developed a dieldrin-resistance also showing 25% crossing over with y, and a DDT-resistance also linked with this chromosome-2 marker gene.

Fulltext Preferred Aedes aegypti larval habitats in urban areas

Cheong WH

Bull World Health Organ, 1967;36(4):586-9.

PMID: 5299457

Fulltext Resistance to dieldrin and DDT and sensitivity to malathion in the bed-bug Cimex hemipterus in Malaya

Reid JA

Bull World Health Organ, 1960;22:586-7.

PMID: 14437086

Fulltext Resistance patterns in DDT-resistant Aedes aegypti

Busvine JR, Coker WZ

Bull World Health Organ, 1958;18(4):651-6.

PMID: 13536807

Colonies of three strains of Aëdes aegypti resistant to DDT were obtained from Trinidad, Haiti and Malaya and reared beside a normal colony. From their relative resistance to a series of compounds analogous to DDT, characteristic resistance "spectra" were obtained. The two colonies from the West Indies showed a similar type of resistance, rather different from the (smaller) resistance of the Malay strain. No resistance to methoxychlor or dieldrin was found.

Fulltext Penang BHC-resistant strain of Culex pipiens fatigans

Wharton RH

Bull World Health Organ, 1958;18(4):684.

PMID: 13536813

Fulltext Dieldrin resistance in Culex pipiens fatigans in Malaya

Wharton RH

Bull World Health Organ, 1958;18(4):657-65.

PMID: 13536808

Resistance to insecticides in Culex pipiens fatigans has already been reported from two areas in Malaya. In Penang two years' use of BHC as a larvicide resulted in the development of a strain which was found to have acquired a tenfold resistance to BHC, and also to dieldrin to which it had not been exposed. In Singapore, when larval control became unsatisfactory after 6 months' use of a dieldrin emulsion, laboratory experiments confirmed that active resistance to dieldrin had developed. The present observations report the finding of two further dieldrin-BHC resistant strains of C. p. fatigans in Malaya, but differ from the previous reports in that resistance, in one strain at least, was developed as a result of house-spraying with dieldrin against adult mosquitos. In this strain resistance to dieldrin was about 100 times in both adults and larvae, resistance to gamma-BHC in larvae was about 20 times, while resistance to DDT was slight.

Fulltext A second international cooperative investigation into tioacetazone side effects

Miller AB, Nunn AJ, Robinson DK, Fox W, Somasundaram PR, Tall R

Bull World Health Organ, 1972;47(2):211-27.

PMID: 4118761

As part of a large-scale international cooperative investigation into the side effects of thioacetazone-containing regimens in the treatment of tuberculosis, an evaluation has been made of the variation in the frequency of side effects between different countries and between different centres in the same country and of the likely reasons for this variation. In 3 countries patients of different racial origin were under observation in the same hospital. Over a 12-week period of treatment there was considerable variation between the countries and centres in the overall frequency of side effects and of those leading to a major departure from prescribed treatment, the variation being similar for the two thioacetazone-containing regimens and for the streptomycin plus isoniazid control regimen, though at a lower level for the latter. In Malaysia, Singapore, and Trinidad, where different racial groups were under treatment, there was no clear indication that race was an important factor in explaining the differences between countries, except for cutaneous side effects in Trinidad and possibly in Malaysia.It is concluded that the differences in the frequency of side effects to thioacetazone-containing regimens probably result from variation in the closeness of supervision of patients, in the recording and interpretation of side effects, and in environmental factors including the previous use of other medicaments or exposure to sensitizing substances.

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