Displaying publications 21 - 40 of 179 in total

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  1. Oliva vidua fulminans, a marine mollusc, responsible for five fatal cases of neurotoxic food poisoning in Sabah, Malaysia
    Kan SK, Singh N, Chan MK
    Trans R Soc Trop Med Hyg, 1986;80(1):64-5.
    PMID: 3727000
    This is the first report in which a marine mollusc, Oliva vidua fulminans (olives), generally not known to be poisonous, was responsible for death in five children after consuming boiled olives with tamarind. The onset of symptoms was rapid 10 to 20 min after consumption of the olives. Signs and symptoms included nausea, vomiting, abdominal pain, tingling sensation around the lips, numbness around the mouth, drowsiness, lethargy and generalized weakness with paraesthesia in the limbs. The five deaths occurred within 3 to 4 hours after eating the poisoned olives and resulted from respiratory failure. Left-over olives from the affected household and freshly collected live olives had a toxicity of 14,200 mouse units (M.U.) and 15,000 M.U. per 100 g meat respectively. No other common chemical poison and organophosphorus insecticides were detected. The neurotoxic agent was acid and heat stable and was toxic at pH less than 4. Its action was similar to that of paralytic shellfish poisoning which was caused by toxins from certain dinoflagellates.
  2. Fulltext Providing a laboratory diagnostic service for pandemic SARS-CoV-2 in a developing country
    Sam IC, Chong J, Kamarudin R, Jafar FL, Lee LM, Bador MK, et al.
    Trans R Soc Trop Med Hyg, 2020 08 01;114(8):553-555.
    PMID: 32497211 DOI: 10.1093/trstmh/traa037
  3. Apoptosis in Blastocystis spp. is related to subtype
    Dhurga DB, Suresh KG, Tan TC, Chandramathi S
    Trans R Soc Trop Med Hyg, 2012 Dec;106(12):725-30.
    PMID: 23141370 DOI: 10.1016/j.trstmh.2012.08.005
    Previous studies have shown that apoptosis-like features are observed in Blastocystis spp., an intestinal protozoan parasite, when exposed to the cytotoxic drug metronidazole (MTZ). This study reports that among the four subtypes of Blastocystis spp. investigated for rate of apoptosis when treated with MTZ, subtype 3 showed the highest significant increase after 72h of in vitro culture when treated with MTZ at 0.1mg/ml (79%; p<0.01) and 0.0001mg/ml (89%; p<0.001). The close correlation between viable cells and apoptotic cells for both dosages implies that the pathogenic potential of these isolates has been enhanced when treated with MTZ. This suggests that there is a mechanism in Blastocystis spp. that actually regulates the apoptotic process to produce higher number of viable cells when treated. Apoptosis may not just be programmed cell death but instead a mechanism to increase the number of viable cells to ensure survival during stressed conditions. The findings of the present study have an important contribution to influence chemotherapeutic approaches when developing drugs against the emerging Blastocystis spp. infections.
  4. Anopheles flavirostris incriminated as a vector of malaria and Bancroftian filariasis in Banggi Island, Sabah, Malaysia
    Hii JL, Kan S, Vun YS, Chin KF, Lye MS, Mak JW, et al.
    Trans R Soc Trop Med Hyg, 1985;79(5):677-80.
    PMID: 3913069
    Seven villages in Banggi Island, Sabah, Malaysia, were surveyed four times to evaluate the roles of local mosquitoes as vectors of malaria and Bancroftian filariasis. 11 species of Anopheles were found biting man. 53.9% of the anophelines caught were An. flavirostris, 27.1% An. balabacensis, 6% An. donaldi and 4.2% An. subpictus. Infective malaria sporozoites, probably of human origin, were found in two of 336 An. flavirostris and 12 of 308 An. balabacensis. Sporozoites, probably of a non-human Plasmodium, were found in An. umbrosus. Nine of 1001 An. flavirostris and four of 365 An. balabacensis harboured L2 or L3 filarial larvae identified as those of Wuchereria bancrofti. This is the first record of An. flavirostris as a natural vector of malaria and W. bancrofti in Sabah.
  5. A case of congenital malaria in Malaysia with IgM malaria antibodies
    Thomas V, Chit CW
    Trans R Soc Trop Med Hyg, 1980;74(1):73-6.
    PMID: 7001686
    Congenital malaria from Malaysia is reported here for the first time. It occurred in a baby boy born to a 16-year-old primigravida who contracted Plasmodium falciparum infection during pregnancy. She suffered malaria during the later stages of pregnancy and at parturition. The placenta was heavily infested with various asexual stages of P. falciparum. Gametocytes were not seen. Extensive search did not show other species. Cord blood showed very light infection with young trophozoites of P. falciparum. Serological studies using IFA technique showed specific IgG and IgM antibodies to P. falciparum in maternal cord and two early neonatal sera. These serum samples showed lower levels of IgG antibodies against P. vivax and P. malariae, but there were no specific IgM antibodies against these species. The value of specific IgM antibody in the diagnosis of congenital malaria is discussed.
  6. Letter: Toxoplasma antibody in West Malaysia (Peninsular Malaya)
    Bisseru B, Chong LK
    Trans R Soc Trop Med Hyg, 1974;68(2):172-3.
    PMID: 4460304
  7. Paediatric gastroenteritis in the eastern Malaysian state of Sarawak: an epidemiological and clinical study
    Barker RA, Maxwell PH, Hong CP, Cordery MC, Chrystie IL
    Trans R Soc Trop Med Hyg, 1988;82(6):898-901.
    PMID: 2855768
    Over a period of 2 months, 35 of 69 (51%) cases of juvenile diarrhoea studied in eastern Malaysia were associated with rotavirus excretion; rotavirus associated diarrhoea occurred most commonly in the 6-24 month age group. Polyacrylamide gel electrophoresis (PAGE) of genome ribonucleic acid showed that only 4 rotavirus electropherotypes could be detected. Of those, 2 predominated and 2 were detected only once each; one of these may have been a reassortment of the two predominant electropherotypes. Analysis of the clinical features of patients excreting rotavirus subgroup 1 or 2, determined by PAGE, demonstrated that rotavirus subgroup 1 was associated with more hypotonic dehydration and need for intravenous therapy: lethargy was significantly more common among those excreting rotavirus subgroup 2.
  8. Detection of microsporidia in local HIV-positive population in Malaysia
    Lono A, Kumar S, Chye TT
    Trans R Soc Trop Med Hyg, 2011 Jul;105(7):409-13.
    PMID: 21596411 DOI: 10.1016/j.trstmh.2011.03.006
    The HIV-positive population, due to their immuno-compromised nature, is considered more susceptible to parasitic infections than other populations. However despite the reports of other opportunistic pathogens such as Cryptosporidium and tuberculosis reported in vulnerable communities, microsporidia have not been highlighted in the local HIV-positive population in Malaysia. This study aimed to provide preliminary information on the prevalence of microsporidia in the local HIV-population. Microsporidia were detected in 21/247 (8.5%) stool samples from the HIV-infected individuals, a significantly higher (P-value <0.05) prevalence than in the control group, in which 5/173 (2.9%) were positive. HIV patients were 3x more at risk for acquiring microspordium (OR: 3.12; 95% CI 1.15-8.44). Spores were ellipsoid in shape with outlines that stained dark pink with the interior a lighter shade. Approximately 21% of the positive specimens were from individuals in the 40-49 years age group. Ten individuals who were positive for microsporidia were also positive for other enteric parasites such as Blastocystis hominis and Giardia lamblia. We detected Encephalitozoon intestinalis DNA following nested PCR from three of 10 samples analysed, as demonstrated by an amplicon of 370bp. From the findings reported, it appears that microsporidial infection in humans may actually be more common than reported. We strongly advocate greater emphasis on personal hygiene through public education on personal hygiene and the consumption of boiled or filtered water.
  9. Prevalence of microsporidia in an indigenous Orang Asli community in Pahang, Malaysia
    Lono A, Kumar GS, Chye TT
    Trans R Soc Trop Med Hyg, 2010 Mar;104(3):214-8.
    PMID: 19716577 DOI: 10.1016/j.trstmh.2009.07.006
    Microsporidia are ubiquitous parasites thought to be closely related to fungi. Their presence in the environment means that humans are frequently exposed to infection. Stool samples were collected from 151 indigenous villagers from the eastern state of Pahang in 2005. The samples were concentrated with water-ether sedimentation, stained with modified trichrome stain and examined under oil-immersion microscopy. Thirty-two specimens (21.2%) were positive for microsporidia. Microsporidia were observed as ovoid or rounded ovoid shapes measuring approximately 1mum, with a bright pink outline containing a central or posterior vacuole. PCR amplification with specific primers on microscopy-positive specimens amplified Encephalitozoon intestinalis DNA from five of the ten specimens used.
  10. A retrospective serological suvey of Royal Marines previously exposed to Pseudomonas pseudomallei in South East Asia
    Preston PJ, Lightfoot N, Clarke P
    Trans R Soc Trop Med Hyg, 1976;70(4):335-7.
    PMID: 1006764
    Following the suggestion that it was possible that cases of melioidosis amongst those who had been exposed abroad in the past, might be escaping notice, 487 Royal Marines were examined by indirect haemagglutination studies. Four hundred and eleven of these subjects had served for variable times in areas where melioidosis has been known to occur in Indonesia and Malaya, between 1960 and 1974, occupied in activities in the jungle and paddy fields during which exposure to the disease was to be expected. No evidence of residual subclinical melioidosis was found and it seems unlikely that recrudescent disease will prove to be a problem in the future for English servicemen who have been in South East Asia.
  11. A presumptive case of naturally occurring Plasmodium knowlesi malaria in man in Malaysia
    Fong YL, Cadigan FC, Coatney GR
    Trans R Soc Trop Med Hyg, 1971;65(6):839-40.
    PMID: 5003320
  12. Hereditary ovalocytosis and reduced susceptibility to malaria in Papua New Guinea
    Cattani JA, Gibson FD, Alpers MP, Crane GG
    Trans R Soc Trop Med Hyg, 1987;81(5):705-9.
    PMID: 3329776
    Ovalocytosis, an hereditary condition in which most erythrocytes are oval in shape, is a polymorphism that occurs in up to 20% or more of the population in Papua New Guinea and Malaysia. Due to the geographical correlation of the trait with endemic malaria, the possibility of a selective advantage in resistance to malaria has been raised. In a study of 202 individuals with greater than or equal to 50% oval red cells matched by age, sex and village of residence with controls having less than or equal to 30% oval cells, ovalocytic subjects had blood films negative for Plasmodium vivax (P = 0.009), for P. falciparum (P = 0.044), and for all species of malaria parasites (P = 0.013), more often than controls. Among individuals parasitaemic at any time there were no clear differences in density of parasitaemia. However, in children 2 to 4 years old, parasite densities of both species were lower in ovalocytic subjects than in controls (0.01 less than P less than 0.025). The differential susceptibility to malaria infection suggested by this study has implications for the evaluation of interventions, including possible future vaccine field trials, in populations where high-frequency ovalocytosis is present.
  13. Chloroquine-resistant falciparum malaria among British service personnel in West Malaysia and Singapore
    McKelvey TP, Lundie AR, Vanreenen RM, Williams ED, Moore HS, Thomas MJ, et al.
    Trans R Soc Trop Med Hyg, 1971;65(3):286-309.
    PMID: 4934534
  14. Is there any association between body mass index and severity of dengue infection?
    Zulkipli MS, Rampal S, Bulgiba A, Peramalah D, Jamil N, See LLC, et al.
    Trans R Soc Trop Med Hyg, 2021 07 01;115(7):764-771.
    PMID: 33587144 DOI: 10.1093/trstmh/trab021
    BACKGROUND: Dengue, an acute infectious disease caused by a flavivirus, is a threat to global health. There is sparse evidence exploring obesity and the development of more severe dengue cases in adults. With increasing prevalence of obesity in areas with a high risk of dengue infection, obesity may increase the burden and mortality related to dengue infection. Our study aimed to determine the association between obesity and the development of more severe dengue infection in primary healthcare settings and whether these associations were modified by dengue fever phase.

    METHODS: A cohort study was conducted among laboratory-confirmed dengue patients aged >18 y in the central region of Peninsular Malaysia from May 2016 to November 2017. We collected demographic, clinical history, physical examination and laboratory examination information using a standardized form. Dengue severity (DS) was defined as either dengue with warning signs or severe dengue. Participants underwent daily follow-up, during which we recorded their vital signs, warning signs and full blood count results. Incidence of DS was modeled using mixed-effects logistic regression. Changes in platelet count and hematocrit were modeled using mixed-effects linear regression. The final multivariable models were adjusted for age, gender, ethnicity and previous dengue infection.

    RESULTS: A total of 173 patients were enrolled and followed up. The mean body mass index (BMI) was 37.4±13.75 kg/m2. The majority of patients were Malay (65.9%), followed by Chinese (17.3%), Indian (12.7%) and other ethnic groups (4.1%). A total of 90 patients (52.0%) were male while 36 patients (20.8%) had a previous history of dengue infection. BMI was significantly associated with DS (adjusted OR=1.17; 95% CI 1.04 to 1.34) and hematocrit (%) (aβ=0.09; 95% CI 0.01 to 0.16), but not with platelet count (x103/µL) (aβ=-0.01; 95% CI -0.84 to 0.81). In the dose response analysis, we found that as BMI increases, the odds of DS, hematocrit levels and platelet levels increase during the first phase of dengue fever.

    CONCLUSION: Higher BMI and higher hematocrit levels were associated with higher odds of DS. Among those with high BMI, the development of DS was observed during phase one of dengue fever instead of during phase two. These novel results could be used by clinicians to help them risk-stratify dengue patients for closer monitoring and subsequent prevention of severe dengue complications.

  15. Non-radioisotopic glucose turnover in children with falciparum malaria and enteric fever
    Singh B, Choo KE, Ibrahim J, Johnston W, Davis TM
    Trans R Soc Trop Med Hyg, 1998 12 23;92(5):532-7.
    PMID: 9861371
    To determine whether glucose turnover is increased in acute falciparum malaria compared to enteric fever in children, steady-state 6,6-D2-glucose turnover was measured in 9 Malaysian children with uncomplicated malaria (6 males and 3 females; median age 10 years, body weight 22 kg) and in 12 with uncomplicated enteric fever (8 males and 4 females; median age 10 years, body weight 24 kg) in acute illness, after quinine (5 malaria patients) and in convalescence. Baseline plasma glucose concentrations in malaria and enteric fever were similar (all values are medians [ranges in brackets]) 5.6 [3.2-11.3] vs. 5.5 [4.2-8.0] mmol/L), as were serum insulin levels (5.6 [0.4-26.5] vs. 6.8 [1.1-22.5] milliunits/L; P > 0.4). Glucose turnover in the malaria patients was higher than in patients with enteric fever (6.27 [2.71-6.87] vs. 5.20 [4.50-6.08] mg/kg.min; P = 0.02) and in convalescence (4.74 [3.35-6.79] mg/kg.min; P = 0.05 vs. acute malaria study), and fell after quinine together with a rise in serum insulin (P = 0.03). Basal plasma lactate concentrations were higher in enteric fever than in malaria (3.4 [1.8-6.4] vs. 0.8 [0.3-3.8] mmol/L; P < 0.0001) and correlated inversely with glucose turnover in this group (rs = -0.60; n = 12; P = 0.02). These data suggest that glucose turnover is 20% greater in malaria than in enteric fever. This might reflect increased non-insulin-mediated glucose uptake in falciparum malaria and/or impaired gluconeogenesis in enteric fever, and may have implications for metabolic complications and their clinical management in both infections.
  16. The use of two-dimension electrophoresis to identify serum biomarkers from patients with dengue haemorrhagic fever
    Thayan R, Huat TL, See LL, Tan CP, Khairullah NS, Yusof R, et al.
    Trans R Soc Trop Med Hyg, 2009 Apr;103(4):413-9.
    PMID: 19203772 DOI: 10.1016/j.trstmh.2008.12.018
    Dengue infection is a major public health problem affecting millions of people living in tropical countries. With no suitable vaccines and specific antiviral drugs, treatment for dengue is usually symptomatic and supportive. Early diagnosis and recognition of severe disease is therefore crucial for better management of the patient. Two-dimension electrophoresis was used to identify disease-associated proteins that can be used for diagnosis and as drug targets for treatment. Two markers, identified by mass spectrometry analysis as alpha1-antitrypsin and NS1 proteins were found to be upregulated in dengue fever (DF; n=10) and dengue haemorrhagic fever (DHF; n=10) patients compared with healthy individuals (n=8). Both alpha1-antitrypsin and NS1 proteins were overexpressed two-fold in DHF patients compared with DF patients. Our study suggests that alpha1-antitrypsin and NS1 protein could be used as biomarkers as early indicators of DHF risk among patients with suspected dengue infection.
  17. Antibodies to Orientia tsutsugamushi, Rickettsia typhi and spotted fever group rickettsiae among febrile patients in rural areas of Malaysia
    Tay ST, Ho TM, Rohani MY, Devi S
    Trans R Soc Trop Med Hyg, 2000 9 7;94(3):280-4.
    PMID: 10974999
    A serosurvey was conducted in 1995-97 among 1596 febrile patients from 8 health centres in Malaysia for antibodies against Orientia tsutsugamushi (OT), Rickettsia typhi (RT) and TT118 spotted fever group rickettsiae (SFGR) by using an indirect immunoperoxidase assay. A total of 51.4% patients had antibody against at least 1 of those rickettsiae. Antibody to SFGR was most prevalent (42.5%), followed by RT (28.1%) and OT (24.9%). The seroprevalences of antibodies to SFGR, RT or OT alone were 12.4, 3.6 and 4.3%, respectively. Antibodies against more than 1 species of rickettsiae were presence in 31.1% of the patients, suggesting the possibility of co-infection, previous exposures or serological cross-reactivities. Seroprevalence of the various rickettsiae varied according to locality, with SFGR antibodies being the most prevalent in most areas. There was no significant association of prevalence of rickettsial antibody with gender. The seroprevalence of OT, SFGR and RT increased with patient age but an increase of antibody titre with age was not significant. Those working in the agricultural sectors had significantly higher seroprevalence of OT, SFGR and RT than those not related with agricultural activities. Scrub typhus remains a public health problem with an estimated annual attack rate of 18.5%. Tick typhus and murine typhus as shown in this serosurvey appear much more widespread than scrub typhus in this country.
  18. Clinical manifestations, laboratory profile and outcomes of dengue virus infection in hospitalised older patients
    Ng WY, Ngim CF, Chow KY, Goh SXM, Zaid M, Dhanoa A
    Trans R Soc Trop Med Hyg, 2021 Nov 09.
    PMID: 34750632 DOI: 10.1093/trstmh/trab168
    BACKGROUND: Due to an ageing population, dengue among older patients is encountered more frequently in many countries. Our study aimed to explore the clinico-laboratory parameters and outcomes among dengue-infected older patients in comparison with younger patients.

    METHODS: This retrospective chart review involved dengue patients with dengue non-structural protein 1 (NS1) antigen positivity admitted to a tertiary hospital in Malaysia from January to July 2015. A comparison was made between older people (aged ≥60 y) and others.

    RESULTS: Among 406 dengue patients, 43 (10.6%) were older people. Older dengue patients were less likely to present with persistent vomiting (adjusted OR [AOR] 0.247, 95% CI 0.093 to 0.656, p=0.005), while restlessness and confusion were more common at presentation (AOR 3.356, 95% CI 1.024 to 11.003, p=0.046). Older patients had significantly lower albumin upon admission (38 vs 40 g/L, p=0.036) and during hospital stay (35 vs 37 g/L, p=0.015). Compared with younger patients, older patients were more likely to have experienced nadir platelet counts of <50×109/L (AOR 2.897, 95% CI to 1.176 to 7.137, p=0.021). They were also more likely to require an extended hospital stay (AOR 3.547, 95% CI 1.575 to 7.986, p=0.002).

    CONCLUSIONS: Diagnosis of dengue in older people may be challenging because of atypical presentations. Increased vigilance is necessary as there is an increased tendency to develop severe thrombocytopenia, hypoalbuminemia and prolonged hospitalisation in older people.

  19. Antibodies to Sarcocystis in Malaysians
    Thomas V, Dissanaike AS
    Trans R Soc Trop Med Hyg, 1978;72(3):303-6.
    PMID: 97821
    Sera from 243 donors belonging to the four main ethnic groups in West Malaysia (Orang Asli, Malays, Chinese and Indians) were tested, using the indirect fluorescent antibody technique for the prevalence of antibodies to Sarcocystis. Almost 20% reacted positively at dilutions of 1:64 or higher and eight among the Orang Asli and Malays gave the highest titres of 1:256. Prevalence was highest in the Orang Asli and lowest in Chinese. 22 sera also reacted positively to Toxoplasma, whether due to polyparasitism or cross-reaction is, as yet, unknown.
  20. Letter: Further studies on trypanosomiasis in Orang Asli (aborigines) in West Malaysia
    Else JG, Thomas V, Kan SP, Dissanaike AS
    Trans R Soc Trop Med Hyg, 1976;70(2):170-1.
    PMID: 960210
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