MyMedR

Studies of the nutritional anaemias of Malaya: the significance of the giant stab cells; as seen in the bone marrow of patients suffering from severe nutritional anaemia

TASKER PW

Trans R Soc Trop Med Hyg, 1956 Sep;50(5):460-4.

PMID: 13380990

Studies of the nutritional anaemias of Malaya: the prevalence of iron deficiency

TASKER PW

Trans R Soc Trop Med Hyg, 1955 Sep;49(5):478-82.

PMID: 13267915

Specificity and sensitivity of a rapid dipstick test (Brugia Rapid) in the detection of Brugia malayi infection

Rahmah N, Taniawati S, Shenoy RK, Lim BH, Kumaraswami V, Anuar AK, et al.

Trans R Soc Trop Med Hyg, 2002 1 31;95(6):601-4.

PMID: 11816429

A total of 753 serum samples from 6 institutions in 3 countries (Malaysia, Indonesia and India) were used to evaluate an immunochromatographic rapid dipstick test, Brugia Rapid, for diagnosis of Brugia malayi infection. The samples comprised sera from 207 microfilaria-positive individuals and 546 individuals from filaria non-endemic areas. The latter consisted of 70 individuals with soil-transmitted helminth infections, 68 with other helminth infections, 238 with protozoan infections, 12 with bacterial and viral infections and 158 healthy individuals. The dipstick is prepared with a goat anti-mouse antibody control line and a B. malayi recombinant-antigen test line. First, the dipstick is dipped into a well containing diluted patient serum, thus allowing specific anti-filarial antibody in the serum to react with the recombinant antigen. Then the dipstick is placed into an adjacent well containing reconstituted anti-human IgG4-gold. After 10 min, development of 2 red-purplish lines denotes a positive result and one line indicates a negative reaction. The overall results of the evaluation showed 97% sensitivity, 99% specificity, 97% positive predictive value and 99% negative predictive value. Brugia Rapid is thus a promising diagnostic tool for detection of B. malayi infection, and would be especially useful for the brugian filariasis elimination programme.

Specific depression of cell-mediated immunity in Malayan filariasis

Kwa BH, Mak JW

Trans R Soc Trop Med Hyg, 1980;74(4):522-7.

PMID: 7445050

The possible depression of cell-mediated immunity by long-term Brugia malayi infection in jirds (Meriones unguiculatus) was investigated. Different groups of infected jirds were sensitized with dinitrofluorobenzene, sheep red blood cells, Dirofilaria immitis adult antigens and B. malayi adult antigens. The 24-hour delayed type hypersensitivity skin response to testing with antigen was measured as an in vivo correlate of cell-mediated immunity. The delayed-type hypersensitivity responses to dinitrofluorobenzene, sheep red blood cells and D. immitis antigens were normal but the response to B. malayi antigens was significantly depressed, confirming that long-term B. malayi infection depresses cell-mediated immunity and that this depression is specific to B. malayi antigens.

Spatiotemporal spread of chikungunya virus in Sarawak, Malaysia

Dass S, Ngui R, Gill BS, Chan YF, Wan Sulaiman WY, Lim YAL, et al.

Trans R Soc Trop Med Hyg, 2021 08 02;115(8):922-931.

PMID: 33783526 DOI: 10.1093/trstmh/trab053

BACKGROUND: We studied the spatiotemporal spread of a chikungunya virus (CHIKV) outbreak in Sarawak state, Malaysia, during 2009-2010.

METHODS: The residential addresses of 3054 notified CHIKV cases in 2009-2010 were georeferenced onto a base map of Sarawak with spatial data of rivers and roads using R software. The spatiotemporal spread was determined and clusters were detected using the space-time scan statistic with SaTScan.

RESULTS: Overall CHIKV incidence was 127 per 100 000 population (range, 0-1125 within districts). The average speed of spread was 70.1 km/wk, with a peak of 228 cases/wk and the basic reproduction number (R0) was 3.1. The highest age-specific incidence rate was 228 per 100 000 in adults aged 50-54 y. Significantly more cases (79.4%) lived in rural areas compared with the general population (46.2%, p<0.0001). Five CHIKV clusters were detected. Likely spread was mostly by road, but a fifth of rural cases were spread by river travel.

CONCLUSIONS: CHIKV initially spread quickly in rural areas mainly via roads, with lesser involvement of urban areas. Delayed spread occurred via river networks to more isolated areas in the rural interior. Understanding the patterns and timings of arboviral outbreak spread may allow targeted vector control measures at key transport hubs or in large transport vehicles.

Some phlebotomid sand-flies and other diptera of Malaysia and Sri Lanka

Lewis DJ, Killick-Kendrick R

Trans R Soc Trop Med Hyg, 1973;67(1):4-5.

PMID: 4777431

Single-dose diethylcarbamazine in the control of periodic brugian filariasis in Peninsular Malaysia

Hakim SL, Vythilingam I, Marzukhi MI, Mak JW

Trans R Soc Trop Med Hyg, 1995 11 1;89(6):686-9.

PMID: 8594697

The study compared the effectiveness of a single dose of diethylcarbamazine (DEC) (6mg/kg) with the standard regimen of 6 doses (total 36 mg/kg) in mass chemotherapy for the control of brugian filariasis. Mass chemotherapy with single-dose DEC was instituted in one area and standard dose in the other and treatment was repeated after one year. Parasitological surveys were conducted before, and 3, 7 and 12 months after treatment. Pretreatment characteristics were not significantly different between the 2 treatment areas. There was a significant reduction in microfilaraemia prevalence rate from 24.7% to 14.7% at 12 months and to 6.8% at 19 months in the single dose area and from 22.8% to 9.6% at 12 months and to 2.7% at 19 months with the standard dose. Maximum reduction was at 7 months after treatment with both regimens. There was also significant progressive reduction in mean microfilarial density from 4.39 +/- 20.37 to 0.89 +/- 4.16 per 60 microL in the single-dose area and from 4.43 +/- 17.31 to 0.75 +/- per 60 microL in the standard dose area. There was a greater reduction of both microfilarial prevalence and density using the standard regimen but it was not statistically significant. Thus, a single dose of DEC is as effective as the standard dose in controlling periodic brugian filariasis.

Seroprevalence of lymphatic filariasis among migrant workers in Peninsular Malaysia

Noordin R, Mohd Zain SN, Yunus MH, Sahimin N

Trans R Soc Trop Med Hyg, 2017 08 01;111(8):370-372.

PMID: 29206992 DOI: 10.1093/trstmh/trx062

Background: Malaysia aims to eliminate lymphatic filariasis (LF) by the year 2020, thus the potential threat of LF from migrant workers needs to be investigated.

Methods: Brugian and bancroftian filariasis among 484 migrant workers from six countries were investigated using rapid tests based on detection of specific IgG4 antibodies against BmR1 (Brugia Rapid) and BmSXP recombinant antigens.

Results: The seroprevalence of brugian filariasis was very low; however, bancroftian filariasis was notable among workers from India, Nepal and Myanmar.

Conclusion: Malaysia is not endemic for Wuchereria bancrofti, but harbors the vectors for the parasite, thus the results showed that migrant workers should be monitored for this infection.

Seroprevalence of dengue and chikungunya viruses among urban refugees in Klang Valley, Malaysia

Sahimin N, Low ZX, Hassandarvish P, Mohd Hanapi IR, Mohd Zain SN, Yahaya H, et al.

Trans R Soc Trop Med Hyg, 2024 Jan 16.

PMID: 38226501 DOI: 10.1093/trstmh/trad097

BACKGROUND: Mosquito-borne diseases pose a significant global public health threat, with Malaysia's Klang Valley experiencing numerous outbreaks in densely populated urban areas.

METHODS: This study aimed to estimate the seroprevalence of anti-dengue and anti-chikungunya antibodies among urban refugees in the Klang Valley, Malaysia, and identify associated risk factors.

RESULTS: High seroprevalence of anti-dengue immunoglobulin G (IgG) and IgM (60.0% [confidence interval {CI} 55.39 to 64.48] and 9.2% [CI 6.77 to 12.25], respectively) were observed among refugees >18 years of age (χ22=11.720, p=0.003), Kachin ethnicity (χ28=72.253, p<0.001), without formal education (χ21=3.856, p=0.050), homes near waste disposal sites (χ21=10.378, p=0.001) and refugees who have experienced flooding (χ21=5.460, p=0.019). Meanwhile, the overall seroprevalence of anti-chikungunya IgG and IgM was 9.7% (CI 7.15 to 12.73) and 10.8% (CI 8.09 to 13.93), respectively, with ages 12-18 years (χ22=6.075, p=0.048), Rohingya ethnicity (χ28=31.631, p<0.001) and homes close to waste disposal sites (χ21=3.912, p=0.048) being significant risk factors. Results showed a link to poor environmental living conditions, with an increase in the vector population with higher availability of breeding sites and thus exposure to dengue and chikungunya virus.

CONCLUSIONS: Health education among the community is the key to disease prevention, as there are no specific antiviral drugs for treatment and limited vaccine availability.

Serological survey on dengue virus infection in Singapore

Goh KT, Yamazaki S

Trans R Soc Trop Med Hyg, 1987;81(4):687-9.

PMID: 3445355

A serological study on dengue infection conducted in Singapore during the period 1982 to 1984 showed that 54.4% of the healthy population between 6 months and over 50 years of age surveyed possessed no haemagglutination-inhibition antibody to dengue type 2 virus. Children below 10 years of age showed the lowest antibody prevalence and were at the greatest risk, with 96.6% susceptible to infection, whereas virtually all adults over 40 showed evidence of prior dengue infection. The geometric mean titre showed a rising trend indicating continuing acquisition of infection in the older age groups. The seropositivity rate of dengue infection of males was twice that of females. Among the 3 major ethnic groups, no significant difference in seropositivity was noted between the Malays and Indians, but the differences between Malays and Chinese and between Indians and Chinese were statistically significant. The study confirmed that the successful implementation of the nation-wide Aedes control programme is reducing endemic dengue virus transmission in the country.

Serological classification of Rickettsia tsutsugamushi organisms found in chiggers (Acarina: Trombiculidae) collected in Peninsular Malaysia

Shirai A, Dohany AL, Ram S, Chiang GL, Huxsoll DL

Trans R Soc Trop Med Hyg, 1981;75(4):580-2.

PMID: 6798724

Seroepidemiology of malaria in Peninsular Malaysia: Plasmodium falciparum antibody profile of adults in four states

Thomas V, Bin HK, Leng YP

Trans R Soc Trop Med Hyg, 1980;74(3):375-80.

PMID: 7001690

In 1973, 2610 sera were collected from adults living in 22 localities in four states in Peninsular Malaysia and tested by IFAT for Plasmodium falciparum antibodies. A larger number of thin films were examined. The attack phase of the Malaria Eradication Programme (MEP) in these areas was started between 1968 and 1973. The results showed that the highest prevalence rates and geometrical mean reciprocal titres (CMRT) were among adults from Kelantan where the antibody prevalence varied greatly among the adults and there was active transmission in at least three areas. The values were lowest for Kedah. The P. falciparum antibody prevalence rates were higher than the parasite rates as revealed in single thin film examinations but a number of the positive sera were reactive only at low titres. The low concentration probably indicated the residual antibody from cured cases or past infections and cross reactions to P. vivax and P. malariae infections. The strong reactions probably indicated current P. falciparum transmission as shown by positive thin films. The present study showed that the antibody profile of adults, as shown by IFAT, is of considerable value in assessing the malaria situation in a given area and that it would be useful as a malariometric tool in epidemiological studies to evaluate the progress of malaria eradication/control programmes.

Septicaemic melioidosis: a review of 50 cases from Malaysia

Puthucheary SD, Parasakthi N, Lee MK

Trans R Soc Trop Med Hyg, 1992 11 1;86(6):683-5.

PMID: 1287945

Fifty cases of septicaemic melioidosis were reviewed. There was a preponderance of disease among males (male:female ratio 3.2:1) and those aged over 30 years. The presenting clinical features were very varied and not pathognomonic, ranging from fever, cough and septicaemia to fulminant septicaemia and shock. Pulmonary involvement was recorded in 58% of the patients. Skin and soft tissue sepsis was seen in 24%, but many had signs and symptoms of multiorgan involvement. Associated underlying illness was identified in 76% of patients, diabetes mellitus being the commonest (38%), while 34% had more than one predisposing factor. The mortality of 65% in our series is a reflection of the less than satisfactory status of the diagnosis and therapy of septicaemic melioidosis. Only 24% of our patients received appropriate empirical antibiotic therapy. A high index of suspicion of melioidosis in endemic areas and the use of appropriate empirical antimicrobial therapy would be a step towards reducing the high mortality rate.

Scrub typhus: a common cause of illness in indigenous populations

Brown GW, Robinson DM, Huxsoll DL, Ng TS, Lim KJ

Trans R Soc Trop Med Hyg, 1976;70(5-6):444-8.

PMID: 402722

An explanation was sought for the disparity between the low reported incidence of scrub typhus and the high prevalence of antibody to Rickettsia tsutsugamushi in the rural population of Malaysia. A combination of isolation of the organism, titration of antibody by indirect immunofluorescence, and the Weil-Felix test was used to confirm infections. Scrub typhus was found to be very common, causing 23% of all febrile illnesses at one hospital. The infection was particularly prevalent in oil-palm workers, causing an estimated 400 cases annually in a population of 10,000 people living on one plantation. The clinical syndrome, whether mild or severe, was difficult to distinguish from that due to other infections. Eschars, rashes and adenopathy were uncommon. When used to examine early sera, the Weil-Felix test failed to confirm the diagnosis in most infections.20

Scrub typhus infection in rats in four habitats in Peninsular Malaysia

Muul I, Lim BL, Walker JS

Trans R Soc Trop Med Hyg, 1977;71(6):493-7.

PMID: 415390

Rickettsia tsutsugamushi isolations were attempted from blood samples obtained from rats captured in four adjacent habitats near Kuala Lumpur, Malaysia. Antibody surveys were also made. Rickettsial infections were most frequent in rats captured in the forest and in lalang grass (Imperata cylindrica) and least frequent in the most extensively disturbed habitat, an Orang Asli (aborigine) village. Forest rats such as Rattus sabanus (31%), as well as rats in the subgenus R. (Rattus), i.e. R. tiomanicus (26%) and R. argentiventer (35%) had frequent active infections. The house rat R. exulans had less frequent infections (15%). Frequency of antibody occurrence followed a similar pattern. No marked seasonal differences in the frequency of infections could be detected during the 18-month study.

Schistosoma japonicum-type infection in Malaysia--report of the first living case

Murugasu R, Wang F, Dissanaike AS

Trans R Soc Trop Med Hyg, 1978;72(4):389-91.

PMID: 705845

The first living patient with a Schistosoma japonicum-type infection who presented with the nephrotic syndrome is reported in detail. It is not clear whether the nephrotic syndrome was due to the schistosome infection or to the deposition of hepatitis B antigen and antibody complexes. This is the tenth case of schistosomiasis reported from aborigines in Malaysia and a sylvatic source of infection is suggested.

Scaling-up attention to nonmalaria acute undifferentiated fever

Naing C, Kassim AI

Trans R Soc Trop Med Hyg, 2012 Jun;106(6):331-2.

PMID: 22541873 DOI: 10.1016/j.trstmh.2012.03.003

Studies have reported that only a small fraction of fever cases in malaria-endemic areas are actually caused by malaria. Much greater emphasis is now needed to step up attention to the appropriate management of nonmalarial acute undifferentiated febrile illness. There is an overlap at the start of clinical manifestations of different febrile illnesses which makes it difficult to adhere to the clinical guidelines. The development of rigorous guidelines based on high quality research and a consensus from the core group of content experts are needed. An innovative financing mechanism for universal access to such appropriate management should also be considered.

Risk factors for endemic giardiasis: highlighting the possible association of contaminated water and food

Mohammed Mahdy AK, Lim YA, Surin J, Wan KL, Al-Mekhlafi MS

Trans R Soc Trop Med Hyg, 2008 May;102(5):465-70.

PMID: 18377940 DOI: 10.1016/j.trstmh.2008.02.004

This study was conducted to reassess the risk factors for giardiasis in communities of the Orang Asli (indigenous people) in Pahang, Malaysia. Stool samples were collected from 321 individuals (2-76 years old; 160 males, 161 females). Data were collected via laboratory analysis of faecal samples and a pre-tested standard questionnaire. River water samples were tested for Giardia cysts and Cryptosporidium oocysts. The overall prevalence of G. intestinalis infection was 23.7%. Children < or =12 years old had the highest infection rate and have been identified as a high risk group (odds ratio (OR)=6.2, 95% CI 1.5-27.0, P<0.005). The risk of getting giardiasis also appeared to be significantly associated with drinking piped water (OR=5.1, 95% CI 0.06-0.7, P<0.005) and eating raw vegetables (OR=2.4, 95% CI 0.2-0.6, P<0.005). In conclusion, sociodemographic factors have always been associated with the high prevalence of Giardia infections in Malaysia. However, the present study also highlights the need to look into the possibility of other risks such as water and food transmission routes. In future, it is necessary that these two aspects be considered in control strategies.

Ribotyping and DNA macrorestriction analysis of isolates of Burkholderia pseudomallei from cases of melioidosis in Malaysia

Vadivelu J, Puthucheary SD, Mifsud A, Drasar BS, Dance DA, Pitt TI

Trans R Soc Trop Med Hyg, 1997 5 1;91(3):358-60.

PMID: 9231217

Forty-nine isolates of Burkholderia pseudomallei from sporadic cases of melioidosis in Malaysia over the past 18 years were examined by BamHI ribotyping and pulsed-field gel electrophoresis (PFGE) of XbaI digests of total deoxyribonucleic acid (DNA). Twenty-four patients had septicaemic melioidosis with a mortality of 70%; mortality in the non-septicaemic disease was 16%. Five ribotype patterns were identified, 2 of which accounted for 90% of all isolates. PFGE revealed a number of different strains within these ribotypes, but some pairs of isolates from unrelated cases gave closely similar DNA profiles. These results are in agreement with Australian studies which showed a high prevalence of a few ribotypes of B. pseudomallei which are further divisible by genotyping, in areas where melioidosis is endemic.

Resistance of head louse (Pediculus humanus capitis de Geer) to DDT in Malaysia

Sinniah B, Sinniah D

Trans R Soc Trop Med Hyg, 1982;76(1):72-4.

PMID: 7080159

A survey of 308,101 schoolchildren conducted in 10 of 11 states in Peninsular Malaysia revealed that 10.7% have Pediculus humanus capitis infestation. The results of treatment with 1%, 2% and 5% DDT in coconut oil in 374 cases reveal cure rates of 3.5%, 15.8% and 51.3%, respectively, suggesting that the head louse has probably developed resistance to this insecticide in Malaysia.

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