Displaying publications 21 - 40 of 86 in total

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  1. 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.
  2. Fulltext Field and laboratory observations in Sabah, East Malaysia on the proportion of Anopheles balabecensis balabacensis eggs hatching after holding in a humid atmosphere
    Rajapaksa N
    Bull World Health Organ, 1971;45(2):263-5.
    PMID: 5316626
  3. Fulltext Nutritional assessment by comparative growth achievement in Malay children below school age
    McKay DA, Lim RK, Notaney KH, Dugdale AE
    Bull World Health Organ, 1971;45(2):233-42.
    PMID: 5316620
    Measurements of child growth have become the most accepted means of assessing the protein-calorie nutritional status of economically developing populations. International reference standards have been suggested for a number of body measurements, but there has been little evaluation of their applicability in South-East Asia.In order to delineate the present range of nutritional standards in West Malaysia, and to aid in the development of guidelines for further nutritional work in this region, anthropometric tests were made on 3 groups of children below school age belonging to the Malay ethnic group and living under diverse conditions. Children of Malaysian Army personnel differed significantly in most measurements from rural village children in Trengganu and children from a small urban elite in Kuala Lumpur. Measurements for the latter group approximated to internationally used standards of height and weight. Parental height data suggest that these differences are not primarily genetic. Anaemia, malaria, and ascariasis were common among the Trengganu children.Weight and height emerge as the measurements that are most sensitive in differentiating between the groups; arm circumferences and skinfold measurements are also useful because they are relatively independent of age. Measurement of chest and head circumferences and of crown-rump lengths appeared to be of little value.
  4. 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.
  5. Fulltext An example of Filariasis control from West Malaysia
    Wilson T
    Bull World Health Organ, 1969;41(2):324-9.
    PMID: 5308708
  6. 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.
    PMID: 5307602
    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.
  7. 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.
  8. 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.
  9. Fulltext Disability after encephalitis: development and validation of a new outcome score
    Lewthwaite P, Begum A, Ooi MH, Faragher B, Lai BF, Sandaradura I, et al.
    Bull World Health Organ, 2010 Aug 01;88(8):584-92.
    PMID: 20680123 DOI: 10.2471/BLT.09.071357
    OBJECTIVE: To develop a simple tool for assessing the severity of disability resulting from Japanese encephalitis and whether, as a result, a child is likely to be dependent.

    METHODS: A new outcome score based on a 15-item questionnaire was developed after a literature review, examination of current assessment tools, discussion with experts and a pilot study. The score was used to evaluate 100 children in Malaysia (56 Japanese encephalitis patients, 2 patients with encephalitis of unknown etiology and 42 controls) and 95 in India (36 Japanese encephalitis patients, 41 patients with encephalitis of unknown etiology and 18 controls). Inter- and intra-observer variability in the outcome score was determined and the score was compared with full clinical assessment.

    FINDINGS: There was good inter-observer agreement on using the new score to identify likely dependency (Kappa = 0.942 for Malaysian children; Kappa = 0.786 for Indian children) and good intra-observer agreement (Kappa = 1.000 and 0.902, respectively). In addition, agreement between the new score and clinical assessment was also good (Kappa = 0.906 and 0.762, respectively). The sensitivity and specificity of the new score for identifying children likely to be dependent were 100% and 98.4% in Malaysia and 100% and 93.8% in India. Positive and negative predictive values were 84.2% and 100% in Malaysia and 65.6% and 100% in India.

    CONCLUSION: The new tool for assessing disability in children after Japanese encephalitis was simple to use and scores correlated well with clinical assessment.

  10. Integrating ethics, health policy and health systems in low- and middle-income countries: case studies from Malaysia and Pakistan
    Hyder AA, Merritt M, Ali J, Tran NT, Subramaniam K, Akhtar T
    Bull World Health Organ, 2008 Aug;86(8):606-11.
    PMID: 18797618
    Scientific progress is a significant basis for change in public-health policy and practice, but the field also invests in value-laden concepts and responds daily to sociopolitical, cultural and evaluative concerns. The concepts that drive much of public-health practice are shaped by the collective and individual mores that define social systems. This paper seeks to describe the ethics processes in play when public-health mechanisms are established in low- and middle-income countries, by focusing on two cases where ethics played a crucial role in producing positive institutional change in public-health policy. First, we introduce an overview of the relationship between ethics and public health; second, we provide a conceptual framework for the ethical analysis of health system events, noting how this approach might enhance the power of existing frameworks; and third, we demonstrate the interplay of these frameworks through the analysis of a programme to enhance road safety in Malaysia and an initiative to establish a national ethics committee in Pakistan. We conclude that, while ethics are gradually being integrated into public-health policy decisions in many developing health systems, ethical analysis is often implicit and undervalued. This paper highlights the need to analyse public-health decision-making from an ethical perspective.
  11. Health imperatives in foreign policy: the case of Malaysia
    Barraclough S, Phua KL
    Bull World Health Organ, 2007 Mar;85(3):225-9.
    PMID: 17486215
    Malaysia's global, regional and bilateral international health relations are surveyed against the historical backdrop of the country's foreign policy. Malaysia has always participated in multilateral agencies, most notably the World Health Organization, as such agencies are part of the longstanding fabric of "good international citizenship". The threats of infectious diseases to human health and economic activity have caused an intensification and an organizational formalization of Malaysian health diplomacy, both regionally and bilaterally. Such diplomacy has also established a basis for developing a wider set of cooperative relationships that go beyond responding to the threat of pandemics. As Malaysia approaches "developed" status, its health sector is becoming increasingly integrated into the global economy through joint research and development ventures and transnational investment. At the same time, it will have the technological, financial and human resources to play an expanded altruistic role in global and regional health.
  12. Fulltext Comparison of safety and immunogenicity of a Vi polysaccharide typhoid vaccine with a whole-cell killed vaccine in Malaysian Air Force recruits
    Panchanathan V, Kumar S, Yeap W, Devi S, Ismail R, Sarijan S, et al.
    Bull World Health Organ, 2001;79(9):811-7.
    PMID: 11584728
    To carry out a comparative study of the safety and immunogenicity of Vi polysaccharide vaccine against whole-cell killed (WCK) typhoid vaccine.
  13. Fulltext A strategy for reducing maternal mortality
    Suleiman AB, Mathews A, Jegasothy R, Ali R, Kandiah N
    Bull World Health Organ, 1999;77(2):190-3.
    PMID: 10083722
    A confidential system of enquiry into maternal mortality was introduced in Malaysia in 1991. The methods used and the findings obtained up to 1994 are reported below and an outline is given of the resulting recommendations and actions.
    PIP: This is a report on the methods, findings, resulting recommendations and actions of a study on maternal mortality in Malaysia during the period 1991-94. Maternal death was defined as the death of a woman while pregnant or within 42 days following termination of pregnancy from any cause related to the pregnancy or its management but not from accidental causes. Between 1991 and 1994 there were 1066 reported maternal deaths, and the maternal mortality ratios for the successive years were respectively 44, 48, 46 and 39 per 100,000 live births. The primary causes of maternal death were postpartum hemorrhage (24%), hypertensive disorders of pregnancy (16%), obstetric pulmonary embolism (13%), and associated medical conditions (7%). Analysis of the 375 deaths from 1992 - 1993 showed that the maternal mortality ratio was 53/100,000 live births for deliveries performed at home, 36/100,000 in government hospitals, and 21/100,000 in private institutions. Shortcomings among health personnel were detected in several cases; these involved failure to diagnose, failure to appreciate the severity of a patient's condition, inadequate therapy, and inappropriate, delayed or failed adherence to protocols. The high proportion of maternal mortality associated with substandard care demonstrates that it is important to make the standard of care more widely available. Reports have been circulated to institutions and organizations providing maternal care and to medical schools. Articles and case histories have been published, and many new protocols and procedures have been developed. Furthermore, seminars have been organized and training modules have been distributed to all involved in the provision of maternity care.
  14. Fulltext Evaluation of cold chain monitoring in Kelantan, Malaysia
    Hanjeet K, Lye MS, Sinniah M, Schnur A
    Bull World Health Organ, 1996;74(4):391-7.
    PMID: 8823961
    An analysis was carried out on a total of 883 cold chain monitor (CCM) cards, which had been attached to batches of poliomyelitis, measles, DPT (diphtheria, pertussis, tetanus) and hepatitis B vaccines, during their transport and storage from the central store in Kuala Lumpur to Kelantan, a state in north-eastern Malaysia; 234 freeze watches attached to hepatitis B vaccines were also analysed. The monitor cards and freeze watches were observed at six levels between the central store and the periphery during distribution of the vaccines, and a colour change in any of the four windows (A, B, C, D) on the CCM cards or the freeze watches was recorded. In addition, 33 unopened vials of oral poliovirus vaccine (OPV), collected from refrigerators in 29 health facilities in Kelantan, were tested for potency using the tissue culture infective dose 50 (TCID50) method; 14 of them (42%) did not meet the WHO criteria for potent vaccines. The results showed that at the final destination 13.4% of all cards remained white while a colour change to blue was observed in 65% in window A, 16.6% in window B, and 4.4% in window C; none had turned blue in window D indicating that the vaccine had not been subjected to temperatures > or = 34 degrees C for 2 hours. All but 2 of the 234 freeze watches had turned purple, which indicates exposure of the hepatitis B vaccines to temperatures below 0 degree C. These results will assist health planners to correct the weaknesses identified in the cold chain system.
  15. 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.
  16. Fulltext Preferred Aedes aegypti larval habitats in urban areas
    Cheong WH
    Bull World Health Organ, 1967;36(4):586-9.
    PMID: 5299457
  17. Fulltext Studies of the ecology of dengue in Malaysia
    Rudnick A
    Bull World Health Organ, 1966;35(1):78-9.
    PMID: 20604276
  18. The effects of diaphenylsulfone (DDS) against chloroquine-resistant Plasmodium falciparum
    Degowin RL, Eppes RB, Carson PE, Powell RD
    Bull World Health Organ, 1966;34(5):671-81.
    PMID: 5328901
    In view of the problems caused by the chloroquine-resistance of some strains of Plasmodium falciparum, the authors have investigated the effectiveness of diaphenylsulfone against two such resistant strains, from Malaya and Viet-Nam. They found that diaphenylsulfone given during acute attacks of malaria had a blood schizontocidal activity against the Malayan resistant strain but was not rapidly effective in terminating acute attacks in non-immune persons, and that, when the drug was given prophylactically in relatively small doses, it was substantially effective in preventing patency of mosquito-induced infection with the same strain. The protective effect of diaphenylsulfone is that of a clinical prophylactic or suppressive drug; it does not appear to be a true causal prophylactic. It was also found that the protective effect is vitiated by the concurrent administration of paraaminobenzoic acid.These studies indicate a need for further assessment of the antimalarial value of sulfones and sulfonamides, both alone and in combination with other drugs, for prevention and cure.
  19. Fulltext Mosquito-borne haemorrhagic fevers of South and South-East Asia
    Halstead SB
    Bull World Health Organ, 1966;35(1):3-15.
    PMID: 5297536
    During the past decade outbreaks of a severe haemorrhagic disease caused by dengue viruses of multiple types have been reported in the Philippines, Thailand, Malaysia, Viet-Nam and eastern India. In many of these outbreaks chikungunya virus, a group A arbovirus, was simultaneously the cause of similar but probably milder disease. Both these viruses appear to be able to be able to produce classical dengue fever in some individuals and disease with haemorrhagic manifestations in others. Because of the growing public health importance and the progressive spread of this disease a unified review of its clinical and epidemiological features has been needed. This paper presents the history and salient clinical features of mosquito-borne haemorrhagic fever and summarizes recent epidemiological studies and current diagnostic and control methods.
  20. 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.
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