A report was made of 4 cases of chloroquine resistant Plasmodium falciparum infections. The infections, detected in Jakarta, were imported from Kotabumi, Tanjung Karang, the Island of Pidada in the Lampung Province and from Pangkalpinang on the Island Bangka in the Province of South Sumatra. Treatment with courses of 1500 mg chloroquine base and with increased dosages up to 2250 mg base failed to cure the patients. The chloroquine sensitivity test in vitro was carried out in 3 patients, which showed that the Plasmodium falciparum strains were resistant to chloroquine at the R I level. The strains appeared to be similar to the Malaya Camp strain. In vivo observations revealed that the parasites were resistant at the R I level with a delayed recrudescence. The chloroquine resistant falciparum malaria cases, acquired in South Sumatra, may therefore be regarded as the first reported cases from a focus outside the already known two foci in Indonesia, namely East Kalimantan and Irian Jaya. It may be expected that chloroquine resistant Plasmodium falciparum will be encountered in other parts of Indonesia in the near future. The use of a combination of sulfadoxine and pyrimethamine should not be recommended in Indonesia because chloroquine is still considered the drug of choice against all malaria infections in Indonesia.
In 1977 and 1978 selected in-patients at the Tegalyoso Hospital, Klaten, Indonesia who had recent onsets of acute fever were serologically studied for evidence for alphavirus and flavivirus infections. A brief clinical history was taken and a check list of signs and symptoms was completed on admission. Acute and convalescent phase sera from 30 patients who showed evidence that a flavivirus had caused their illnesses were tested for neutralizing antibodies to several flaviviruses which occur in South-east Asia. Paired sera from seven patients demonstrated a fourfold rise in antibody titre from acute to convalescent phase. The most common clinical manifestations observed in this series of patients included high fever, malaise, stomach ache, dizziness and anorexia. None of the seven patients had headache or rash despite the fact that headache and rash had been associated with two of the three previously studied. The onsets of illness clustered toward the end of the rainy season when populations of Aedes aegypti, a probable vector in Malaysia, were most abundant.
Malays, Chinese and Indians from peninsular Malaysia; Ibans and Bidayuh from Sarawak state, Northern Borneo; and Bataks, Minangkabau and Javanese from North Sumatra, Indonesia, were subtyped for Gc (group-specific component) by polyacrylamide gel isoelectric focusing. All eight populations investigated were found to be polymorphic for three common alleles, Gc1F, Gc1S and Gc2.
Haemaphysalis (Garnhamphysalis) mjoebergi Warburton was reported from four male specimens from Sarawak, Borneo. We redescribe herein the male, from three specimens from Sarawak and 24 from Lampung District, Sumatra, and describe the female from 24 specimens from Lampung. Male structural variation in the dental formula and development of the coxa IV spur and segments of legs III and IV is unusual or unique in the genus Haemaphysalis. "Atypical" males might easily be misidentified. This species provides an ideal model for experimental study of population genetics and evolutionary processes and of biological factors influencing body size and structural variation in the genus Haemaphysalis. The sambar deer, Cervus unicolor brookei Hose (Sarawak) and C. unicolor equinus Cuvier (Sumatra), appears to be the chief host in humid, marshy, lowland forests and secondary growth. Single collections were from a human and a domestic cow. The dynamics and vector potential of this tick should be investigated in environments being exploited for human settlement and cattle breeding.
DDT indoor residual sprayings in the Province of Central Java, Indonesia, for the past 28 years are reoieuied in terms ofAnopheles aconitus resistance to DDT and incidences of malaria. DDT resistance by An. aconitus has continued to increase and spread since its first detection in Central Java in 1962. In most areas malaria transmission is perennial, which appears to be not interrupted by DDT residual spraying of inner walls because of DDT resistance. In searching for alternatives to DDT, fenitrothion was the most effective residual compound among five insecticides tested in village scale trials, giving control for about 13 weeks at 2 g/m2. Because the target species rests largely on the lower portions of walls, when applied at 2 g/m2 to only one horizontal swath between 10 and 85 cm from the ground, this compound was effective for over two months, about one-third less than that found in full coverage applications. For a single application this selective method reduced the amount of insecticide by 65 percent and manpower by 43 percent, and three applications, to compensate for less residual effectiveness, will reduce insecticide use by about 50 percent and manpower by 15 percent, compared to two applications with full coverage. Further field investigations on application of insecticides and the ecology of the DDT-resistant vector continue to be needed in Central Java to reduce further the cost of residual sprayings in malaria control programmes. This review also suggests the possibility of other selective spraying methods and anti-vector methods applicable at the village level by the community.
"The commitment to population programs is now widespread," says Rafael Salas, Executive Director of the UNFPA, in its report "State of World Population." About 80% of the total population of the developing world live in countries which consider their fertility levels too high and would like them reduced. An important impetus came from the World Conference of 1974. The Plan of Action from the conference projected population growth rates in developing countries of 2.0% by 1985. Today it looks as though this projection will be realized. While in 1969, for example, only 26 developing countries had programs aimed at lowering or maintaining fertility levels, by 1980 there were 59. The International Population Conference, recently announced by the UN for 1984, will, it is hoped, help sustain that momentum. Cuba is the country which has shown the greatest decline in birth rate so far. The birth rate fell 47% between 1965-1970 and 1975-1980. Next came China with a 34% decline in the same period. After these came a group of countries--each with populations of over 10 million--with declines of between 15 and 25%: Chile, Colombia, India, Indonesia, the Republic of Korea, Malaysia and Thailand. Though birth rates have been dropping significantly the decline in mortality rates over recent years has been less than was hoped for. The 1974 conference set 74 years as the target for the world's average expectation of life, to be reached by the year 2000. But the UN now predicts that the developing countries will have only reached 63 or 64 years by then. High infant and child mortality rates, particularly in Africa, are among the major causes. The report identifies the status of women as an important determinant of family size. Evidence from the UNFPA-sponsored World Fertility Survey shows that in general the fertility of women decreases as their income increases. It also indicates that women who have been educated and who work outside the home are likely to have smaller families. Access to contraceptives is, of course, a major influence on fertility decline. According to UNFPA some of the Latin American countries have the highest contraceptive use among developing countries. The countries of Asia come next and contraceptives are least used in sub-Saharan Africa where birth rates of 45/1000 are still common. The money for population programs, says the report, has come largely from developing countries themselves. A survey of 15 countries showed them to have contributed 67% out of their own budgets--the rest having come from external aid. And in programs aided by UNFPA the local input has been even higher. During 1979-1981 the developing countries themselves budgeted $4.6 for each dollar budgeted by UNFPA. The report also highlights some of the emerging problems for the next 2 decades--and which will be high on the agenda of the 1984 conference. These include "uncontrolled urban growth" in developing countries as well as an important change in overall population age structure as more and more old people survive. Aging populations are of particular concern to the developed countries but, as the report points out, even countries like China--which has achieved a steep drop in fertility and mortality--will face the problems of an aging population by the year 2000.
Malays, Chinese, and Indians from Peninsular Malaysia; Ibans and Bidayuh from Sarawak State; Kadazans from Sabah State, Northern Borneo; and Bataks, Minangkabau, and Javanese from North Sumatra, Indonesia, were subtyped for transferrin C by polyacrylamide gel isoelectric focusing. All nine populations studied are polymorphic for two alleles, TfCl and TfC2, TfC3 was polymorphic in six populations and present as a rare variant in the other three. The frequency of TfC1 ranged from 0.855 in Bidayuh to 0.711 in Javanese, that of TfC2 from 0.231 in Indians to 0.113 in Bidayuh, and that of TfC3 from 0.030 in Javanese and Chinese to 0.008 in Bidayuh. TfDchi is polymorphic in all the populations that we studied except in Minangkabau, in whom it is present as a rare variant, and in Indians, in whom it is absent.
The health of a population and the development of health services in a country at a particular time in history are directly linked to the socioeconomic system. This paper discusses health and health services in Malay Peninsula during the time that it was a British colony. Economic production under British colonialism, which is basically a capitalist system, is organized primarily for the purpose of realizing profits. The health of the population is in direct conflict with and generally subordinated to this main objective. The pattern of health that emerges reflects this general framework. Moreover, health services under the colonialist system are developed primarily to serve the economic interests of the colonialists. Hence, the structure of health services is biased toward curative medicine and centered mainly in the urban areas.
This study is based on a survey conducted in Hong Kong, Indonesia, Korea, Malaysia, the Philippines, Singapore, Sri Lanka and Thailand on occupational injuries during the years 1975-1980. The number of work accidents have risen rapidly during this period in all of the 8 countries studied. In the case of Thailand, the total number of work injuries increased four fold from 1975-1978, whereas, in Singapore it has almost doubled in 6 years. The number of permanent disablement nearly trebled in Korea, and the Philippines for the year 1967-1980. The largest percentage of accidents are lost-time injuries in all of the 8 countries. Thailand had a three fold increase in lost-time injuries whilst in Hong Kong the figure doubled. Six out of the 8 countries indicated that the building construction industry had the largest number of fatal accidents, followed by the manufacturing industry.
Schistosomiasis in Southeast Asia, caused by Schistosoma japonicum, Schistosoma mekongi and Schistosoma japonicum-like, have been reported from six different countries. The S. japonicum infections are highly prevalent in the Philippines with Oncomelania hupensis quadrasi as the vector snail, and in localized areas in Indonesia with O.h. lindoensis as the snail vector. The S. mekongi infections are recent discovery in the Lower Mekong Basin in Laos and Kampuchea, with Tricula aperta as the vector snail. The S. japonicum-like infections are found as isolated cases diagnosed by the finding of S. japonicum-like eggs in the faeces, rectal biopsy, tissue biopsy or at necropsy in Thailand and Malaysia. The control measures of schistosomiasis have been implemented in the Philippines and Indonesia, while further research studies are being conducted in Thailand and Malaysia.