Displaying publications 81 - 100 of 179 in total

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  1. Performance of the rural health improvement scheme in reducing the incidence of waterborne diseases in rural Sarawak, Malaysia
    Liew KB, Lepesteur M
    Trans R Soc Trop Med Hyg, 2006 Oct;100(10):949-55.
    PMID: 16730364 DOI: 10.1016/j.trstmh.2005.11.018
    This study evaluates and discusses the impact of the rural health improvement scheme in reducing the incidence of dysentery, enteric fever, cholera and viral hepatitis in Sarawak, Malaysia, using data compiled from state and federal health department reports. This study suggests that from 1963 to 2002, water supply intervention contributed to a more than 200-fold decrease in dysentery and a 60-fold decrease in enteric fever. Variations in reporting of viral hepatitis during that period make it difficult to detect a trend. Cholera was still endemic in 2002. Cholera and dysentery outbreaks, occurring when rural populations relied on contaminated rivers for their water supply, suggested that sanitation intervention was not as effective in reducing waterborne diseases. Recommendations are made for successive one-component interventions focusing on catchment management to ensure protection of current and alternative water supplies.
  2. Mutations in rpoB and fusA cause resistance to rifampicin and fusidic acid in methicillin-resistant Staphylococcus aureus strains from a tertiary hospital in Malaysia
    Lim KT, Teh CS, Yusof MY, Thong KL
    Trans R Soc Trop Med Hyg, 2014 Feb;108(2):112-8.
    PMID: 24336696 DOI: 10.1093/trstmh/trt111
    The prevalence of resistance to rifampicin and fusidic acid among Malaysian strains of methicillin-resistant Staphylococcus aureus (MRSA) is increasing. This study aimed to determine the mechanisms of rifampicin and fusidic acid resistance and the genetic diversity of MRSA strains from a Malaysian tertiary hospital.
  3. Plasmodium falciparum: increased proportion of severe resistance (RII and RIII) to chloroquine and high rate of resistance to sulfadoxine-pyrimethamine in Peninsular Malaysia after two decades
    Lokman Hakim S, Sharifah Roohi SW, Zurkurnai Y, Noor Rain A, Mansor SM, Palmer K, et al.
    Trans R Soc Trop Med Hyg, 1996 5 1;90(3):294-7.
    PMID: 8758083
    Uncomplicated falciparum malaria patients were randomly assigned to receive either 25 mg/kg chloroquine (CHL) over 3 d or a statim dose of 25 mg/kg sulfadoxine (SDX) plus 1.25 mg/kg pyrimethamine (PYR). Patients were followed up for 28 d and the parasite response graded according to World Health Organization criteria. Overall resistance to CHL was 63.3% and 47.4% to SDX/PYR. RI, RII and RIII rates were 9.1%, 42.4% and 12.1% for CHL and 10.5%, 21.1% and 15.8% for SDX/PYR, respectively. Degree and rates of resistance to CHL were significantly correlated with pre-treatment parasite density, but not those to SDX/PYR. Plasma CHL and SDX/PYR levels were within the reported ranges and were not significantly different in patients with sensitive and resistant responses.
  4. Detection of microsporidia in local HIV-positive population in Malaysia
    Lono A, Kumar S, Chye TT
    Trans R Soc Trop Med Hyg, 2011 Jul;105(7):409-13.
    PMID: 21596411 DOI: 10.1016/j.trstmh.2011.03.006
    The HIV-positive population, due to their immuno-compromised nature, is considered more susceptible to parasitic infections than other populations. However despite the reports of other opportunistic pathogens such as Cryptosporidium and tuberculosis reported in vulnerable communities, microsporidia have not been highlighted in the local HIV-positive population in Malaysia. This study aimed to provide preliminary information on the prevalence of microsporidia in the local HIV-population. Microsporidia were detected in 21/247 (8.5%) stool samples from the HIV-infected individuals, a significantly higher (P-value <0.05) prevalence than in the control group, in which 5/173 (2.9%) were positive. HIV patients were 3x more at risk for acquiring microspordium (OR: 3.12; 95% CI 1.15-8.44). Spores were ellipsoid in shape with outlines that stained dark pink with the interior a lighter shade. Approximately 21% of the positive specimens were from individuals in the 40-49 years age group. Ten individuals who were positive for microsporidia were also positive for other enteric parasites such as Blastocystis hominis and Giardia lamblia. We detected Encephalitozoon intestinalis DNA following nested PCR from three of 10 samples analysed, as demonstrated by an amplicon of 370bp. From the findings reported, it appears that microsporidial infection in humans may actually be more common than reported. We strongly advocate greater emphasis on personal hygiene through public education on personal hygiene and the consumption of boiled or filtered water.
  5. Prevalence of microsporidia in an indigenous Orang Asli community in Pahang, Malaysia
    Lono A, Kumar GS, Chye TT
    Trans R Soc Trop Med Hyg, 2010 Mar;104(3):214-8.
    PMID: 19716577 DOI: 10.1016/j.trstmh.2009.07.006
    Microsporidia are ubiquitous parasites thought to be closely related to fungi. Their presence in the environment means that humans are frequently exposed to infection. Stool samples were collected from 151 indigenous villagers from the eastern state of Pahang in 2005. The samples were concentrated with water-ether sedimentation, stained with modified trichrome stain and examined under oil-immersion microscopy. Thirty-two specimens (21.2%) were positive for microsporidia. Microsporidia were observed as ovoid or rounded ovoid shapes measuring approximately 1mum, with a bright pink outline containing a central or posterior vacuole. PCR amplification with specific primers on microscopy-positive specimens amplified Encephalitozoon intestinalis DNA from five of the ten specimens used.
  6. CHLOROQUINE RESISTANT FALCIPARUM MALARIA IN MALAYA
    MONTGOMERY R, EYLES DE
    Trans R Soc Trop Med Hyg, 1963 Nov;57:409-16.
    PMID: 14081295
  7. Case report: recurrence of Plasmodium vivax malaria due to defective cytochrome P450 2D6 function in Pos Lenjang, Pahang, Malaysia
    Mat Salleh NH, Rahman MFA, Samsusah S, De Silva JR, Ng DC, Ghozali AH, et al.
    Trans R Soc Trop Med Hyg, 2020 Sep 01;114(9):700-703.
    PMID: 32511702 DOI: 10.1093/trstmh/traa042
    Five children in Pos Lenjang, Pahang, Malaysia were PCR-positive for vivax malaria and were admitted to the hospital from 5 to 26 July 2019. One of the patients experienced three episodes of recurrence of vivax malaria. Microsatellite analysis showed that reinfection is unlikely. Drug resistance analysis indicated that Riamet (artemether-lumefantrine) is effective. Cytochrome P450 2D6 (CYP2D6) testing showed that this patient has defective CYP2D6 function. Primaquine failure to clear the Plasmodium vivax hypnozoites may be the cause of recurring infections in this patient. This report highlights the need for the development of liver-stage curative antimalarials that do not require metabolism by the CYP2D6 enzyme.
  8. Chloroquine-resistant falciparum malaria among British service personnel in West Malaysia and Singapore
    McKelvey TP, Lundie AR, Vanreenen RM, Williams ED, Moore HS, Thomas MJ, et al.
    Trans R Soc Trop Med Hyg, 1971;65(3):286-309.
    PMID: 4934534
  9. Risk factors for endemic giardiasis: highlighting the possible association of contaminated water and food
    Mohammed Mahdy AK, Lim YA, Surin J, Wan KL, Al-Mekhlafi MS
    Trans R Soc Trop Med Hyg, 2008 May;102(5):465-70.
    PMID: 18377940 DOI: 10.1016/j.trstmh.2008.02.004
    This study was conducted to reassess the risk factors for giardiasis in communities of the Orang Asli (indigenous people) in Pahang, Malaysia. Stool samples were collected from 321 individuals (2-76 years old; 160 males, 161 females). Data were collected via laboratory analysis of faecal samples and a pre-tested standard questionnaire. River water samples were tested for Giardia cysts and Cryptosporidium oocysts. The overall prevalence of G. intestinalis infection was 23.7%. Children < or =12 years old had the highest infection rate and have been identified as a high risk group (odds ratio (OR)=6.2, 95% CI 1.5-27.0, P<0.005). The risk of getting giardiasis also appeared to be significantly associated with drinking piped water (OR=5.1, 95% CI 0.06-0.7, P<0.005) and eating raw vegetables (OR=2.4, 95% CI 0.2-0.6, P<0.005). In conclusion, sociodemographic factors have always been associated with the high prevalence of Giardia infections in Malaysia. However, the present study also highlights the need to look into the possibility of other risks such as water and food transmission routes. In future, it is necessary that these two aspects be considered in control strategies.
  10. Intestinal parasitic infections and risk analysis among urban refugees in the Klang Valley, Malaysia
    Mohd Hanapi IR, Behnke JM, Sahimin N, Saifulazmi NF, Golam Mohammad Khan ASJ, Abdul Mutalib RNS, et al.
    Trans R Soc Trop Med Hyg, 2024 Jan 02;118(1):18-32.
    PMID: 37497742 DOI: 10.1093/trstmh/trad047
    BACKGROUND: Global studies show intestinal parasitic infections (IPIs) have been introduced and spread with refugee inflows from low to high socio-economic countries. However, there is relatively limited information on the prevalence of infections among the community.

    METHODS: A 2-year cross-sectional study was conducted to determine the prevalence and associated risk factors for infections among urban refugees in the Klang Valley, Malaysia. A total of 418 faecal samples were collected and examined by microscopy.

    RESULTS: Faecal screening revealed moderate levels (32.3%) of infections in the community. Three nematode (Ascaris lumbricoides, Trichuris trichiura and hookworm) and three protozoan species (Entamoeba, Giardia and Cryptosporidium) were recorded, with the highest prevalence being A. lumbricoides (20.6%) followed by T. trichiura (10.3%), while other infections were <5%. Statistical analysis found that young males with less education were more likely to be infected with helminths. Additionally, living near waste disposal sites, the presence of stray animals, eating with bare hands, bare footedness, poor handwashing practices and no anthelmintic treatment constituted significant risk factors for helminth infections. Protozoan infections were linked to drinking tap water or from water dispensers and poor handwashing practices.

    CONCLUSIONS: These findings emphasize the importance of health education in addition to introduction of biannual anthelmintic treatment to promote community health and well-being.

  11. The pigbel story of Papua New Guinea
    Murrell TG, Walker PD
    Trans R Soc Trop Med Hyg, 1991 1 1;85(1):119-22.
    PMID: 2068739
    Enteritis necroticans (EN), known as pigbel in Papua New Guinea (PNG), may be the important predisposing lesion to mid-gut volvulus, jejunal and ileal ileus and other forms of small bowel strangulation in communities where protein deprivation, poor food hygiene, epochal meat feasting and staple diets containing trypsin inhibitors co-exist. Such human habitats occur in Africa, Central and South America, western Pacific, Asian and south-east Asian cultures. Isolated outbreaks of necrotizing enteritis have been reported from Uganda, Malaysia and Indonesia but as yet no systematic epidemiological study of the prevalence of small bowel strangulations has been described in the surgical literature of 'third world' countries. Now that enteritis necroticans is preventable by vaccination, such studies should be undertaken. This paper outlines the story of pigbel and its control in PNG.
  12. Letter: First case of schistosomiasis in Malaysia
    Murugasu R, Dissanaike AS
    Trans R Soc Trop Med Hyg, 1973;67(6):880.
    PMID: 4788765
  13. Schistosoma japonicum-type infection in Malaysia--report of the first living case
    Murugasu R, Wang F, Dissanaike AS
    Trans R Soc Trop Med Hyg, 1978;72(4):389-91.
    PMID: 705845
    The first living patient with a Schistosoma japonicum-type infection who presented with the nephrotic syndrome is reported in detail. It is not clear whether the nephrotic syndrome was due to the schistosome infection or to the deposition of hepatitis B antigen and antibody complexes. This is the tenth case of schistosomiasis reported from aborigines in Malaysia and a sylvatic source of infection is suggested.
  14. Mammals and scrub typhus ecology in peninsular Malaysia
    Muul I, Liat LB, Walker JS
    Trans R Soc Trop Med Hyg, 1975;69(1):121-30.
    PMID: 806995
    The overall comparisons of habitats are given in (Table III). The habitats are arranged in order of extent of alterations by man, with the least disturbed at the top. The highest average blood isolation rates came from the least disturbed areas. The highest monthly maximal rickettsial isolation rates from blood and maximal prevalence rates of antibody per month were also obtained at Bukit Lanjan, the habitat least altered by activities of man. The lowest average blood isolation rate (6%) and the lowest monthly maximal rickettsial isolation and antibody prevalence rates were obtained at Bukit Mandol, the habitat most extensively and intensively altered by man. The intermediate habitats had intermediate rates. We caution anyone interpreting these observations, however, in terms of human disease, which seem to be associated with hyperendemic foci. Here we are not dealing with hyperendemicity from the standpoint of human disease, but present evidence of widespread endemicity from which hyperendemic foci may derive. Also, we have not yet identified the prevalent strains and do not know their infectivity to man.
  15. Scrub typhus infection in rats in four habitats in Peninsular Malaysia
    Muul I, Lim BL, Walker JS
    Trans R Soc Trop Med Hyg, 1977;71(6):493-7.
    PMID: 415390
    Rickettsia tsutsugamushi isolations were attempted from blood samples obtained from rats captured in four adjacent habitats near Kuala Lumpur, Malaysia. Antibody surveys were also made. Rickettsial infections were most frequent in rats captured in the forest and in lalang grass (Imperata cylindrica) and least frequent in the most extensively disturbed habitat, an Orang Asli (aborigine) village. Forest rats such as Rattus sabanus (31%), as well as rats in the subgenus R. (Rattus), i.e. R. tiomanicus (26%) and R. argentiventer (35%) had frequent active infections. The house rat R. exulans had less frequent infections (15%). Frequency of antibody occurrence followed a similar pattern. No marked seasonal differences in the frequency of infections could be detected during the 18-month study.
  16. Scaling-up attention to nonmalaria acute undifferentiated fever
    Naing C, Kassim AI
    Trans R Soc Trop Med Hyg, 2012 Jun;106(6):331-2.
    PMID: 22541873 DOI: 10.1016/j.trstmh.2012.03.003
    Studies have reported that only a small fraction of fever cases in malaria-endemic areas are actually caused by malaria. Much greater emphasis is now needed to step up attention to the appropriate management of nonmalarial acute undifferentiated febrile illness. There is an overlap at the start of clinical manifestations of different febrile illnesses which makes it difficult to adhere to the clinical guidelines. The development of rigorous guidelines based on high quality research and a consensus from the core group of content experts are needed. An innovative financing mechanism for universal access to such appropriate management should also be considered.
  17. Efficacy and safety of chloroquine for treatment in patients with uncomplicated Plasmodium vivax infections in endemic countries
    Naing C, Aung K, Win DK, Wah MJ
    Trans R Soc Trop Med Hyg, 2010 Nov;104(11):695-705.
    PMID: 20850161 DOI: 10.1016/j.trstmh.2010.08.009
    Chloroquine (CQ) is a relatively inexpensive drug for treatment of malaria. If efficacy of CQ is still assumed, then it should be indicated in malaria treatment policies as the drug of choice for uncomplicated Plasmodium vivax malaria in endemic countries with resource constraints. The objective of this review is to summarize the existing evidence on the relative efficacy and safety of CQ in treating patients with uncomplicated P. vivax malaria in endemic countries. We searched online data bases (PUBMED, MEDLINE, EMBASE, The Cochrane Library) and the reference lists of the retrieved articles. Fifteen randomized controlled trials (n=6215) assessing the relative efficacy and safety of CQ for treatment of uncomplicated P. vivax malaria were included. CQ monotherapy was compared to CQ plus primaquine (PQ), artemisinin/artemether, artemisinin based combination therapy, quinine, CQ plus tafenoquine, chlorguanil plus dapsone, azithromycin, or placebo. Treatment efficacy was not significantly different between the CQ monotherapy group and that of the CQ with PQ 14 day group at 28 day follow-up (55/711, 7.7% vs 35/712, 4.9%; P=0.16). Evidence from the trials identified for this review draw a fairly clear conclusion about the relative efficacy and safety of CQ for treating uncomplicated P. vivax malaria infection. However, further research in this field with well powered, randomized, non-inferiority design, using the standardized protocol is needed.
  18. Efficacy and safety of dihydroartemisinin-piperaquine for treatment of uncomplicated Plasmodium falciparum malaria in endemic countries: meta-analysis of randomised controlled studies
    Naing C, Mak JW, Aung K, Wong JY
    Trans R Soc Trop Med Hyg, 2013 Feb;107(2):65-73.
    PMID: 23222952 DOI: 10.1093/trstmh/trs019
    The present review aimed to synthesise available evidence on the efficacy of dihydroartemisinin-piperaquine (DP) in treating uncomplicated Plasmodium falciparum malaria in people living in malaria-endemic countries by performing a meta-analysis of relevant studies. We searched relevant studies in electronic data bases up to December 2011. Published results from randomised controlled trials (RCTs) comparing efficacy of DP with other artemisinin-based combination therapies (ACTs), or non-ACTs, or placebo were selected. The primary endpoint was 28-day and 42-day treatment failure. We identified 26 RCTs. Many of the studies included in the present review were of high quality. Overall, DP, artesunate-mefloquine (MAS3) and artemether-lumefentrine (AL) were equally effective for reducing the risk of recurrent parasitaemia. The PCR confirmed efficacy of DP (99.5%) and MAS3 (97.7%) at day 28 exceeded 90%; both are efficacious. Comparable efficacy was also found for DP (95.6%) and AL (94.3%). The present review has documented that DP is comparable to other currently used ACTs such as MAS3 and AL in treating uncomplicated falciparum malaria. The better safety profile of DP and once-daily dosage improves adherence and its fixed co-formulation ensures that both drugs are taken together. Our conclusion is that DP has the potential to become a first-line antimalarial drug.
  19. Do colloids in comparison to crystalloids for fluid resuscitation improve mortality?
    Naing CM, Win DK
    Trans R Soc Trop Med Hyg, 2010 May;104(5):311-2.
    PMID: 20206954 DOI: 10.1016/j.trstmh.2010.02.001
    Permanent neurological impairment or death arising from hospital-acquired hyponatremia in both children and adults is well documented. The choice of intravenous fluids for fluid resuscitation in critically ill patients is a top priority in evidence-based medicine. The question of whether colloids in comparison to crystalloids can improve mortality in such cases remains to be answered. Well powered, randomized clinical trials addressing the comparative efficacy of different types of intravenous fluids is a high priority as is the ethical justification for such trials. The understanding of the pathophysiological process serves important information on clinical practice.
  20. Chemosuppression of malaria by the triple combination mefloquine/sulfadoxine/pyrimethamine: a field trial in an endemic area in Malaysia
    Navaratnam V, Mohamad M, Hussain S, Kumar A, Jamaludin A, Sulaiman I, et al.
    Trans R Soc Trop Med Hyg, 1989 11 1;83(6):755-9.
    PMID: 2694509
    Malaria, particularly that due to chloroquine-resistant Plasmodium falciparum, which requires management with antimalarial drugs capable of protecting against multiresistant strains, has emerged in Malaysia. A study was carried out to assess the efficacy and tolerability of 2 dosages of mefloquine/sulfadoxine/pyrimethamine (MSP; RO 13-5112) compared to Fansidar in a malaria endemic area. 914 subjects in 3 random groups were studied. Occurrence of malaria was assessed both clinically as well as by blood films. Plasma drug levels were also measured. The results showed that the low dose of MSP was completely effective in suppressing parasitaemia. 2.7% of the study population reported adverse drug reactions, the lowest incidence being in subjects on the low dose; their blood chemical profiles were also the least affected. The plasma levels of pyrimethamine and sulfadoxine achieved in the low dose group were slightly higher than expected, but there was no significant difference in bioavailability. The study showed that, for chemoprophylaxis, a low dose of MSP provided effective protection with minimal side effects.
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