Displaying publications 41 - 60 of 179 in total

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  1. Fulltext Epidemiological profile and outcomes of snakebite injuries treated in emergency departments in South Korea, 2011-2016: a descriptive study
    Senek MZF, Kong SY, Shin SD, Sun KM, Kim J, Ro YS
    Trans R Soc Trop Med Hyg, 2019 10 11;113(10):590-598.
    PMID: 31225621 DOI: 10.1093/trstmh/trz050
    BACKGROUND: Snakebite is a global public health crisis, but there are no nationwide data on snakebite in South Korea. The aim of this study was to describe the epidemiological profile and outcomes of snakebite cases in South Korea seasonally.

    METHODS: The selected subjects were patients of all ages with a chief complaint of snakebite who presented to participating emergency departments (EDs) between 1 January 2011 and 31 December 2016.

    RESULTS: A total of 1335 patients were eligible for the study. There were an average of 223 snakebite cases reported each year. Most snakebites occurred during the summer months (55.9%) in patients aged 40-59 y (36.3%) and males (61.5%). Snakebites occurred most frequently on Mondays (22.9%) between 12:00 and 17:59 h (42.0%) outdoors (57.9%) and in farm areas (20.7%). Over 82% of the bites were by venomous snakes across all seasons, and 66% of the patients visited EDs without using emergency medical services. Based on the excess mortality ratio-adjusted injury severity score, 88, 9.2 and 2.8% had mild, moderate and severe injuries, respectively. There were 10 fatalities during the study period.

    CONCLUSION: This study provides essential information to understand and assess the burden and distribution of snakebites in South Korea and provides valuable information for developing appropriate prevention and control interventions to address it.

  2. The longevity of antibody to Rickettsia tsutsugamushi in patients with confirmed scrub typhus
    Saunders JP, Brown GW, Shirai A, Huxsoll DL
    Trans R Soc Trop Med Hyg, 1980;74(2):253-7.
    PMID: 6770503
    Serological surveillance for up to two years of 114 patients with laboratory confirmed scrub typhus showed that antibody to Rickettsia tsutsugamushi as demonstrated by the indirect fluorescent antibody test is short-lived. The mean reversion time from mean peak titre (1:499) was 48.9 weeks and the calculated annual reversion rate to a titre less than 1:50 was 61%. This can be used to estimate attack rates based on point prevalence of antibody. The relationship between antibody prevalence and attack rates observed by other workers was confirmed using this model. The possible uses of the finding and its implications in Malaysia are briefly discussed.
  3. Prevalence of Helicobacter pylori infection among asymptomatic healthy blood donors in Northern Peninsular Malaysia
    Sasidharan S, Uyub AM
    Trans R Soc Trop Med Hyg, 2009 Apr;103(4):395-8.
    PMID: 19211121 DOI: 10.1016/j.trstmh.2008.11.021
    Helicobacter pylori infection is recognized as being strongly associated with chronic gastritis, duodenal ulceration and, probably, gastric carcinoma. Seroepidemiological studies have shown that a large proportion of healthy people have antibodies against H. pylori. A serological study was conducted in asymptomatic healthy blood donors in Northern Peninsular Malaysia to assess the seropositivity for H. pylori and to investigate the relationship with ethnic group, gender, ABO blood group and age. A total of 5370 serum samples collected from 3677 male and 1693 female donors in different age groups, and who had no gastrointestinal complaints, were studied with an in-house ELISA for the presence of H. pylori IgG and IgA antibodies. Seven hundred and sixty subjects (14.2%) were seropositive. The overall seropositivity did not differ with ethnicity, gender, ABO blood group and age among asymptomatic healthy blood donors in Northern Peninsular Malaysia.
  4. Further evidence of ethnic and gender differences for Helicobacter pylori infection among endoscoped patients
    Sasidharan S, Uyub AM, Azlan AA
    Trans R Soc Trop Med Hyg, 2008 Dec;102(12):1226-32.
    PMID: 18586289 DOI: 10.1016/j.trstmh.2008.05.006
    HeIicobacter pylori infection rate was determined in 697 consecutive patients with ulcer, gastritis, duodenitis and non-ulcer dyspepsia by endoscopy at a Malaysian hospital in 1999-2002. Biopsies of the gastric antrum and body were subjected to the urease test, Gram staining of impression smears and culture examination. Infection was defined as a positive result in at least one test. The infection rates were 32.1, 10.4, 20.0 and 16.2% in ulcer, gastritis, duodenitis and non-ulcer dyspepsia patients, respectively. Overall, the prevalence of H. pylori infection was 14.6%, with the rate among the Indian (21.7%), Chinese (19.2%) and Bangladeshi foreign worker (23.1%) groups significantly higher (P<0.05) than that of the Malays (5.8%). Generally, the prevalence rate among males (18.9%) was significantly higher (P<0.001) than that among females (9.0%), but for a particular ethnic group, such trend and significant differences (P<0.05) were observed only among the Malays. In terms of gender, the prevalence rates of Malay males and females were also significantly lower (P<0.05) than those of Chinese and Indians. In conclusion, there is a significant difference in H. pylori infection prevalence rates among ethnic groups (highest in Indians, then Chinese and unusually low in Malays) and gender groups (highest in males) in Malaysia.
  5. 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
  6. Low seroprevalence rates of Zika virus in Kuala Lumpur, Malaysia
    Sam IC, Montoya M, Chua CL, Chan YF, Pastor A, Harris E
    Trans R Soc Trop Med Hyg, 2019 11 01;113(11):678-684.
    PMID: 31294807 DOI: 10.1093/trstmh/trz056
    BACKGROUND: Zika virus (ZIKV) is believed to be endemic in Southeast Asia. However, there have been few Zika cases reported to date in Malaysia, which could be due to high pre-existing levels of population immunity.

    METHODS: To determine Zika virus (ZIKV) seroprevalence in Kuala Lumpur, Malaysia, 1085 serum samples from 2012, 2014-2015 and 2017 were screened for anti-ZIKV antibodies using a ZIKV NS1 blockade-of-binding assay. Reactive samples were confirmed using neutralization assays against ZIKV and the four dengue virus (DENV) serotypes. A sample was possible ZIKV seropositive with a ZIKV 50% neutralization (NT50) titre ≥20. A sample was probable ZIKV seropositive if, in addition, all DENV NT50 titres were <20 or the ZIKV NT50 titre was >4-fold greater than the highest DENV NT50 titre.

    RESULTS: We found low rates of possible ZIKV seropositivity (3.3% [95% confidence interval {CI} 2.4 to 4.6]) and probable ZIKV seropositivity (0.6% [95% CI 0.3 to 1.4]). Possible ZIKV seropositivity was independently associated with increasing age (odds ratio [OR] 1.04 [95% CI 1.02 to 1.06], p<0.0001) and male gender (OR 3.5 [95% CI 1.5 to 8.6], p=0.005).

    CONCLUSIONS: The low ZIKV seroprevalence rate, a proxy for population immunity, does not explain the low incidence of Zika in dengue-hyperendemic Kuala Lumpur. Other factors, such as the possible protective effects of pre-existing flavivirus antibodies or reduced transmission by local mosquito vectors, should be explored. Kuala Lumpur is at high risk of a large-scale Zika epidemic.

  7. 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.

  8. The distribution of antibodies to Japanese Encephalitis, dengue, and yellow fever viruses in five rural communities in Malaya
    SMITH CE
    Trans R Soc Trop Med Hyg, 1958 May;52(3):237-52.
    PMID: 13556868
  9. Predicting enteric fever without bacteriological culture results
    Ross IN, Abraham T
    Trans R Soc Trop Med Hyg, 1987;81(3):374-7.
    PMID: 3686631
    We used Bayes' theorem to calculate the probability of enteric fever in 260 patients presenting with undiagnosed fever, without recourse to blood or stool culture results. These individuals were divided into 110 patients with enteric fever (63 culture positive, 47 culture negative) and 150 patients with other causes of fever. Comparison of the frequencies of occurrence of 19 clinical and laboratory events, said to be helpful in the diagnosis of enteric fever, in the two groups revealed that only 8 events were significantly more frequent in enteric fever. These were: a positive Widal test at a screening dilution of 1:40; a peak temperature greater than = 39 degrees C; previous treatment for the fever; a white blood cell count less than 9 X 10(6)/litre; a polymorphonuclear leucocyte count less than 3.5 X 10(6)/litre; splenomegaly; fever duration greater than 7 d; and hepatomegaly. When the probability of enteric fever was determined prospectively in 110 patients, using only 6 of these discriminating events, the probability of patients with a positive prediction having enteric fever (diagnostic specificity) was 0.80 (95% confidence interval: 0.68 to 0.91) and the probability of those with a negative prediction not having enteric fever (diagnostic sensitivity) was 0.92 (0.85 to 0.99). Using all 19 events did not alter the diagnostic specificity or diagnostic sensitivity. This study shows that a small number of clinical and laboratory features can objectively discriminate enteric fever from other causes of fever in the majority of patients. Calculating the probability of enteric fever can aid in diagnosis, when culturing for salmonella is either unavailable or is negative.
  10. Diagnostic use of Burkholderia pseudomallei selective media in a low prevalence setting
    Roesnita B, Tay ST, Puthucheary SD, Sam IC
    Trans R Soc Trop Med Hyg, 2012 Feb;106(2):131-3.
    PMID: 22112687 DOI: 10.1016/j.trstmh.2011.10.007
    Routine use of selective media improves diagnosis of Burkholderia pseudomallei, but resources may be limited in endemic developing countries. To maximise yield in the relatively low-prevalence setting of Kuala Lumpur, Malaysia, B. pseudomallei selective agar and broth were compared with routine media for 154 respiratory specimens from patients with community-acquired disease. Selective media detected three additional culture-positive specimens and one additional melioidosis patient, at a consumables cost of US$75. Burkholderia pseudomallei was not isolated from 74 diabetic foot ulcer samples. Following careful local evaluation, focused use of selective media may be cost-effective.
  11. Was Anopheles donaldi a vector of malaria in Kuala Lumpur, Malaysia, in the past?
    Reid JA
    Trans R Soc Trop Med Hyg, 1980;74(3):337-9.
    PMID: 7001688
    Anopheles donaldi Reid, a member of the A. barbirostris species group, is a vector of human filariasis and probably malaria. The discovery of some old specimens of this species, collected in Kuala Lumpur town where it no longer occurs, together with evidence from the literature about past malaria in the town, suggest that donaldi may have played a part in transmitting that malaria.
  12. Further observations in an area with an exceptionally low prevalence of Helicobacter pylori infection
    Raj SM, Lee YY, Choo KE, Noorizan AM, Zulkifli A, Radzi M, et al.
    Trans R Soc Trop Med Hyg, 2008 Nov;102(11):1163-4.
    PMID: 18678380 DOI: 10.1016/j.trstmh.2008.06.015
  13. Further evidence for an exceptionally low prevalence of Helicobacter pylori infection among peptic ulcer patients in north-eastern peninsular Malaysia
    Raj SM, Yap K, Haq JA, Singh S, Hamid A
    Trans R Soc Trop Med Hyg, 2001 3 31;95(1):24-7.
    PMID: 11280057
    The Helicobacter pylori infection rate was determined in 124 consecutive patients with duodenal ulcers (DU), gastric ulcers (GU), duodenal erosions or gastric erosions diagnosed by endoscopy at a single institution in north-eastern peninsular Malaysia in 1996-97. Biopsies of the gastric antrum and body were subjected to the urease test, Gram staining of impression smears, culture and histopathological examination. Serology was undertaken on all patients using a locally validated commercial kit. Infection was defined as a positive result in at least one test. The infection rates were 20% (10/50), 21.2% (7/33), 16.7% (1/6) and 17.1% (6/35) in DU, GU, duodenal erosion and gastric erosion patients, respectively. The infection rate among Malays [7.0%, (6/86)] was lower than in non-Malays [47.4% (18/38)] (P < 0.001). There was a higher infection rate among males, who constituted 62.1% (77/124) of the sample. Seventy-eight patients (62.9%) were receiving non-steroidal anti-inflammatory drugs (NSAIDs) and 33 patients (26.6%) were neither receiving NSAIDs nor were infected with H. pylori. The H. pylori infection rate among peptic ulcer patients in this predominantly Malay rural population appears to be the lowest reported in the world thus far. Empirical H. pylori eradication therapy in peptic ulcer patients is clearly not indicated in this community. The possible reasons for the low prevalence of H. pylori infection are discussed.
  14. Effect of intestinal helminthiasis on intestinal permeability of early primary schoolchildren
    Raj SM, Sein KT, Anuar AK, Mustaffa BE
    Trans R Soc Trop Med Hyg, 1996 11 1;90(6):666-9.
    PMID: 9015510
    Intestinal permeability of 246 early primary schoolchildren at 2 schools (106 of whom were infected with intestinal helminths) was assessed by using the lactulose/mannitol differential absorption test. The ratio of the urinary recoveries of lactulose and mannitol was determined after oral administration of a standard solution of the 2 sugars. Assessment of intestinal permeability was repeated on 100 infected children after treatment and on a cohort of 68 uninfected children. Infected and uninfected groups were compared with respect to baseline lactulose/mannitol ratio (L/M1) and change in lactulose/mannitol ratio between assessments (delta L/M). The correlations between baseline intensity of infection and L/M1, and between fall in intensity and delta L/M, were evaluated. Based on a crude index of socioeconomic status, each child was assigned to one of 3 socioeconomic groups; all but 3 children belonged to either groups 2 or 3. Trichuris trichiura and Ascaris lumbricoides were the 2 predominant infections; the hookworm infection rate was relatively low. The results suggested that helminthiasis exerted only a marginal effect on intestinal permeability, the impact of which in children from lower socioeconomic backgrounds was negligible in comparison with the cumulative effects of other factors.
  15. Effect of intestinal helminthiasis on school attendance by early primary schoolchildren
    Raj SM, Sein KT, Anuar AK, Mustaffa BE
    Trans R Soc Trop Med Hyg, 1997 3 1;91(2):131-2.
    PMID: 9196748
    Stool examination of 249 early primary schoolchildren at 2 schools in north-eastern peninsular Malaysia revealed that 73 were infected with Ascaris lumbricoides, 103 with Trichuris trichiura, and 18 with hookworms. Infected children were treated with a single dose of 400 mg of albendazole. The school attendance records during a 60 d period before treatment and 2 consecutive 60 d periods after treatment were examined. The absenteeism rate did not improve more among infected children after treatment than it did among the uninfected control children. The correlation between worm intensity and the number of lost school-days was poor. There was no evidence that intestinal helminthiasis caused school absenteeism among this group of children.
  16. Porocephaliasis: a description of two cases in Sabah
    Rail GA
    Trans R Soc Trop Med Hyg, 1967;61(5):715-7.
    PMID: 6069733 DOI: 10.1016/0035-9203(67)90140-X
  17. Prevalence of Enterobius vermicularis in man in Malaysia
    Rahman WA
    Trans R Soc Trop Med Hyg, 1991 3 1;85(2):249.
    PMID: 1887485
  18. Prevalence of Giardia in dogs in Malaysia: survey of a residential housing estate
    Rahman WA
    Trans R Soc Trop Med Hyg, 1990 11 1;84(6):805.
    PMID: 2096513
  19. 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.
  20. A recombinant antigen-based IgG4 ELISA for the specific and sensitive detection of Brugia malayi infection
    Rahmah N, Lim BH, Khairul Anuar A, Shenoy RK, Kumaraswami V, Lokman Hakim S, et al.
    Trans R Soc Trop Med Hyg, 2001 8 9;95(3):280-4.
    PMID: 11490997
    An IgG4 ELISA based on a novel recombinant antigen was evaluated for detection of Brugia malayi infection, using 2487 sera from various institutions: 2031 samples from Universiti Sains Malaysia, 276 blinded sera from 2 other institutions in Malaysia, 140 blinded sera from India and 40 blinded sera from Thailand. These sera were from various groups of individuals, i.e., microfilaraemics, chronic patients, endemic normals, non-endemic normals and individuals with other parasitic and bacterial infections. Based on a cut-off optical density reading of 0.300, the IgG4 ELISA demonstrated specificity rates of 95.6-100%, sensitivity rates of 96-100%, positive predictive values of 75-100% and negative predictive values of 98.9-100%. These evaluation studies demonstrated the high specificity and sensitivity of this test for the detection of active B. malayi infection. Thus, the IgG4 ELISA would be very useful as a tool in diagnosis and in elimination programmes for brugian filariasis.
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