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Fulltext Molecular characterization and epidemiology of rotavirus isolates obtained from children with diarrhoea in Malaysia

Zuridah H, Kirkwood CD, Bishop RF, Bogdanovic-Sakran N, Yap KL

Med J Malaysia, 2009 Sep;64(3):193-6.
PMID: 20527266 MyJurnal

This retrospective study examined the G/P type of rotavirus in RNA samples that have previously been e-typed by RNA-PAGE in 1996. The results were then compared to 2007 samples to ascertain the extent of changes that may have occurred in this 11-years time interval. The G and P genotypes were determined by hemi-nested PCR and further analysed by phylogenetic study. In 1996, the G/P combination G1P[8], G(UT)P[8] and G1P(UT) prevalence rate were 81%, 9% and 7%, respectively. As expected, the G9 genotype which has already emerged worldwide was identified in 42% of the 2007 samples with the remaining 33% G1P[8] and 25% G1P(UT) Analysis of the RNA pattern showed that majority of the isolates were long e-type in both series, nevertheless minor differences within electropherotypes were observed. Genetic diversity in some strains of the human group A rotaviruses was analysed by phylogenetic methods. These findings will help in the decision to introduce rotavirus vaccines within the next decade.

Matched MeSH terms: Diarrhea/genetics*; Diarrhea/epidemiology*; Diarrhea/virology*
Bufavirus genotype 3 in Turkish children with severe diarrhoea

Altay A, Yahiro T, Bozdayi G, Matsumoto T, Sahin F, Ozkan S, et al.

Clin Microbiol Infect, 2015 Oct;21(10):965.e1-4.
PMID: 26086570 DOI: 10.1016/j.cmi.2015.06.006

Recently a parvovirus called bufavirus (BuV) has been implicated as a causative agent of diarrhoea. To further reveal the epidemiology and genetic characteristics of BuV, this study was performed in Turkish children with diarrhoea. BuV was detected in 1.4% (8/583) of stool samples. All stool samples from healthy children (n = 148) were negative for BuV. Diarrhoea in BuV-positive patients was severe and occurred mainly during the colder months of the year. Complete genome sequences were generated from four BuVs. Only BuV3 was found, which was genetically and phylogenetically similar to Bhutanese BuV3, indicating that BuV3 is prevalent in Asian countries.

Matched MeSH terms: Diarrhea
Fulltext Use of probiotics in clinical practice with special reference to diarrheal diseases: A position statement of the Malaysian Society of Gastroenterology and Hepatology

Lee YY, Leow AH, Chai PF, Raja Ali RA, Lee WS, Goh KL

JGH Open, 2021 Jan;5(1):11-19.
PMID: 33490608 DOI: 10.1002/jgh3.12469

Probiotics comprise a large group of microorganisms, which have different properties and thus confer different benefits. The use of probiotics has shown promising results in the management of diarrheal diseases. While the availability of probiotic products has flourished in the marketplace, there is limited guidance on the selection of probiotics for clinical use. This position paper is aimed at informing clinicians about the proper selection criteria of probiotics based on current evidence on strain-specific efficacy and safety for the management of diarrheal diseases. Members of the working group discussed issues on probiotic use in clinical practice, which were then drafted into statements. Literature to support or refute the statements were gathered through a search of medical literature from 2011 to 2020. Recommendations were formulated based on the drafted statements and evidence gathered, revised as necessary, and finalized upon agreement of all members. Twelve statements and recommendations were developed covering the areas of quality control in the manufacturing of probiotics, criteria for selection of probiotics, and established evidence for use of probiotics in diarrheal diseases in adults and children. Recommendations for the use of specific probiotic strains in clinical practice were categorized as proven and probable efficacy based on strength of evidence. Robust evidence is available to support the use of probiotics for diarrheal diseases in clinical practice. Based on the results obtained, we strongly advocate the careful evaluation of products, including manufacturing practices, strain-specific evidence, and contraindications for at-risk populations when choosing probiotics for use in clinical practice.

Matched MeSH terms: Diarrhea
Fulltext The importance of breastfeeding in rotaviral diarrhoeas

Prameela KK, Vijaya LR

Malays J Nutr, 2012 Apr;18(1):103-11.
PMID: 23713234 MyJurnal

Globally, rotaviral vaccines in use today have contributed to the reduction of the incidence of rotaviral diarrhoeas. Despite the substantial protection conferred by the current vaccines against the rotaviral strains, it is only prudent to recognise that other protective factors, like breastfeeding, also provide some degree of protection against this disease. This article has attempted to review some important mechanisms of protection in breast milk against the rotaviruses and highlight the oft forgotten non-immunoglobulin fraction in breast milk as an additional tool of protection against rotavirus disease. The adaptive capacity of breast milk to environment is another compelling reason to continue breastfeeding as it can usefully complement and be significant in the use of many vaccines. Vital immunoprotective constituents in breast milk beneficially protect the infant by initiating and strengthening many immune responses and should be borne in mind as essential tools of defence even in an era where vaccines play a pivotal role in the combat against certain diseases. It is impressive that besides nutritive advantages, the suckling infant enjoys appreciable immunoprotection via exclusive breastfeeding.

Matched MeSH terms: Diarrhea, Infantile/immunology; Diarrhea, Infantile/prevention & control; Diarrhea, Infantile/virology*
Studies of bacterial disease in West Malaysian Orang Asli. Distribution of enteropathogens

Haug NL, Davis CE, Anandan J, Lim TW

Med J Malaya, 1969 Sep;24(1):24-31.
PMID: 4243839
Matched MeSH terms: Diarrhea/diagnosis; Diarrhea/drug therapy; Diarrhea/etiology
Fulltext The Effects of Probiotic Supplementation on the Incidence of Diarrhea in Cancer Patients Receiving Radiation Therapy: A Systematic Review with Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

Devaraj NK, Suppiah S, Veettil SK, Ching SM, Lee KW, Menon RK, et al.

Nutrients, 2019 Nov 27;11(12).
PMID: 31783578 DOI: 10.3390/nu11122886

The protective effects of probiotic supplementation against radiation-induced diarrhea (RID) have been reported in previous systematic reviews; however so far, only non-conclusive results have been obtained. The objective of this study was to systematically update and evaluate the available evidence for probiotic supplementation. The protocol of this systematic review has been registered (CRD42018106059) with the International Prospective Register of Systematic Reviews (PROSPERO). The primary efficacy outcome was the incidence of RID. Secondary outcomes were the incidence of watery stool, soft stool, and antidiarrheal medication use. There were eight trials, and a total of 1116 participants were included in the primary analysis. Compared with placebo, probiotics were associated with a lower risk of RID [risk ratio (RR) = 0.62, 95% CI = 0.46, 0.83]. A requisite heterogeneity-adjusted trial sequential analysis indicated conclusive evidence for this beneficial effect. No statistically significant reduction in RID (RR = 0.52, 95% CI = 0.14, 1.91) was observed on subgroup analysis in patients receiving both radiation therapy and chemotherapy. However, those patients receiving only radiation therapy (RT) demonstrated significant benefit (RR = 0.61, 95% CI = 0.48, 0.78). There was a significant difference in the antidiarrheal medication use (RR = 0.54, 95% CI = 0.35, 0.84) observed with the use of probiotics. However, no significant difference was observed for the incidence of soft and watery stool. The use of probiotics is beneficial in preventing RID in patients receiving RT.

Matched MeSH terms: Diarrhea/etiology; Diarrhea/epidemiology*; Diarrhea/prevention & control
Prevalence and predictors of depression, anxiety, and stress among recovered COVID-19 patients in Vietnam

Trang LTT, Ngoc Le C, Chutipatana N, Shohaimi S, Suwanbamrung C

Rocz Panstw Zakl Hig, 2023;74(2):217-230.
PMID: 37309979 DOI: 10.32394/rpzh.2023.0261

BACKGROUND: During the COVID-19 pandemic, a high prevalence of mental health distress has been reported among people who have recovered from the disease.
OBJECTIVES: To assess the prevalence of depression, anxiety, and stress as well as identify predictors among recovered COVID-19 patients after more than six months of being discharged in Dong Thap Province, Vietnam.
MATERIAL AND METHODS: The cross-sectional study was conducted among 549 eligible participants recruited by stratified sampling. Data was collected using the depression, anxiety and stress scale - 21 items had Content Validity Index = 0.9, and Cronbach's alpha for depression, anxiety and stress sub-scales were 0.95, 0.81, and 0.86, respectively. Descriptive statistics were used to measure the prevalence levels and distribution of characteristics of the participant, while factors influencing depression, anxiety, and stress were predicted using binary logistic regression.
RESULTS: The overall prevalence of depression, anxiety, and stress were 24.8% (95% CI: 21.2-28.6), 41.5% (95% CI: 37.4-45.8), and 25.3% (95% CI: 21.7-29.2), respectively. The predictors of depression were living in urban area (OR = 1.97; 95% CI: 1.27-3.08), holding a bachelor's degree (OR:3.51; 95% CI: 1.13-10.8), having a high monthly income (OR: 2.57; 95% CI: 1.03-6.38), diabetes (OR: 2.21; 95% CI: 1.04-4.68), heart disease (OR: 3.83; 95% CI: 1.79-8.17), respiratory disease (OR: 3.49; 95% CI: 1.24-9.84), and diarrhea (OR: 4.07; 95% CI: 1.06-15.6). Living in the urban area (OR: 1.57; 95% CI: 1.07-2.29), having sleep disturbance (OR: 2.32; 95% CI: 1.56-3.46), and fatigue (OR: 1.57; 95% CI: 1.03-2.39) were predictors for anxiety. Having respiratory disease (OR: 3.75; 95% CI: 1.47-9.60) or diarrhea (OR: 4.34; 95% CI: 1.18-15.9) were predictors of stress.
CONCLUSION: People who have recovered from COVID-19 should be assessed for symptoms of depression, anxiety, and stress. Primary healthcare providers should develop interventions to support their recovery.

Matched MeSH terms: Diarrhea
Fulltext Zingiber zerumbet (L.) Smith: A Review of Its Ethnomedicinal, Chemical, and Pharmacological Uses

Yob NJ, Jofrry SM, Affandi MM, Teh LK, Salleh MZ, Zakaria ZA

Evid Based Complement Alternat Med, 2011;2011:543216.
PMID: 21584247 DOI: 10.1155/2011/543216

Zingiber zerumbet Sm., locally known to the Malay as "Lempoyang," is a perennial herb found in many tropical countries, including Malaysia. The rhizomes of Z. zerumbet, particularly, have been regularly used as food flavouring and appetizer in various Malays' cuisines while the rhizomes extracts have been used in Malay traditional medicine to treat various types of ailments (e.g., inflammatory- and pain-mediated diseases, worm infestation and diarrhea). Research carried out using different in vitro and in vivo assays of biological evaluation support most of these claims. The active pharmacological component of Z. zerumbet rhizomes most widely studied is zerumbone. This paper presents the botany, traditional uses, chemistry, and pharmacology of this medicinal plant.

Matched MeSH terms: Diarrhea
Fulltext Antioxidant and Cytotoxic Effect of Barringtonia racemosa and Hibiscus sabdariffa Fruit Extracts in MCF-7 Human Breast Cancer Cell Line

Amran N, Rani AN, Mahmud R, Yin KB

Pharmacognosy Res, 2016 Jan-Mar;8(1):66-70.
PMID: 26941539 DOI: 10.4103/0974-8490.171104

The fruits of Barringtonia racemosa and Hibiscus sabdariffa have been used in the treatment of abscess, ulcer, cough, asthma, and diarrhea as traditional remedy.

Matched MeSH terms: Diarrhea
Management of diarrhoea cases by community pharmacies in 3 cities of Pakistan

Hussain A, Ibrahim MI

East Mediterr Health J, 2012 Jun;18(6):635-40.
PMID: 22888622

Community pharmacies are valued for their potential role in the management of common ailments. This cross-sectional study aimed to document the management of diarrhoea by community pharmacies in 3 cities in Pakistan. Visits were performed to 371 randomly selected pharmacies to request advice for a simulated paediatric case of diarrhoea. The pharmacy's management was scored on a checklist including history taking and provision of advice and information. Customers were served by a salesperson in 97.3% of visits and by a pharmacist in only 2.2%. Medication was dispensed in 77.1% of visits. Of the medications dispensed, 58.7% were antiamoebics, 14.0% antibiotics and 18.9% antidiarrhoeals; only 8.4% were oral rehydration salts. None of the regimens matched with a standard prescription. The dosage regimen was explained to the customer in only 52.6% of cases. Drug safety, unqualified personnel, lack of history taking, inappropriate treatment and lack of counselling are concerns to be addressed.

Matched MeSH terms: Diarrhea/drug therapy*; Diarrhea/epidemiology
Epidemiology and strain characterization of rotavirus diarrhea in Malaysia

Hung LC, Wong SL, Chan LG, Rosli R, Ng AN, Bresee JS

Int J Infect Dis, 2006 Nov;10(6):470-4.
PMID: 17046306

The objectives of the study were to describe the epidemiology and strain characterization of rotavirus (RV), to determine the proportion of hospitalizations for diarrhea attributable to RV among children under 5 years of age, and to estimate the disease burden of RV diarrhea in Malaysia.

Matched MeSH terms: Diarrhea/microbiology; Diarrhea/epidemiology*
[Tropical sprue as the cause of chronic diarrhea after travel to Southeast Asia]

Kirchgatterer A, Allinger S, Balon R, Tuppy H, Knoflach P

Z Gastroenterol, 1998 Oct;36(10):897-900.
PMID: 9846368

A 43-year-old woman developed abdominal pain and diarrhea following a travel to Malaysia. Examinations in another hospital proved no evidence of infection, an empirical antibiotic therapy with ciprofloxacin yielded no benefit. One and a half year later, the patient was admitted to our department because of persistent diarrhea and wasting. Laboratory tests showed megaloblastic anemia, folate deficiency and steatorrhea. Stool specimens for bacterial pathogens and parasites were negative. Endoscopy and biopsy from the distal portion of the duodenum revealed broadening and shortening of the villi and an increased infiltration of the lamina propria by chronic inflammatory cells (plasma cells and lymphocytes). In conclusion, diagnosis of tropical sprue was established. The therapy comprised of tetracycline for six weeks and folic acid for six months. Subsequently, the diarrhea disappeared, the patient continuously gained weight and was free of any complaints. The complete remission following this regimen proved the suspected diagnosis. Differential diagnosis in any patient who recently returned from the tropics may be a challenge. Tropical sprue predominantly occurs during or after a longer stay in endemic areas. However, if chronic diarrhea and signs of malabsorption develop after a short journey to India, South-East Asia and parts of the Caribbean, tropical sprue has to be considered, too.

Matched MeSH terms: Diarrhea/etiology*; Diarrhea/pathology
Risk factors for the transmission of diarrhoea in children: a case-control study in rural Malaysia

Knight SM, Toodayan W, Caique WC, Kyi W, Barnes A, Desmarchelier P

Int J Epidemiol, 1992 Aug;21(4):812-8.
PMID: 1521988

In response to a recorded increasing incidence of diarrhoea in Tumpat District, Malaysia, a case-control study was performed to identify modifiable risk factors for the transmission of diarrhoea, in children aged 4-59 months. Ninety-eight pairs of children, matched on age and sex, were recruited prospectively from health centres. Exposure status was determined during a home visit. Interviewers were 'blinded' as to the disease status of each child. Odds ratios were measured through matched pair analysis and conditional logistic regression. Risk factors for diarrhoea identified were: reported--drinking of unboiled water, storage of cooked food before consumption and bottle feeding; and observations--animals inside the house and absence of washing water in latrines. Water quality, source of drinking water, reported hand washing behaviour, indiscriminate defecation by children, cup use and the absence of a functional latrine were not associated with diarrhoea. Nonsignificant associations were found for: accessibility of washing water source, type of water storage container and use of fly covers for food.

Matched MeSH terms: Diarrhea/etiology; Diarrhea/epidemiology*
Rotavirus electropherotypes in Malaysian children

Yap KL, Wong YH, Khor CM, Ooi YE

Can J Microbiol, 1992 Sep;38(9):996-9.
PMID: 1334446

A 12-month study was carried out on the molecular epidemiology of rotavirus in urban and suburban Malaysian children. Analysis of faecal samples from 973 hospitalized diarrhoeic children by polyacrylamide gel electrophoresis detected 268 rotaviruses (28%). All isolates were group A rotaviruses, which produced 22 electropherotypes: 16 (91.5%) with long RNA migration patterns and 6 (8.5%) with short patterns. One of the long-pattern electropherotypes was the predominant strain (71.1% of the total electropherotypes) isolated during this study. Although 3 other strains were detected sporadically over the study period, 16 others were present only during the first 7 months and 2 others were confined to the last 5 months. Long- and short-pattern electropherotypes were found to co-circulate extensively. There was a significant association of short-pattern electropherotypes with infection in older children. In addition, the prevalence of vomiting and mean duration of diarrhoea were significantly associated with different electropherotypes.

Matched MeSH terms: Diarrhea, Infantile/microbiology*; Diarrhea, Infantile/epidemiology
Fulltext Tetracycline-resistant vibrio cholerae El Tor

Hassan H, Teh A

Med J Malaysia, 1993 Mar;48(1):95-6.
PMID: 8341181

http://www.e-mjm.org/1993/v48n1/Vibrio_Cholerae_El_Tor.pdf

Matched MeSH terms: Diarrhea/drug therapy; Diarrhea/microbiology*
An update on diarrhoeal diseases in Malaysia

Ismail A

Southeast Asian J. Trop. Med. Public Health, 1988 Sep;19(3):397-400.
PMID: 3217821

Analysis of diarrhoeal disease patterns in Malaysia from 1981-1986 suggested that infectious hepatitis ranked as the most predominant diarrhoeal disease followed by typhoid, food poisoning, dysentery and cholera. Although these five major food and water-borne diseases are still endemic in this country, diarrhoeal diseases per se no longer become an important public health problem in Malaysia. Enforcement of the cholera control program brought the incidence of the disease to a minimal. Unfortunately, this fatal form of diarrhoeal disease caused the greatest mortality compared to the others. Seasonal influence also played a part in controlling the occurrence of the disease. There was a preponderance of diarrhoeal diseases during the rainy season implicating contaminated water as a source of transmission. Although greater than half of the population has been supplied with piped water and sanitary latrines, a lot more has to be done before diarrhoeal diseases could be eliminated from this country.

Matched MeSH terms: Diarrhea/etiology; Diarrhea/epidemiology*
Diarrhoeal diseases in rural Malaysia: risk factors in young children

Lye MS

Ann Acad Med Singap, 1984 Apr;13(2):156-62.
PMID: 6497315

A survey was conducted in six selected rural villages to obtain baseline data on socioeconomic status, nutrition, environmental sanitation and behavioural aspects in relation to diarrhoeal diseases, using a standard questionnaire. Subsequent to this, children 0-4 years of age were followed weekly for six months for diarrhoeal disease. Eleven variables representing socioeconomic status, nutritional status, housing condition, environmental sanitation, mother's knowledge and beliefs were investigated using stepwise logistic regression to determine significant predictors of diarrhoeal disease. Children who were below two years of age, living in conditions of poor sanitation and poor quality water supply, whose houses were prone to flooding and who had mothers whose sanitary habits were not influenced by their religious beliefs, were at significantly greater risk of diarrhoeal disease.

Matched MeSH terms: Diarrhea/etiology; Diarrhea/epidemiology*
Isolation of a Plesiomonas shigelloides in Malaysia

Ampalam SD, Fang L

Med J Malaya, 1971 Jun;25(4):282-4.
PMID: 4261301
Matched MeSH terms: Diarrhea/diagnosis; Diarrhea/microbiology*
Fulltext Cholera in selected countries in Asia

Lopez AL, Dutta S, Qadri F, Sovann L, Pandey BD, Bin Hamzah WM, et al.

Vaccine, 2020 02 29;38 Suppl 1:A18-A24.
PMID: 31326255 DOI: 10.1016/j.vaccine.2019.07.035

INTRODUCTION: Although the current pandemic of cholera originated in Asia, reports of cholera cases and outbreaks in the region are sparse. To provide a sub-regional assessment of cholera in South and Southeast Asia, we collated published and unpublished data from existing surveillance systems from Bangladesh, Cambodia, India, Malaysia, Nepal, Pakistan, Philippines, Thailand and Vietnam.
METHODS: Data from existing country surveillance systems on diarrhea, acute watery diarrhea, suspected cholera and/or confirmed cholera in nine selected Asian countries (Bangladesh, Cambodia, India, Malaysia, Nepal, Pakistan, Philippines, Thailand and Vietnam) from 2011 to 2015 (or 2016, when available) were collated. We reviewed annual cholera reports from WHO and searched PubMed and/or ProMED to complement data, where information is not completely available.
RESULTS: From 2011 to 2016, confirmed cholera cases were identified in at least one year of the 5- or 6-year period in the countries included. Surveillance for cholera exists in most countries, but cases are not always reported. India reported the most number of confirmed cases with a mean of 5964 cases annually. The mean number of cases per year in the Philippines, Pakistan, Bangladesh, Malaysia, Nepal and Thailand were 760, 592, 285, 264, 148 and 88, respectively. Cambodia and Vietnam reported 51 and 3 confirmed cholera cases in 2011, with no subsequent reported cases.
DISCUSSION AND CONCLUSION: We present consolidated results of available surveillance in nine Asian countries and supplemented these with publication searches. There is paucity of readily accessible data on cholera in these countries. We highlight the continuing existence of the disease even in areas with improved sanitation and access to safe drinking water. Continued vigilance and improved surveillance in countries should be strongly encouraged.

Matched MeSH terms: Diarrhea/microbiology; Diarrhea/epidemiology
Gastrointestinal infections in children in the Southeast Asia region: emerging issues

Lee WS

J Pediatr Gastroenterol Nutr, 2000 Mar;30(3):241-5.
PMID: 10749405
Matched MeSH terms: Diarrhea/epidemiology; Diarrhea/virology

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