The Malaria Eradication Program was started in 1967 in Peninsular Malaysia. Since then and up to 1980, there was a reduction in the number of reported malaria cases from 160,385 in 1966 to 9,110 cases for Peninsular Malaysia. Although the concept of eradication has changed to one of control in the 1980, the anti-malaria activities have remained the same. However, additional supplementary activities such as the use of impregnated bednets, and the Primary Health Care approach, have been introduced in malarious and malaria-prone areas. Focal spraying activity is instituted in localities with outbreaks in both malaria-prone and non-malarious areas. Passive case detection has been maintained in all operational areas. In 1990, 50,500 cases of malaria were reported of which 69.7% (35,190) were from Sabah, 27.8% (14,066) from Peninsular Malaysia and 2.5% (1,244) from Sarawak. Until June 1991 a total of 18,306 cases were reported for the country. Plasmodium falciparum continues to be the predominant species, contributing to 69.6% of the parasites involved. The case fatality rate for 1990 was 0.09%. There were 43 deaths all of which were attributed to cerebral malaria. The problems faced in the prevention and control of malaria include problems associated with the opening of land for agriculture, mobility of the aborigines of Peninsular Malaysia (Orang Asli) and inaccessibility of malaria problem areas. There is need to ensure prompt investigation and complete treatment of cases especially in malarious areas. The promotion of community participation in control activities should be intensified. Primary Health Care should be continued and intensified in the malarious areas.(ABSTRACT TRUNCATED AT 250 WORDS)
The prevalence and intensity of intestinal nematode infections were assessed during 3 anthelminthic interventions in an urban community in Malaysia. The prevalence levels of Ascaris lumbricoides at Interventions 1, 2 and 3 were 30.6%, 18.9% and 15.5%, respectively and the mean intensities were 1.9, 0.75 and 0.81 worms per person. For Trichuris trichiura, the prevalence levels at Interventions 1, 2 and 3 were 46.9%, 21.6% and 15.7%, respectively. The mean intensities for T. trichiura at Interventions 1, 2 and 3 were 3.30, 0.92 and 0.07 worms per person. No gender-related prevalence and intensity were observed for the two geohelminths in this community. Prevalences and intensity had convex age profiles. Although repeated chemotherapeutic intervention reduced both prevalence and intensity levels, intensity was a more sensitive indicator than prevalence. The results indicate that age-targetting treatment at school children of 7-12 years of age would be an appropriate strategy for this community.
Field tests were conducted to compare the degree of protection from bites of Mansonia species and Anopheles maculatus by applying two repellent/insecticidal bars, MOSBAR and MOSKIL, to exposed arms and legs. Human test subjects were exposed to natural populations of mosquitos for an 8-hour night time period while using the repellent/insecticidal bars. MOSBAR gave good protection against the bites of Mansonia and An. maculatus. MOSKIL was effective against An. maculatus but not against Mansonia. High mortality was observed among the mosquitos collected from human test subjects treated with the repellent/insecticidal bars. Use of MOSBAR in terms of cost-effectiveness and safety by field and health workers entering into malaria and filariasis endemic areas is discussed.
A nationwide screening program searching for microbial control agents of mosquitos was initiated in Malaysia in 1986. A total of 725 samples were collected and 2,394 bacterial colonies were isolated and screened for larvicidal activity. From such screening, 20 Bacillus thuringiensis, 6 B. sphaericus, 1 Clostridium bifermentans and 2 Pseudomonas pseudomallei larvicidal isolates were obtained. Of these, a new B. thuringiensis named as subspecies malaysianensis was found, while the C. bifermentans was also a new anaerobe individualized as serovar malaysia. It was concluded that this screening program was highly successful.
The prevalence of antibody to human herpesvirus type 6 (HHV-6) and Epstein-Barr virus (EBV) viral capsid antigens (VCA) were analysed in sera from Kadazans of Sabah, North Borneo. At a serum dilution of 10, about 34% were positive for HHV-6 antibody but in contrast all 95 individuals studied were positive for EBV VCA antibody. The study shows that HHV-6 and EBV infection occur independently. The low frequency of seropositive individuals in this community suggests that other than socioeconomic factors are responsible for the spread of the virus.
Two highly active synthetic pyrethroid insecticides, lambdacyhalothrin and cypermethrin, were evaluated as thermal fogs against houseflies (Musca domestica Linnaeus) and mosquitos (Aedes aegypti Linnaeus). Lambdacyhalothrin (OMS 3021) showed an average of 2.5 times more knockdown activity and over 5 times more adulticidal activity than cypermethrin against Musca domestica and Aedes aegypti. These results demonstrate that lambdacyhalothrin is highly effective at very low rates as a thermal fog against Ae. aegypti and M. domestica. Commercially available formulations of 2.5% and 5% lambdacyhalothrin can be diluted either with water for ULV cold aerosol space-spraying or with diesel/kerosene for thermal fogging at recommended application rates of 0.5-1 g ai/ha for mosquito control and 2 g ai/ha for housefly control. Due to the very low rates of application, formulated products of lambdacyhalothrin are unlikely to present any acute hazards in normal use. The low dosages required to bring about rapid control of houseflies and mosquitos make this new pyrethroid insecticide particularly cost-effective. Coupled with its good residual activity (Jutsum et al, 1984), lambdacyhalothrin can be adopted as a powerful tool in integrated pest management program for the control of medically important pests and vectors.
Descriptions of the eggs of Mansonia uniformis, Ma. indiana and Ma. annulifera are provided with the aid of scanning electron micrographs. Eggs of these three species, although similar in shape and colour, are covered by outer chorionic reticulum and tubercles which provide reliable morphological character for their identification. Size, distribution and number of lobes on the large tubercles present in the region between the anterior tube and posterior region, are important distinguishing features. Measurements of egg sizes and other chorionic differences are also discussed.
JE is neither classified as an entity in the Malaysian Medical records system nor is it a notifiable disease but is grouped under the broad umbrella of viral encephalitis. There is no centralised program by the Ministry of Health specially for JE surveillance and control. JE is endemic, occurs sporadically throughout the country all year round. Asymptomatic inapparent infections have been found to be more frequent than acute clinical encephalitis cases, judging from results of previous serosurveys (Pond et al., 1954). JE vaccination has never been tried in Malaysia. In a relative sense, JEV infection unlike dengue virus infection, does not appear to be much of a problem in Malaysia. Perhaps, the laboratory confirmed cases represent only a small proportion of the total hospitalised cases that actually occurred. The reasons may be that these cases could not be confirmed by laboratory tests due to improper timing or failure to obtain the second serum specimen, or failure to perform lumbar puncture on patient's refusal. Attempts to improve the case detection rate of JE in Malaysia should be made namely, by increasing clinical index of suspicion, instituting better specimen collection procedures and by adopting rapid diagnostic tests.
Insecticide-impregnated bednets appear to be a potentially cost-effective intervention against endemic malaria in the tropics, but this has yet to be confirmed by field trials. There are two aspects to consider in assessing such trials: (1) the extent to which subjects use nets regularly and properly, and (2) the effectiveness of nets which are truly used regularly and properly in reducing malaria transmission. The second aspect is currently of primary concern, to determine if human-vector relationships for a particular at-risk population are such that bednets can be effective. But to give bednets a "fair" test in this regard requires regular and proper use in the first place. The study described here suggests they did not get a "fair" test in one field trial in Sabah, East Malaysia. The study also strongly suggests that direct observations, rather than post hoc questioning of subjects, may be essential to accurately gauge bednet usage rates. Accurate usage rates are required to determine what proportion of a population needs to use nets to reduce malaria transmission, and to evaluate the effectiveness of promotional programs over time. Direct observations can also yield valuable data on night-time activities that increase malaria risk, such as television viewing that keeps people awake and out of bednets.
Susceptibility tests were carried between 1987-1989 on Anopheles maculatus female adults collected from twelve different localities in Peninsular Malaysia to DDT. Mosquitoes collected from all localities except those from Kuala Berang, Trengganu state were found to be susceptible to DDT when tested with 4% impregnated paper. Several factors contributing to the lack of development of resistance despite many years of residual spraying in Peninsular Malaysia include exophily, exophagic and excito-repellency behaviour of An. maculatus and the inadequate spraying coverage of houses.
The prevalence of clinically observed oral lichenoid reaction in 186 Malay army personnel using Fansidar for 9 weeks was found to be 4.8%. The prevalence was found to be 0.5% in 186 army personnel who had stopped using Fansidar for 2 months and 0% in 143 army personnel (control group) who had not used Fansidar for at least 4 months. The lesion showed a higher prevalence for the gingiva. There was no correlation between cigarette smoking and the occurrence of these lesions in each group.
Serum IgG levels and complement C3 levels were assayed on Day 0, 1, 3-4, 7 and 56-70 post-treatment with diethylcarbamizine citrate (DEC) in a series to 26 patients with Brugia malayi infection and 6 volunteers without infection. On treatment, the microfilariae were cleared from the blood within 24 hours. The eosinophils decreased dramatically on Day 1 post-treatment but increased rapidly by Day 4 to 7 and then dropped to normal levels in 45 days. The serum IgG mean levels decreased briefly following treatment with DEC but then returned to original levels. However, the complement C3 levels gradually increased over the 2 months period of study reaching statistical significance levels (p less than 0.01) in patients with initial high blood microfilariae. The observation suggests that Brugia malayi infection probably induces a high rate of synthesis of complement C3 and this process continued in the post-treatment phase. Since, DEC treatment did not cause a decrease in complement C3 with the elimination of blood microfilariae, it would appear that the complement C3 is consumed following antibody attachment to the microfilariae as they enter the blood circulation.
Five strains of Ma. uniformis from Malaysia were tested for their susceptibility to infection with subperiodic B. malayi. All were found to be susceptible with infection rates ranging from 62% to 100%. The susceptibility rates were directly related to the microfilarial densities of the cat at the time of feeding. Statistical analysis showed no significant difference (p greater than 0.05) among the means of the indices of experimental infection as well as the percentage of infective mosquitoes of the five strains and an old laboratory colony. They were all equally susceptible to subperiodic B. malayi.
CDC Light traps were used to study the attractant effect of CO2 and 1-octen-3-ol on trap catches of mosquito populations at three different locations in Malaysia. There was a significant increase in the number of mosquitos caught in traps baited with CO2 and CO2 with 1-octen-3-ol. The number of mosquitos caught in the CDC light trap and in the CDC light trap baited with 1-octen-3-ol alone were very few. 1-octen-3-ol and CO2 acted synergistically in attracting significantly greater numbers of Culex tritaeniorhynchus. However Anopheles sp. were not very attracted to light traps even with attractants added to them.
Schistosoma malayensis Sp N is a putative new species of schistosome discovered in Peninsular Malaysia in 1973. This paper comprises the first report on the detailed gastrointestinal pathology present in rabbits infected with strains of the parasite. Two different strains of schistosome--the Baling and Koyan strains--from two different ecosystems were used to infect inbred rabbits and the resulting pathophysiology was studied. Our results showed that the Baling strain of S. malayensis was more virulent than the Koyan strain and produced nodular, segmental circumferential lesions and large bilharziomas measuring 1-7 cm in diameter in the distal jejunum, ileum and the ileo-caecal junction. The findings indicate that the Baling strain of S. malayensis was more pathogenic for rabbits as compared with the Koyan strain--in relation to the gross pathology of the gut and the tissue egg load. Earlier reports have shown that rabbits infected with S. japonicum induces significant intestinal lesions in rabbits (Cheever et al, 1980 a,b) but these animals are refractory to infection with S. mekongi (Byram and Lichtenberg, 1980). Our studies show that the two strains of S. malayensis adapted well in rabbits. It is also established that in rabbits, the virulence of the Baling strain of S. malayensis is greater than that of S. mekongi and approximates that of S. japonicum.
The prevalence of Enterobius vermicularis in four groups of adults, all trainee public health inspectors or public health nurses, aged 18-35 years and all living in hostels on campus was studied. The modified scotch tape technique was used and the subjects were taught to do the examination on themselves to detect the presence of eggs over a period of 6 successive mornings. Each was given an elaborately illustrated diagram on how and when to take the samples and given demonstration in groups. The samples were examined by trained people. Most of the subjects took samples on 6 consecutive days. Of the 119 subjects who returned samples, the overall prevalence of E. vermicularis was 9.2% and this was thought to be high for this particular age group. This was due to the higher prevalence (19.4%) in one group, whereas in the others the range was 3.5-8.0%. Based on the samples returned on the first day none of the subjects were detected as having the infection. After examination on 3 successive days (109 subjects) 10.1% were found to be infected (chi 2 = 10.704; d. f. = 1) and after examination on 6 successive days (72 subjects) 13.9% were found to be infected (chi 2 = 3.026; d. f. = 1). There was no significance between examination over 3 successive days and 6 consecutive days (chi 2 = 0.296; d. f. = 1). There was no difference in the prevalence between males and females.(ABSTRACT TRUNCATED AT 250 WORDS)
Five pesticides were evaluated against laboratory colonies of Leptotrombidium fletcheri (Womersly and Heaslip) by the Pasteur pipet technique. The pesticides were dieldrin (LC50 = 3.6 ppm, LC99 = 18.2 ppm), bromopropylate (LC50 = 9.2 ppm, LC99 = 239.6 ppm), dicofol (LC50 = 27.8 ppm, LC99 = 118.1 ppm), fenthion (LC50 = 15.4 ppm, LC99 = 29.7 ppm), and malathion (LC50 = 84.7 ppm, LC99 = 313.9 ppm). Dieldrin was the most toxic. Dicofol was recommended for further evaluation in field trials.
A serological investigation for human T cell leukemia virus I (HTLV-I) infection was carried out at the University Hospital, Kuala Lumpur. A total of 626 sera from a non-patient population and 1,038 sera from unselected in-patients were screened for HTLV-I antibodies using an enzyme-linked immunosorbent assay (ELISA). 27/1664 (1.6%) were found to be reactive. However, on Western blotting, only 2 sera were confirmed positive, both showing reactions for the major core (p19 and p24) and the envelope (gp46) proteins. Both of the serum samples were from unselected hospital patients. Most of the remaining sera which were reactive on screening showed indeterminate results on Western blotting. These were further tested by radioimmunoprecipitation assay (RIPA) and none of these sera gave a positive reaction. Therefore, only 2/1038 (0.19%) unselected patients could be confirmed to have antibodies to HTLV-I. None of the normal individuals screened showed a positive Western blot result. Our data indicate that HTLV-I infection is present in our population, but at a low prevalence rate.
The efficacy of two formulations, wettable powder and emulsifiable concentrate, of cyfluthrin sprayed on plywood [10 mg (ai)/m2] was assessed against six species of mosquitos. The bioassay followed the WHO standard method, with some modification for the bioassay of insecticidal deposits on wall surfaces. The results indicated that these two formulations of cyfluthrin were effective against Anopheles dirus and Mansonia uniformis, moderately toxic to Aedes aegypti and Ae. albopictus in decreasing mortality through out the study period. It was least effective against Culex quinquefasciatus and An. maculatus, respectively. There was no statistically significant difference between these two formulations.