Displaying publications 21 - 40 of 193 in total

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  1. Fariz-Safhan MN, Tee HP, Abu Dzarr GA, Sapari S, Lee YY
    Trop Biomed, 2014 Jun;31(2):270-80.
    PMID: 25134895 MyJurnal
    During a dengue outbreak in 2005 in the East-coast region of Peninsular Malaysia, one of the worst hit areas in the country at that time, we undertook a prospective study. We aimed to describe the bleeding outcome and changes in the liver and hematologic profiles that were associated with major bleeding outcome during the outbreak. All suspected cases of dengue admitted into the only referral hospital in the region during the outbreak were screened for WHO 2002 criteria and serology. Liver function, hematologic profile and severity of bleeding outcome were carefully documented. The association between symptoms, liver and hematologic impairments with the type of dengue infection (classical vs. hemorrhagic) and bleeding outcome (major vs. non-major) was tested. Dengue fever was confirmed in 183 cases (12.5/100,000 population) and 144 cases were analysed. 59.7% were dengue hemorrhagic fever, 3.5% were dengue shock syndrome and there were 3 in-hospital deaths. Major bleeding outcome (gastrointestinal bleeding, intracranial bleeding or haemoptysis) was present in 14.6%. Elevated AST, ALT and bilirubin were associated with increasing severity of bleeding outcome (all P < 0.05). Platelet count and albumin level were inversely associated with increasing severity of bleeding outcome (both P < 0.001). With multivariable analysis, dengue hemorrhagic fever was more likely in the presence of abdominal pain (OR 1.1, 95% CI 0.02- 1.6) and elevated AST (OR 1.0, 95% CI 1.0-1.1) but the presence of pleural effusion (OR 5.8, 95% CI: 1.1-29.9) and elevated AST (OR 1.008, 95% CI: 1.005-1.01) predicted a severe bleeding outcome. As a conclusion, the common presence of a severe hemorrhagic form of dengue fever may explain the rising death toll in recent outbreaks and the worst impairment in liver and hematologic profiles was seen in major bleeding outcome.
    Study site: Hospital Tengku Ampuan Afzan (HTAA), Kuantan, Pahang, Malaysia
    Matched MeSH terms: Dengue/epidemiology*
  2. Shah S, Abbas G, Riaz N, Anees Ur Rehman, Hanif M, Rasool MF
    Expert Rev Pharmacoecon Outcomes Res, 2020 Aug;20(4):343-354.
    PMID: 32530725 DOI: 10.1080/14737167.2020.1782196
    BACKGROUND: Communicable diseases such as AIDS/HIV, dengue fever, and malaria have a great burden and subsequent economic loss in the Asian region. The purpose of this article is to review the widespread burden of communicable diseases and related health-care burden for the patient in Asia and the Pacific.

    AREAS COVERED: In Central Asia, the number of new AIDS cases increased by 29%. It is more endemic in the poor population with variations in the cost of illness. Dengue is prevalent in more than 100 countries, including the Asia-Pacific region. In Southeast Asia, the annual economic burden of dengue fever was between $ 610 and $ 1,384 million, with a per capita cost of $ 1.06 to $ 2.41. Globally, 2.9 billion people are at risk of developing malaria, 90% of whom are residents of the Asia and Pacific region. The annual per capita cost of malaria control ranged from $ 0.11 to $ 39.06 and for elimination from $ 0.18 to $ 27.

    EXPERT OPINION: The cost of AIDS, dengue, and malaria varies from country to country due to different health-care systems. The literature review has shown that the cost of dengue disease and malaria is poorly documented.

    Matched MeSH terms: Dengue/epidemiology
  3. Nyamah MA, Sulaiman S, Omar B
    Trop Biomed, 2010 Apr;27(1):33-40.
    PMID: 20562811 MyJurnal
    This cross-sectional study was to compare and categorize potential breeding sites of dengue vectors, Aedes aegypti and Aedes albopictus at three different places, namely, an urban (Taman Permas Jaya, Johor Bahru, Johor), a suburban (Kg. Melayu Gelang Patah, Johor Bahru, Johor) and a rural (Felda Simpang Waha, Kota Tinggi, Johor) habitats in Malaysia. Larval surveys were conducted once in every two months at each habitat over a period of 11 months from August 2000 until June 2001. There was a significant difference between the three study sites in terms of potential breeding sites inspected (p<0.001). There were more potential breeding sites found in the rural area when compared to the urban and suburban habitats. The mean Potential Container Index (PCI) values in descending order were as follows: rural habitat (57.72)>suburban (29.35)>urban habitat (16.97). Both breeding sites and potential breeding sites were the nominator and the total number of containers inspected as the denominator in the formula of PCI, thus the latter could be a potential indicator to initiate anti-dengue campaign at the community level to rid off potential Aedes breeding sites. The three most common potential breeding sites of Aedes species were similar for urban and suburban habitats (flower pots, pails and bowls respectively). However, flower pots, vases and tyres were the three most common potential breeding sites for the rural habitat. Another finding in this study was that various types of larval habitats were found indoors and outdoors for both species.
    Matched MeSH terms: Dengue/epidemiology*
  4. Lam SK
    Expert Rev Vaccines, 2013 Sep;12(9):995-1010.
    PMID: 24053394 DOI: 10.1586/14760584.2013.824712
    Dengue is a major public health concern worldwide, with the number of infections increasing globally. The illness imposes the greatest economic and human burden on developing countries that have limited resources to deal with the scale of the problem. No cure for dengue exists; treatment is limited to rehydration therapy, and with vector control strategies proving to be relatively ineffective, a vaccine is an urgent priority. Despite the numerous challenges encountered in the development of a dengue vaccine, several vaccine candidates have shown promise in clinical development and it is believed that a vaccination program would be at least as cost-effective as current vector control programs. The lead candidate vaccine is a tetravalent, live attenuated, recombinant vaccine, which is currently in Phase III clinical trials. Vaccine introduction is a complex process that requires consideration and is discussed here. This review discusses the epidemiology, burden and pathogenesis of dengue, as well as the vaccine candidates currently in clinical development.
    Matched MeSH terms: Dengue/epidemiology*
  5. Saifur RG, Dieng H, Hassan AA, Salmah MR, Satho T, Miake F, et al.
    PLoS One, 2012;7(2):e30919.
    PMID: 22363516 DOI: 10.1371/journal.pone.0030919
    BACKGROUND: The domestic dengue vector Aedes aegypti mosquitoes breed in indoor containers. However, in northern peninsular Malaysia, they show equal preference for breeding in both indoor and outdoor habitats. To evaluate the epidemiological implications of this peridomestic adaptation, we examined whether Ae. aegypti exhibits decreased survival, gonotrophic activity, and fecundity due to lack of host availability and the changing breeding behavior.

    METHODOLOGY/PRINCIPAL FINDINGS: This yearlong field surveillance identified Ae. aegypti breeding in outdoor containers on an enormous scale. Through a sequence of experiments incorporating outdoors and indoors adapting as well as adapted populations, we observed that indoors provided better environment for the survival of Ae. aegypti and the observed death patterns could be explained on the basis of a difference in body size. The duration of gonotrophic period was much shorter in large-bodied females. Fecundity tended to be greater in indoor acclimated females. We also found increased tendency to multiple feeding in outdoors adapted females, which were smaller in size compared to their outdoors breeding counterparts.

    CONCLUSION/SIGNIFICANCE: The data presented here suggest that acclimatization of Ae. aegypti to the outdoor environment may not decrease its lifespan or gonotrophic activity but rather increase breeding opportunities (increased number of discarded containers outdoors), the rate of larval development, but small body sizes at emergence. Size is likely to be correlated with disease transmission. In general, small size in Aedes females will favor increased blood-feeding frequency resulting in higher population sizes and disease occurrence.

    Matched MeSH terms: Dengue/epidemiology*
  6. Mohd Zim MA, Sam IC, Omar SF, Chan YF, AbuBakar S, Kamarulzaman A
    J Clin Virol, 2013 Feb;56(2):141-5.
    PMID: 23201456 DOI: 10.1016/j.jcv.2012.10.019
    Chikungunya virus (CHIKV) and dengue virus (DENV) co-circulate in areas endemic with the Aedes mosquito vectors. Both viruses cause similar illnesses which may be difficult to distinguish clinically. CHIKV is also associated with persistent arthralgia.
    Matched MeSH terms: Dengue/epidemiology
  7. Rathakrishnan A, Klekamp B, Wang SM, Komarasamy TV, Natkunam SK, Sathar J, et al.
    PLoS One, 2014;9(3):e92021.
    PMID: 24647042 DOI: 10.1371/journal.pone.0092021
    With its elusive pathogenesis, dengue imposes serious healthcare, economic and social burden on endemic countries. This study describes the clinical and immunological parameters of a dengue cohort in a Malaysian city, the first according to the WHO 2009 dengue classification.
    Matched MeSH terms: Dengue/epidemiology*
  8. Jaenisch T, Tam DT, Kieu NT, Van Ngoc T, Nam NT, Van Kinh N, et al.
    BMC Infect Dis, 2016 Mar 11;16:120.
    PMID: 26968374 DOI: 10.1186/s12879-016-1440-3
    The burden of dengue continues to increase globally, with an estimated 100 million clinically apparent infections occurring each year. Although most dengue infections are asymptomatic, patients can present with a wide spectrum of clinical symptoms ranging from mild febrile illness through to severe manifestations of bleeding, organ impairment, and hypovolaemic shock due to a systemic vascular leak syndrome. Clinical diagnosis of dengue and identification of which patients are likely to develop severe disease remain challenging. This study aims to improve diagnosis and clinical management through approaches designed a) to differentiate between dengue and other common febrile illness within 72 h of fever onset, and b) among patients with dengue to identify markers that are predictive of the likelihood of evolving to a more severe disease course.
    Matched MeSH terms: Dengue/epidemiology*
  9. Suppiah J, Chan SY, Ng MW, Khaw YS, Ching SM, Mat-Nor LA, et al.
    J Biomed Sci, 2017 Jun 28;24(1):40.
    PMID: 28659189 DOI: 10.1186/s12929-017-0344-x
    BACKGROUND: Dengue and leptospirosis infections are currently two major endemics in Malaysia. Owing to the overlapping clinical symptoms between both the diseases, frequent misdiagnosis and confusion of treatment occurs. As a solution, the present work initiated a pilot study to investigate the incidence related to co-infection of leptospirosis among dengue patients. This enables the identification of more parameters to predict the occurrence of co-infection.

    METHOD: Two hundred sixty eight serum specimens collected from patients that were diagnosed for dengue fever were confirmed for dengue virus serotyping by real-time polymerase chain reaction. Clinical, laboratory and demographic data were extracted from the hospital database to identify patients with confirmed leptospirosis infection among the dengue patients. Thus, frequency of co-infection was calculated and association of the dataset with dengue-leptospirosis co-infection was statistically determined.

    RESULTS: The frequency of dengue co-infection with leptospirosis was 4.1%. Male has higher preponderance of developing the co-infection and end result of shock as clinical symptom is more likely present among co-infected cases. It is also noteworthy that, DENV 1 is the common dengue serotype among all cases identified as dengue-leptospirosis co-infection in this study.

    CONCLUSION: The increasing incidence of leptospirosis among dengue infected patients has posed the need to precisely identify the presence of co-infection for the betterment of treatment without mistakenly ruling out either one of them. Thus, anticipating the possible clinical symptoms and laboratory results of dengue-leptospirosis co-infection is essential.

    Matched MeSH terms: Dengue/epidemiology*
  10. Ng CF, Lum LC, Ismail NA, Tan LH, Tan CP
    J Clin Virol, 2007 Nov;40(3):202-6.
    PMID: 17928264 DOI: 10.1016/j.jcv.2007.08.017
    BACKGROUND: Difficulties in the classification of dengue infection have been documented. Such difficulties could be due to the low awareness of the World Health Organization diagnostic guidelines among clinicians.
    OBJECTIVE: To study the diagnostic practices of clinicians in classifying patients as dengue fever (DF) or dengue haemorrhagic fever (DHF)/dengue shock syndrome (DSS) at the time of discharge during an outbreak.
    METHODS: A prospective descriptive study of clinical features and disease classification in adult and pediatric dengue patients in the University of Malaya Medical Centre.
    RESULTS: Five hundred and twenty adult and 191 pediatric patients were enrolled. Thrombocytopenia and evidence of plasma leakage were present in 8% of adult and 19% of pediatric patients. Of these, 93% and 49%, respectively, were given the discharge diagnoses of DF instead of DHF/DSS. Hemoconcentration, serous effusion and thrombocytopenia were not recognized in clinicians' discharge diagnosis of DHF/DSS for adult patients. The receiver operating characteristic (ROC) curve suggested a lack of consistency in the use of WHO guidelines in establishing DHF/DSS in adult patients, while implying otherwise for pediatric patients.
    CONCLUSION: DHF/DSS is an under-recognized condition by clinicians managing these patients. This can affect the case fatality rate of DHF/DSS and the economic burden of the disease. The lack of awareness in disease manifestations especially plasma leakage, can lead to delayed recognition of DHF/DSS.
    Study site: Outpatient department and inpatients, adult medical and pediatric wards, University Malaya Medical Center (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Dengue/epidemiology*; Severe Dengue/epidemiology*
  11. Mallhi TH, Khan AH, Adnan AS, Sarriff A, Khan YH, Jummaat F
    BMC Infect Dis, 2015 Sep 30;15:399.
    PMID: 26423145 DOI: 10.1186/s12879-015-1141-3
    BACKGROUND: The incidence of dengue is rising steadily in Malaysia since the first major outbreak in 1973. Despite aggressive measures taken by the relevant authorities, Malaysia is still facing worsening dengue crisis over the past few years. There is an urgent need to evaluate dengue cases for better understanding of clinic-laboratory spectrum in order to combat this disease.

    METHODS: A retrospective analysis of dengue patients admitted to a tertiary care teaching hospital during the period of six years (2008 - 2013) was performed. Patient's demographics, clinical and laboratory findings were recorded via structured data collection form. Patients were categorized into dengue fever (DF) and dengue hemorrhagic fever (DHF). Appropriate statistical methods were used to compare these two groups in order to determine difference in clinico-laboratory characteristics and to identify independent risk factors of DHF.

    RESULTS: A total 667 dengue patients (30.69 ± 16.13 years; Male: 56.7 %) were reviewed. Typical manifestations of dengue like fever, myalgia, arthralgia, headache, vomiting, abdominal pain and skin rash were observed in more than 40 % patients. DHF was observed in 79 (11.8 %) cases. Skin rash, dehydration, shortness of breath, pleural effusion and thick gall bladder were more significantly (P  40 years (OR: 4.1, P 

    Matched MeSH terms: Dengue/epidemiology; Severe Dengue/epidemiology
  12. Wong LP, AbuBakar S, Chinna K
    PLoS Negl Trop Dis, 2014 May;8(5):e2789.
    PMID: 24853259 DOI: 10.1371/journal.pntd.0002789
    Demographic, economic and behavioural factors are central features underpinning the successful management and biological control of dengue. This study aimed to examine these factors and their association with the seroprevalence of this disease.
    Matched MeSH terms: Dengue/epidemiology
  13. Chow VT, Seah CL, Chan YC
    Intervirology, 1994;37(5):252-8.
    PMID: 7698880
    By a combination of PCR and direct-cycle sequencing using consensus primers, we analyzed approximately 400-bp fragments within the NS3 genes of twenty-one dengue virus type 3 strains isolated from five neighboring Southeast Asian countries at different time intervals from 1956 to 1992. The majority of base disparities were silent mutations, with few predicted amino acid substitutions, thus emphasizing the strict conservation of the NS3 gene. Phylogenetic trees constructed on the basis of these nucleotide differences revealed distinct but related clusters of strains from the Philippines, Indonesia, and strains from Singapore and Malaysia of the 1970s and early 1980s, while the Thai cluster was relatively more distant. This genetic relationship was compatible with that proposed by other workers who have studied other dengue 3 virus genes such as E, M and prM. However, we observed that the more recent, epidemic-associated dengue 3 strains from Singapore and Malaysia of the late 1980s and early 1990s were more closely related to the Thai cluster, implying their evolution from the latter, and emphasizing the importance of viral spread via increasing travel within the Southeast Asian area and elsewhere. Nucleotide sequence analysis of the NS3 genes of dengue viruses can serve to advance the understanding of the epidemiology and evolution of these viruses.
    Matched MeSH terms: Dengue/epidemiology*
  14. Cardosa MJ, Zuraini I
    PMID: 1818383
    This study describes the use of an IgM capture ELISA using cell culture derived antigens and a polyclonal rabbit antiflavivirus antisera for the detection of dengue positive cases. The IgM capture ELISA is compared with the dot enzyme immunoassay and the results are discussed in the context of dengue endemicity.
    Matched MeSH terms: Dengue/epidemiology
  15. Thiruchelvam L, Dass SC, Zaki R, Yahya A, Asirvadam VS
    Geospat Health, 2018 05 07;13(1):613.
    PMID: 29772882 DOI: 10.4081/gh.2018.613
    This study investigated the potential relationship between dengue cases and air quality - as measured by the Air Pollution Index (API) for five zones in the state of Selangor, Malaysia. Dengue case patterns can be learned using prediction models based on feedback (lagged terms). However, the question whether air quality affects dengue cases is still not thoroughly investigated based on such feedback models. This work developed dengue prediction models using the autoregressive integrated moving average (ARIMA) and ARIMA with an exogeneous variable (ARIMAX) time series methodologies with API as the exogeneous variable. The Box Jenkins approach based on maximum likelihood was used for analysis as it gives effective model estimates and prediction. Three stages of model comparison were carried out for each zone: first with ARIMA models without API, then ARIMAX models with API data from the API station for that zone and finally, ARIMAX models with API data from the zone and spatially neighbouring zones. Bayesian Information Criterion (BIC) gives goodness-of-fit versus parsimony comparisons between all elicited models. Our study found that ARIMA models, with the lowest BIC value, outperformed the rest in all five zones. The BIC values for the zone of Kuala Selangor were -800.66, -796.22, and -790.5229, respectively, for ARIMA only, ARIMAX with single API component and ARIMAX with API components from its zone and spatially neighbouring zones. Therefore, we concluded that API levels, either temporally for each zone or spatio- temporally based on neighbouring zones, do not have a significant effect on dengue cases.
    Matched MeSH terms: Dengue/epidemiology*
  16. Packierisamy PR, Ng CW, Dahlui M, Inbaraj J, Balan VK, Halasa YA, et al.
    Am J Trop Med Hyg, 2015 Nov;93(5):1020-1027.
    PMID: 26416116 DOI: 10.4269/ajtmh.14-0667
    Dengue fever, an arbovirus disease transmitted by Aedes mosquitoes, has recently spread rapidly, especially in the tropical countries of the Americas and Asia-Pacific regions. It is endemic in Malaysia, with an annual average of 37,937 reported dengue cases from 2007 to 2012. This study measured the overall economic impact of dengue in Malaysia, and estimated the costs of dengue prevention. In 2010, Malaysia spent US$73.5 million or 0.03% of the country's GDP on its National Dengue Vector Control Program. This spending represented US$1,591 per reported dengue case and US$2.68 per capita population. Most (92.2%) of this spending occurred in districts, primarily for fogging. A previous paper estimated the annual cost of dengue illness in the country at US$102.2 million. Thus, the inclusion of preventive activities increases the substantial estimated cost of dengue to US$175.7 million, or 72% above illness costs alone. If innovative technologies for dengue vector control prove efficacious, and a dengue vaccine was introduced, substantial existing spending could be rechanneled to fund them.
    Matched MeSH terms: Dengue/epidemiology
  17. Suaya JA, Shepard DS, Siqueira JB, Martelli CT, Lum LC, Tan LH, et al.
    Am J Trop Med Hyg, 2009 May;80(5):846-55.
    PMID: 19407136
    Despite the growing worldwide burden of dengue fever, the global economic impact of dengue illness is poorly documented. Using a common protocol, we present the first multicountry estimates of the direct and indirect costs of dengue cases in eight American and Asian countries. We conducted prospective studies of the cost of dengue in five countries in the Americas (Brazil, El Salvador, Guatemala, Panama, and Venezuela) and three countries in Asia (Cambodia, Malaysia, and Thailand). All studies followed the same core protocol with interviews and medical record reviews. The study populations were patients treated in ambulatory and hospital settings with a clinical diagnosis of dengue. Most studies were performed in 2005. Costs are in 2005 international dollars (I$). We studied 1,695 patients (48% pediatric and 52% adult); none died. The average illness lasted 11.9 days for ambulatory patients and 11.0 days for hospitalized patients. Among hospitalized patients, students lost 5.6 days of school, whereas those working lost 9.9 work days per average dengue episode. Overall mean costs were I$514 and I$1,394 for an ambulatory and hospitalized case, respectively. With an annual average of 574,000 cases reported, the aggregate annual economic cost of dengue for the eight study countries is at least I$587 million. Preliminary adjustment for under-reporting could raise this total to $1.8 billion, and incorporating costs of dengue surveillance and vector control would raise the amount further. Dengue imposes substantial costs on both the health sector and the overall economy.
    Matched MeSH terms: Dengue/epidemiology*
  18. Zeng W, Halasa-Rappel YA, Baurin N, Coudeville L, Shepard DS
    Vaccine, 2018 01 08;36(3):413-420.
    PMID: 29229427 DOI: 10.1016/j.vaccine.2017.11.064
    Following publication of results from two phase-3 clinical trials in 10 countries or territories, endemic countries began licensing the first dengue vaccine in 2015. Using a published mathematical model, we evaluated the cost-effectiveness of dengue vaccination in populations similar to those at the trial sites in those same Latin American and Asian countries. Our main scenarios (30-year horizon, 80% coverage) entailed 3-dose routine vaccinations costing US$20/dose beginning at age 9, potentially supplemented by catch-up programs of 4- or 8-year cohorts. We obtained illness costs per case, dengue mortality, vaccine wastage, and vaccine administration costs from the literature. We estimated that routine vaccination would reduce yearly direct and indirect illness cost per capita by 22% (from US$10.51 to US$8.17) in the Latin American countries and by 23% (from US$5.78 to US$4.44) in the Asian countries. Using a health system perspective, the incremental cost-effectiveness ratio (ICER) averaged US$4,216/disability-adjusted life year (DALY) averted in the five Latin American countries (range: US$666/DALY in Puerto Rico to US$5,865/DALY in Mexico). In the five Asian countries, the ICER averaged US$3,751/DALY (range: US$1,935/DALY in Malaysia to US$5,101/DALY in the Philippines). From a health system perspective, the vaccine proved to be highly cost effective (ICER under one times the per capita GDP) in seven countries and cost effective (ICER 1-3 times the per capita GDP) in the remaining three countries. From a societal perspective, routine vaccination proved cost-saving in three countries. Including catch-up campaigns gave similar ICERs. Thus, this vaccine could have a favorable economic value in sites similar to those in the trials.
    Matched MeSH terms: Dengue/epidemiology*
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