MyMedR

Seroepidemiology of malaria in Peninsular Malaysia: Plasmodium falciparum antibody profile of adults in four states

Thomas V, Bin HK, Leng YP

Trans R Soc Trop Med Hyg, 1980;74(3):375-80.

In 1973, 2610 sera were collected from adults living in 22 localities in four states in Peninsular Malaysia and tested by IFAT for Plasmodium falciparum antibodies. A larger number of thin films were examined. The attack phase of the Malaria Eradication Programme (MEP) in these areas was started between 1968 and 1973. The results showed that the highest prevalence rates and geometrical mean reciprocal titres (CMRT) were among adults from Kelantan where the antibody prevalence varied greatly among the adults and there was active transmission in at least three areas. The values were lowest for Kedah. The P. falciparum antibody prevalence rates were higher than the parasite rates as revealed in single thin film examinations but a number of the positive sera were reactive only at low titres. The low concentration probably indicated the residual antibody from cured cases or past infections and cross reactions to P. vivax and P. malariae infections. The strong reactions probably indicated current P. falciparum transmission as shown by positive thin films. The present study showed that the antibody profile of adults, as shown by IFAT, is of considerable value in assessing the malaria situation in a given area and that it would be useful as a malariometric tool in epidemiological studies to evaluate the progress of malaria eradication/control programmes.

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.

Clinical, genetic and fertility studies of Indians with beta S-globin gene and the influence of Hb S on Plasmodium falciparum malaria infection

Joishy SK, Hassan K, Lopes M, Lie-Injo LE

Trans R Soc Trop Med Hyg, 1988;82(4):515-9.

PMID: 3076706

Clinical studies were carried out on mild Indian sickle cell anaemia in Malaysia, and genetic and fertility studies were carried out on 101 families with and without sickle-cell haemoglobin (Hb S). The Indian sickle cell anaemia patients reached adulthood, and pregnancies and deliveries were uneventful without blood transfusion. There was no foetal wastage and the number of children produced was not significantly different from that in families without Hb S. 28 Indian patients hospitalized with Plasmodium falciparum malaria infection were also examined for their beta S genotype. P. falciparum malaria infection occurred much more frequently in individuals without Hb S than in Hb S carriers.

Discovery of a site of transmission and hosts of a Schistosoma japonicum-like schistosome in Peninsular Malaysia

Greer GJ, Ow-Yang CK, Singh KI, Lim HK

Trans R Soc Trop Med Hyg, 1980;74(3):425.

PMID: 7434446

Scrub typhus: a common cause of illness in indigenous populations

Brown GW, Robinson DM, Huxsoll DL, Ng TS, Lim KJ

Trans R Soc Trop Med Hyg, 1976;70(5-6):444-8.

PMID: 402722

An explanation was sought for the disparity between the low reported incidence of scrub typhus and the high prevalence of antibody to Rickettsia tsutsugamushi in the rural population of Malaysia. A combination of isolation of the organism, titration of antibody by indirect immunofluorescence, and the Weil-Felix test was used to confirm infections. Scrub typhus was found to be very common, causing 23% of all febrile illnesses at one hospital. The infection was particularly prevalent in oil-palm workers, causing an estimated 400 cases annually in a population of 10,000 people living on one plantation. The clinical syndrome, whether mild or severe, was difficult to distinguish from that due to other infections. Eschars, rashes and adenopathy were uncommon. When used to examine early sera, the Weil-Felix test failed to confirm the diagnosis in most infections.20

Japanese encephalitis in Sarawak: virus isolation and serology in a Land Dyak village

Simpson DI, Bowen ET, Platt GS, Way H, Smith CE, Peto S, et al.

Trans R Soc Trop Med Hyg, 1970;64(4):503-10.

PMID: 4394986

Single-dose diethylcarbamazine in the control of periodic brugian filariasis in Peninsular Malaysia

Hakim SL, Vythilingam I, Marzukhi MI, Mak JW

Trans R Soc Trop Med Hyg, 1995 11 1;89(6):686-9.

PMID: 8594697

The study compared the effectiveness of a single dose of diethylcarbamazine (DEC) (6mg/kg) with the standard regimen of 6 doses (total 36 mg/kg) in mass chemotherapy for the control of brugian filariasis. Mass chemotherapy with single-dose DEC was instituted in one area and standard dose in the other and treatment was repeated after one year. Parasitological surveys were conducted before, and 3, 7 and 12 months after treatment. Pretreatment characteristics were not significantly different between the 2 treatment areas. There was a significant reduction in microfilaraemia prevalence rate from 24.7% to 14.7% at 12 months and to 6.8% at 19 months in the single dose area and from 22.8% to 9.6% at 12 months and to 2.7% at 19 months with the standard dose. Maximum reduction was at 7 months after treatment with both regimens. There was also significant progressive reduction in mean microfilarial density from 4.39 +/- 20.37 to 0.89 +/- 4.16 per 60 microL in the single-dose area and from 4.43 +/- 17.31 to 0.75 +/- per 60 microL in the standard dose area. There was a greater reduction of both microfilarial prevalence and density using the standard regimen but it was not statistically significant. Thus, a single dose of DEC is as effective as the standard dose in controlling periodic brugian filariasis.

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.

Diagnosis of malaria using a plate hybridization method for the detection of polymerase chain reaction products

Hakim SL, Furuta T, Rain AN, Normaznah Y, Zamri MR, Kojima S, et al.

Trans R Soc Trop Med Hyg, 1995 5 1;89(3):271-2.

PMID: 7660430

Specific depression of cell-mediated immunity in Malayan filariasis

Kwa BH, Mak JW

Trans R Soc Trop Med Hyg, 1980;74(4):522-7.

PMID: 7445050

The possible depression of cell-mediated immunity by long-term Brugia malayi infection in jirds (Meriones unguiculatus) was investigated. Different groups of infected jirds were sensitized with dinitrofluorobenzene, sheep red blood cells, Dirofilaria immitis adult antigens and B. malayi adult antigens. The 24-hour delayed type hypersensitivity skin response to testing with antigen was measured as an in vivo correlate of cell-mediated immunity. The delayed-type hypersensitivity responses to dinitrofluorobenzene, sheep red blood cells and D. immitis antigens were normal but the response to B. malayi antigens was significantly depressed, confirming that long-term B. malayi infection depresses cell-mediated immunity and that this depression is specific to B. malayi antigens.

Thoughts about populations with unexpected low prevalences of Helicobacter pylori infection

Graham DY, Yamaoka Y, Malaty HM

Trans R Soc Trop Med Hyg, 2007 Sep;101(9):849-51.

PMID: 17658569

Helicobacter pylori is one of the few remaining major pathogens that accompanied humans on their travels from Africa. A recently published study reports the unexpected finding of a low H. pylori prevalence among pregnant women in Zanzibar (Farag, T.H., Stolzfus, R.J., Khalfan, S.S., Tielsch, J.M., 2007. Unexpectedly low prevalence of Helicobacter pylori infection among pregnant women on Pemba Island, Zanzibar. Trans. R. Soc. Trop. Med. Hyg. 101). The apparent epidemiology of higher prevalence with higher socioeconomic status and decrease with age are unprecedented. As with many 'unexpected' events, a search of the literature reveals evidence of low prevalence populations in Java and Malaysia, with clues dating back to the mid-twentieth century. Why some populations apparently lost H. pylori infection remains an open question. However, the tools needed to resolve the dilemma are readily available and we hope investigators will soon rise to the challenge.

Changes in abundance and behaviour of vector mosquitoes induced by land use during the development of an oil palm plantation in Sarawak

Chang MS, Hii J, Buttner P, Mansoor F

Trans R Soc Trop Med Hyg, 1997 7 1;91(4):382-6.

PMID: 9373626

Surveys were conducted of adult and immature mosquitoes in an area undergoing oil palm development in north Sarawak. Point prevalence data from 2 sites were collected annually, coinciding with annual phases of forest clearing, burning/cultivation, and maintenance. Major habitat perturbation during the forest/clearing transition shifted the major mosquito faunal equilibrium in terms of species composition, relative density and occurrence. Analyses of variance showed that the mean numbers of 4 species of Anopheles decreased significantly after forest clearing. Relative densities of immature stages decreased after forest clearing, but A. letifer and Culex tritaeniorhynchus remained relatively unchanged after the second year. Comparisons with the pre-development forest stage showed that the reductions in person-biting rates, adult survival and combined entomological inoculation rates (EIR) of A. donaldi and A. letifer decreased the risk of malaria transmission by 90% over the 4 years period. Concomitant reductions in EIR and annual malaria incidence were also correlated. This study highlighted the 'law of unintended consequences', since 2 contrasting effects were observed: reduction of malaria vectors but concomitant increase of dengue vectors.

Letter: Disappointing results in Malaysia with the "Dill Glazko" eosin colour tests for chloroquine in urine

Dondero TJ, Mariappan M

Trans R Soc Trop Med Hyg, 1974;68(4):338-9.

PMID: 4419901

Prophylactic and sporontocidal treatment of chloroquine resistant Plasmodium falciparum from Malaya

Clyde DF, DuPont HL, Miller RM, McCarthy VC

Trans R Soc Trop Med Hyg, 1970;64(6):834-8.

PMID: 4924648

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.

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.

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.

Involvement of small mammals in the transmission of scrub typhus in Malaysia: isolation and serological evidence

Walker JS, Gan E, Chan Teik Chye, Muul I

Trans R Soc Trop Med Hyg, 1973;67(6):838-45.

PMID: 4207572

Letter: Toxoplasma antibody in West Malaysia (Peninsular Malaya)

Dasgupta B, Nandalal P

Trans R Soc Trop Med Hyg, 1974;68(2):173.

PMID: 4460305

Profile distribution of juvenile Aedes species in an urban area of Malaysia

Che Dom N, Faiz Madzlan M, Nadira Yusoff SN, Hassan Ahmad A, Ismail R, Nazrina Camalxaman S

Trans R Soc Trop Med Hyg, 2016 Apr;110(4):237-45.

PMID: 27076510 DOI: 10.1093/trstmh/trw015

Dengue fever (DF) is an urban vector-borne disease transmitted by Aedes aegypti and Aedes albopictus. Both species deposit their eggs in favorable breeding sites either in natural or artificial containers. An understanding of their habitat characteristics is crucial in curbing DF outbreaks

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