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Association of HLA-B*1502 allele with carbamazepine-induced toxic epidermal necrolysis and Stevens-Johnson syndrome in the multi-ethnic Malaysian population

Chang CC, Too CL, Murad S, Hussein SH

Int J Dermatol, 2011 Feb;50(2):221-4.
PMID: 21244392 DOI: 10.1111/j.1365-4632.2010.04745.x

BACKGROUND: Carbamazepine (CBZ), a frequently used anticonvulsant drug, is one of the most common causes of life-threatening cutaneous adverse drug reactions such as toxic epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS). Recent studies have revealed a strong association between HLA-B*1502 and CBZ-induced TEN/SJS in the Taiwan Han Chinese population.
OBJECTIVES: This study is aimed to investigate the association between human leucocyte antigens (HLA) and CBZ-induced TEN/SJS in the multi-ethnic Malaysian population.
METHODS: A sample of 21 unrelated patients with CBZ-induced TEN/SJS and 300 race-matched, healthy controls were genotyped for HLA-A, -B and -DR using polymerase chain reaction (PCR). Allele frequencies were compared.
RESULTS: HLA-B*1502 was present in 75.0% (12/16) of Malay patients with CBZ-induced TEN/SJS but in only 15.7% (47/300) of normal controls (odds ratio 16.15, 95% confidence interval 4.57-62.4; corrected P-value = 7.87 × 10(-6) ), which suggests a strong association between HLA and CBZ-induced TEN/SJS. Additionally, HLA-B*1502 was found in all three Chinese and two Indian patients. Existing data show that frequencies of the HLA-B*1502 allele are generally much higher in Asian populations than in White European populations, which explains the higher incidences of SJS and TEN in Asian countries.
CONCLUSIONS: HLA-B*1502 is strongly associated with CBZ-induced TEN/SJS in the Malay population in Malaysia, as has been seen in Han Chinese in Taiwan. This indicates that the genetic association apparent in the incidence of CBZ-induced TEN/SJS is linked with the presence of HLA-B*1502, irrespective of racial origin. Screening of patients for this genetic marker can help to prevent the occurrence of TEN/SJS.

Matched MeSH terms: Incidence
Roles of adiposity, lifetime physical activity and serum adiponectin in occurrence of breast cancer among Malaysian women in Klang Valley

Shahar S, Salleh RM, Ghazali AR, Koon PB, Mohamud WN

Asian Pac J Cancer Prev, 2010;11(1):61-6.
PMID: 20593932

BACKGROUND: Lack of physical activities throughout life is related to obesity and is a risk factor of breast cancer, however, the associations of these factors with adiponectin in the occurrence of breast cancer have not been well investigated.
OBJECTIVE: This study investigated the relationship between adiposity, lifetime physical activities and serum adiponectin as breast cancer risk factors among Malaysian women in Klang Valley, Malaysia.
DESIGN: A case-control study was carried out among 70 newly diagnosed breast cancer patients and 138 controls aged 29 to 65 years old in Klang Valley.
SUBJECTS: The inclusion criteria for both groups were not having menstruation for premenopausal women, no evidence of pregnancy, not lactating and no chronic diseases such as hypertension and diabetes at the time of data collection. In addition, the cases must be pathologically newly diagnosed with breast cancer (stage I to III) and not on any therapy for cancer, with the exception of surgery. The controls were matched with cases for age +/- 5 years and menopausal status.
MEASUREMENTS: Subjects were interviewed to obtain information on socio-demography, health and reproductive history using a pretested questionnaire. Subjects were also asked on their engagement of physical activity since secondary school. Anthropometric parameters included height, weight, waist and hips were also measured. A total of 6 ml of fasting venous blood was drawn for analysis of serum adiponectin in duplicate using Linko Adiponectin ELISA Kit. Fasting blood glucose (FBG) and blood pressure were also measured.
RESULTS: Mean body mass index (BMI) among cases and controls were not significantly different (p> 0.05) at 26.1 -/+ 4.8 kg/m2 and 25.3 -/+ 4.5 kg/m2, respectively. FBG among cases (6.3 -/+ 1.8 mmol/L) was higher than controls (5.6 -/+ 1.1 mmol/L) (p<0.05). Waist hip ratio (WHR) of cases (0.85 -/+ 0.07) was also higher than controls (0.80 -/+ 0.06) (p<0.05). Abdominal obesity (WHR > 0.85) increased risk of breast cancer by three folds [Adjusted OR 3.3 (95%CI 1.8-6.2)] (p<0.05). Adiponectin level was inversely related to waist circumference (r=-0.510, p=0.000), BMI (r=-0.448, p=0.000) and FBG (r=-0.290, p=0.026). Adiponectin level in cases (11.9 -/+ 4.8 microg/ml) were lower than controls (15.2 -/+ 7.3 microg/ml) (p<0.05). A greater reduction of breast cancer risk was observed with the increasing level of serum adiponectin level according to percentiles (p<0.05). Subjects with mean serum adiponectin level at the highest quintile (> 75th)( >or= 16.7 microg/ml) had 80% reduced risk of breast cancer [Adjusted OR 0.2 (0.0-0.6)](p<0.05). A higher percentage of cases (47%) had not engaged in any physical activity throughout life as compared to controls (19%)[Adjusted OR 3.7 (1.7-7.7)](p<0.001).
CONCLUSIONS: Abdominal obesity and physical inactivity throughout life were associated with low serum adiponectin and breast cancer risk among subjects. Thus, it is essential for Malaysian women to be physically active and achieve a healthy waistline in order to increase serum adiponectin level and reduce breast cancer risk.

Matched MeSH terms: Incidence
Temporal changes in psychobehavioral responses during the 2009 H1N1 influenza pandemic

Wong LP, Sam IC

Prev Med, 2010 Jul;51(1):92-3.
PMID: 20403375 DOI: 10.1016/j.ypmed.2010.04.010

This paper aimed to examine the temporal changes in psychobehavioral responses in relation to reported 2009 H1N1 influenza deaths.

Matched MeSH terms: Incidence
An outbreak of histoplasmosis among healthy young Japanese women after traveling to Southeast Asia

Ohno H, Ogata Y, Suguro H, Yokota S, Watanabe A, Kamei K, et al.

Intern. Med., 2010;49(5):491-5.
PMID: 20190491

Histoplasmosis, caused by Histoplasma capsulatum, is an endemic mycosis in many countries of the world except for Japan. Outbreaks of histoplasmosis among Japanese people are very rare and are mainly imported by travelers. We report an outbreak of histoplasmosis among healthy Japanese people who traveled to a resort area in Southeast Asia. Three young Japanese women traveled to Langkawi island, Malaysia and stayed on the island for five days without visiting caves, a known reservoir of H. capsulatum. All three individuals developed flu-like symptoms with multiple nodule shadows on chest X rays or chest CT scans at around ten days after their return to Japan. Serum samples obtained from the three subjects were positive for anti-Histoplasma antibody and specific PCR for H. capsulatum on lung biopsy specimens and the serum from one patient was positive. The clinical course of all three patients improved without the use of anti-fungal agents and no recurrence has been confirmed. Clinical attendants should consider histoplasmosis when they see patients with flu-like symptoms with abnormal chest X-rays after visiting H. capsulatum endemic areas, especially Southeast Asia.

Matched MeSH terms: Incidence
Retinopathy of prematurity in extremely low birth weight infants in Malaysia

Choo MM, Martin FJ, Theam LC, U-Teng C

J AAPOS, 2009 Oct;13(5):446-9.
PMID: 19840721 DOI: 10.1016/j.jaapos.2009.06.008

To identify differences in incidence, risk factors, and outcomes of retinopathy of prematurity (ROP) between 2 birth weight categories within a cohort of extremely low birth weight (ELBW) infants in Malaysia.

Matched MeSH terms: Incidence
Fatal lightning strikes in Malaysia

Murty OP, Kian CK, Ari Husin MH, Nanta Kumar RK, Mohammed Yusuf WY

Am J Forensic Med Pathol, 2009 Sep;30(3):246-51.
PMID: 19704405 DOI: 10.1097/PAF.0b013e31819d20a4

Lightning strike is a natural phenomenon with potentially devastating effects and represents one of the important causes of deaths from environmental phenomena. Almost every organ system may be affected as lightning current passes through the human body taking the shortest pathways between the contact points. A 10 years retrospective study (1996-2005) was conducted at University Hospital Kuala Lumpur (20 cases) also including cases during last 3 years from Hospital Tengku Ampuan Rahimah, Klang (7 cases) from the autopsy reports at Forensic Pathology Units of these 2 hospitals. Both these hospitals are attached to University of Malaya. There were 27 fatal cases of lightning strike with male preponderance(92.59%) and male to female ratio of 12.5:1. Majority of victims of lightning strike were from the age group between 30 and 39 years old. Most of the victims were foreign workers. Indonesians workers contributed to 59.26% of overall cases. Majority of them were construction workers who attributed i.e.11 of 27 cases (40.74%). Most of the victims were brought in dead (37.04%). In majority of the cases the lightning incidence occurred in the evenings, with the frequency of 15 of 27 cases (62.5%). The month of December represented with the highest number of cases (5 cases of 23 cases); 2004 had the highest incidence of lightning strike which was 5 (19.23%). Lightning strike incidence occurred when victims had taken shelter (25.9%) under trees or shades. Lightning strike in open areas occurred in 10 of 27 cases (37.0%). Head and neck were the most commonly affected sites with the incidence of 77.78% and 74% respectively in all the victims. Only 29.63% of the cases presented with ear bleeding.

Matched MeSH terms: Incidence
Fulltext The National Mental Health Registry (NMHR)

Aziz AA, Salina AA, Abdul Kadir AB, Badiah Y, Cheah YC, Nor Hayati A, et al.

Med J Malaysia, 2008 Sep;63 Suppl C:15-7.
PMID: 19227671

The National Mental Health Registry (NMHR) collects information about patients with mental disorder in Malaysia. This information allows us to estimate the incidence of selected mental disorders, and to evaluate risk factors and treatment in the country. The National Mental Health Registry (NMHR) presented its first report in 2004, a year after its establishment. The report focused on schizophrenia as a pioneer project for the National Mental Health Registry. The development of the registry has progressed with data collected from government-based facilities, the academia and the private sector. The 2003-2005 report was recently published and distributed. Since then the registry has progressed to include suicides and other mental illnesses such as depression. The NMHR Report 2003-2005 provides detailed information about the profile of persons with Schizophrenia who presented for the first time to various psychiatry and mental health providers throughout Malaysia. More detailed description regarding pharmacotherapy is reported and few cross tabulations done in an effort to provide better understanding and more clinically meaningful reports.

Matched MeSH terms: Incidence
Fulltext A report of the Malaysian dialysis registry of the National Renal Registry, Malaysia

Lim YN, Lim TO, Lee DG, Wong HS, Ong LM, Shaariah W, et al.

Med J Malaysia, 2008 Sep;63 Suppl C:5-8.
PMID: 19230240

The Malaysian National Renal Registry was set up in 1992 to collect data for patients on renal replacement therapy (RRT). We present here the report of the Malaysian dialysis registry. The objectives of this papar are: (1) To examine the overall provision of dialysis treatment in Malaysia and its trend from 1980 to 2006. (2) To assess the treatment rate according to the states in the country. (3) To describe the method, location and funding of dialysis. (4) To characterise the patients accepted for dialysis treatment. (5) To analyze the outcomes of the dialysis treatment. Data on patients receiving dialysis treatment were collected at initiation of dialysis, at the time of any significant outcome, as well as yearly. The number of dialysis patients increased from 59 in 1980 to almost 15,000 in 2006. The dialysis acceptance rate increased from 3 per million population in 1980 to 116 per million population in 2006, and the prevalence rate from 4 to 550 per million population over the same period. The economically advantaged states of Malaysia had much higher dialysis treatment rates compared to the less economically advanced states. Eighty to 90% of new dialysis patients were accepted into centre haemodialysis (HD), and the rest into the chronic ambulatory peritoneal dialysis (CAPD) programme. The government provided about half of the funding for dialysis treatment. Patients older than 55 years accounted for the largest proportion of new patients on dialysis since the 1990s. Diabetes mellitus has been the main cause of ESRD and accounted for more than 50% of new ESRD since 2002. Annual death rate averaged about 10% on HD and 15% on CAPD. The unadjusted 5-year patient survival on both HD and CAPD was about 80%. Fifty percent of dialysis patients reported very good median QoL index score. About 70% of dialysis patients were about to work full or part time. There has been a very rapid growth of dialysis provision in Malaysia particularly in the older age groups. ESRD caused by diabetes mellitus, despite being a preventable and treatable cause of ESRD--has increased and accounted for more than 50% of incident dialysis patients. Death and survival rates on dialysis are comparable to those from other countries.

Matched MeSH terms: Incidence
International comparison of UK registry data (chapter 17)

Caskey F, Steenkamp R, Ansell D

Nephrol Dial Transplant, 2007 Aug;22 Suppl 7:vii185-93.
PMID: 17724048

In 2005, the incidence of renal replacement therapy (RRT) in the United Kingdom was 110 per million of the population (pmp) using the day 0 definition and 103 pmp using the day 90 definition. Relative to the 42 countries reporting data to the USRDS, the day 0 and day 90 rates for RRT incidence in the UK are the 32nd and 35th lowest, respectively. However, the overall incidence for the UK masks higher rates in Scotland, Wales and Northern Ireland (123, 129 and 140 pmp, respectively). Of the six countries with RRT incidence rates comparable with those in the UK (Australia, Finland, Malaysia, New Zealand, Norway and the Netherlands) three had relatively high rates for the age band 20-44, and two had relatively high rates for the age band 45-60. The proportion of incident patients with diabetes as the cause of established renal failure also varied considerably among these six comparator countries from 16% to 40% but rates of peritoneal dialysis utilization were comparable with that in the UK and generally higher than in countries with higher rates of RRT incidence. When transplantation rates were considered alongside prevalence rates for RRT, the UK position appeared relatively high at 46% (11th out of 37 countries), although still considerably lower than in Norway and the Netherlands (72 and 54%, respectively). Although variation in RRT incidence rate exists within the four countries of the UK, the overall RRT incidence, reported for the first time this year, appears similar to that observed in a number of demographically similar countries around the world. Examining the UK alongside the six comparator countries, different patterns of RRT incidence were observed across the age bands and variation in the RRT incidence secondary to diabetes mellitus raised interesting questions. The higher rates of renal transplantation achieved in several of the comparator countries also justifies further analysis.

Matched MeSH terms: Incidence
Fulltext The rate of glove perforations in orthopaedic procedures: single versus double gloving. A prospective study

Chan KY, Singh VA, Oun BH, To BH

Med J Malaysia, 2006 Dec;61 Suppl B:3-7.
PMID: 17605178

Glove perforation during surgery has always been a matter of concern as it increases the infection rate and the risk of transmission of blood borne diseases. To determine the common causes, the site and the awareness of glove perforations in orthopaedic surgery, a prospective study was conducted to assess the rate of glove perforation during 130 consecutive orthopaedic operations. All gloves worn by the surgical team were assessed after the surgery using the water-loading test. A total of 1452 gloves were tested, and the rate of perforation was 3.58%. Most of these perforations (61.5%) were unnoticed. The main surgeons had the most perforations (76.9%), followed by first assistants (13.5%) and second assistants (9.6%). Most perforations occurred at the non-dominant hand. The commonest site of perforation was the index finger followed by the thumb. Shearing force with instruments accounted for 45% of the noticed perforations. Majority of these occurred during nailing procedures (33%) and internal fixation without the use of wires (19%). Our rate of glove perforation is similar to other series. Most of them went unnoticed and were mainly due to shearing injuries rather than perforation by sharps. Therefore, there is an increased risk of contamination and break in asepsis during surgery.

Matched MeSH terms: Incidence
Fulltext Are there any real Helicobacter pylori infection-negative gastric cancers in Asia?

Tokudome S, Ando R, Ghadimi R, Tanaka T, Hattori N, Yang Z, et al.

Asian Pac J Cancer Prev, 2007 Mar;8(3):462-3.
PMID: 18159988

The great variability in gastric cancer rates across Asia, with very high incidences in Japan and Korea, and exceedingly low incidences in ethnic Malays, whether in Malaysia or Indonesia, appears largely due to variation in Helicobacter pylori infection rates. While between 2% and 10.6% of gastric cancers in a recent Japanese survey were considered to be negative for bacterial infection on the basis of seropositivity and H. pylori-dependent mucosal atrophy, it is notoriously difficult to preclude past infection. The situation is greatly complicated by reported differences in the etiology of gastric cardia and non-cardia cancers. In the Western world there do appear to be tumours arising close to the esophageal-gastric junction which are not related to H. pylori and associated inflammation, but in most Asian populations these appear to be very rare. Therefore preventive efforts, and particularly screening, should be focused on markers of bacterial infection, with avoidance of unnecessary exposure to X-ray radiation.

Matched MeSH terms: Incidence
Sarcoidosis in Singapore: epidemiology, clinical presentation and ethnic differences

Anantham D, Ong SJ, Chuah KL, Fook-Chong S, Hsu A, Eng P

Respirology, 2007 May;12(3):355-60.
PMID: 17539838

The aim of this study is to better understand the epidemiological and clinical features of patients with sarcoidosis in Singapore and to ascertain if ethnic differences exist.

Matched MeSH terms: Incidence
Study of the factors associated with the presence of white dots in the corneas of regular soft contact lens users from an Asian country

Bastion ML, Mohamad MH

Eye Contact Lens, 2006 Sep;32(5):223-7.
PMID: 16974154

PURPOSE: To investigate factors associated with the presence of microdot deposits or white dots (WDs) on confocal microscopy in regular soft contact lens (SCL) users.
METHODS: This cross-sectional observational study investigated changes in the cornea in regular SCL users by using an in vivo slit-scanning microscope (ConfoScan 3). Images were analyzed by noting the presence of highly reflective WDs. Factors associated with WDs were analyzed by using an unpaired t test with Welch correction.
RESULTS: There were 56 SCL wearers. Of these, a group of 10 had WDs (GWD) in various parts of the cornea. They had worn SCLs for 7 to 20 years and had a mean total duration of SCL wear of 13.6 +/- 4.4 years. Their mean age was 35.8 +/- 10.4 years. They were compared with a group of SCL wearers with no evidence of WDs (GNWD). The mean age of GNWD was 29.1 +/- 7.2 years, with a mean duration of SCL use of 8.17 +/- 5.1 years. The two groups were compared in terms of age, total duration of SCL wear (years), duration in hours per week, SCL water content (%), mean cell density in the endothelium and stroma, endothelial cell coefficient of cell size variation, and percentage of hexagonal cells. Only the duration of SCL wear was significantly associated with the presence of WDs (p=0.0042). WDs were most commonly found in the posterior stroma (n = 9). Two patients had WDs in the epithelium, with one of these having WDs in the endothelium. All patients except one with a hazy left eye scan had WDs bilaterally and symmetrically.
CONCLUSIONS: Confocal microscopy allows visualization of WDs in the corneas of Asian regular SCL users. Patients with WDs have a longer history of SCL wear. WDs may represent an early stage of corneal disease or degeneration associated with alterations in cell behavior.

Matched MeSH terms: Incidence
Fulltext Rubella vaccination programme in Malaysia: analysis of a seroprevalence study in an antenatal clinic

Sekawi Z, Muizatul WMN, Marlyn M, Jamil MAY, Ilina I

Med J Malaysia, 2005 Aug;60(3):345-8.
PMID: 16379190 MyJurnal

In many developed countries, the incidence of rubella and congenital rubella syndrome (CRS) is considered to be negligible due to the availability of an effective vaccine. However, in Malaysia, several CRS cases are seen every year. This casts doubt on the effectiveness of the rubella vaccination programme. Very few seroprevalence studies were done over the years, making it difficult to discuss the effectiveness of the vaccination programme. The objective of this study is to determine the prevalence of rubella immunity among pregnant women attending antenatal clinics in a local teaching hospital. The hospital database on rubella immunity was assessed retrospectively from August 2001 to June 2002. A cross-sectional study of interviewed method as well as determination of rubella immunity by laboratory tests were carried out in July 2002. A total of 414 women were included, of whom 134 women were interviewed. The rubella immunity status was 92.3%. Based on this figure, rubella vaccination programme in Malaysia is a success despite the presence of CRS cases. Malaysia must ensure rubella vaccine coverage among target groups is high in order to minimise CRS cases.
Study site: Antenatal clinic, Pusat Perubatan Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia

Matched MeSH terms: Incidence
Gender differences in coping skills of parents with hearing-impaired children

Md Daud MK, Noor SS, Yusoff MN, Abd Rahman N, Zakaria MN

B-ENT, 2013;9(4):319-23.
PMID: 24597108

To assess differences between the coping strategies of the mothers and fathers with hearing-impaired children.

Matched MeSH terms: Incidence
Does palm oil vitamin E reduce the risk of pregnancy induced hypertension?

Mahdy ZA, Siraj HH, Khaza'ai H, Mutalib MS, Azwar MH, Wahab MA, et al.

Acta Medica (Hradec Kralove), 2013;56(3):104-9.
PMID: 24592747

In view of the high anti-oxidative potential oftocotrienol, the role of the tocotrienol-rich fraction (TRF) of palm oil in preventing pregnancy induced hypertension (PIH) was explored in a randomized double-blind placebo-controlled clinical trial in an urban teaching hospital. Healthy primigravidae were randomized to receive either oral TRF 100 mg daily or placebo, from early second trimester until delivery. Out of 299 women, 151 were randomized into the TRF arm and 148 into the placebo arm. A total of 15 (5.0%) developed PIH. Although there was no statistically significant difference in the incidence of PIH (4/151 or 2.6% in the TRF arm vs. 11/148 or 7.4% in the placebo arm, p = 0.058) between the two arms, there was a tendency towards a lower incidence of PIH in the TRF arm compared to the placebo arm. With TRF supplementation, the relative risk (RR) of PIH was 0.36 (95% CI 0.12-1.09). In conclusion, although TRF from palm oil does not statistically significantly reduce the risk of development of PIH in the population studied, the 64% reduction in incidence of PIH is substantial. The findings warrant further clinical trials, particularly in high risk populations.

Matched MeSH terms: Incidence
Risk mapping of dengue in Selangor and Kuala Lumpur, Malaysia

Hassan H, Shohaimi S, Hashim NR

Geospat Health, 2012 Nov;7(1):21-5.
PMID: 23242677

Dengue fever is a recurring public health problem afflicting thousands of Malaysians annually. In this paper, the risk map for dengue fever in the peninsular Malaysian states of Selangor and Kuala Lumpur was modelled based on co-kriging and geographical information systems. Using population density and rainfall as the model's only input factors, the area with the highest risk for dengue infection was given as Gombak and Petaling, two districts located on opposite sides of Kuala Lumpur city that was also included in the risk assessment. Comparison of the modelled risk map with the dengue case dataset of 2010, obtained from the Ministry of Health of Malaysia, confirmed that the highest number of cases had been found in an area centred on Kuala Lumpur as predicted our risk profiling.

Matched MeSH terms: Incidence
Fulltext A clinical appraisal of patients with psoriasis treated in Seremban General Hospital, Malaysia

Siow KY, Mohd Safdar NA, Chong KH, Chua KB

Med J Malaysia, 2004 Aug;59(3):330-4.
PMID: 15727378 MyJurnal

A prospective clinical study of 181 patients with psoriasis seen in Seremban General Hospital showed the incidence of psoriasis among dermatology outpatients was 2.15%. A significantly higher proportion of male patients were affected, with a male to female ratio of 1.7:1. Within the racial groups; 63 were Malays, 37 Chinese, and 81 Indians. There was a significantly higher proportion of Indians affected as compared with the races. The mean age of patients in this study was 43.7 years old but the mean age of onset of psoriasis in these patients was 33.1 years old. Thirty-one (17.1%) patients gave a positive family history of psoriasis and the mean age of onset of psoriasis was lower (29.3 years old) for patients with a positive family history. Plaque psoriasis was the commonest type of clinical presentation with the scalp being the commonest site affected. Psoriatic arthropathy was seen in 35 (19.3%) patients. Ninety-five (52.5%) patients gave a positive history of factors exacerbating their pre-existing disease and stress was singled out as the most common exacerbating factor.
Study site: Skin clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia

Matched MeSH terms: Incidence
Fulltext Regional epidemiology of invasive pneumococcal disease in Asian adults: epidemiology, disease burden, serotype distribution, and antimicrobial resistance patterns and prevention

Hung IF, Tantawichien T, Tsai YH, Patil S, Zotomayor R

Int J Infect Dis, 2013 Jun;17(6):e364-73.
PMID: 23416209 DOI: 10.1016/j.ijid.2013.01.004

To summarize published data on the clinical and economic burden, epidemiology, antimicrobial resistance levels, serotype prevalence, and prevention strategies for pneumococcal disease among adults in Asia.

Matched MeSH terms: Incidence
Fulltext Increasing incidence of Plasmodium knowlesi malaria following control of P. falciparum and P. vivax Malaria in Sabah, Malaysia

William T, Rahman HA, Jelip J, Ibrahim MY, Menon J, Grigg MJ, et al.

PLoS Negl Trop Dis, 2013;7(1):e2026.
PMID: 23359830 DOI: 10.1371/journal.pntd.0002026

BACKGROUND: The simian parasite Plasmodium knowlesi is a common cause of human malaria in Malaysian Borneo and threatens the prospect of malaria elimination. However, little is known about the emergence of P. knowlesi, particularly in Sabah. We reviewed Sabah Department of Health records to investigate the trend of each malaria species over time.
METHODS: Reporting of microscopy-diagnosed malaria cases in Sabah is mandatory. We reviewed all available Department of Health malaria notification records from 1992-2011. Notifications of P. malariae and P. knowlesi were considered as a single group due to microscopic near-identity.
RESULTS: From 1992-2011 total malaria notifications decreased dramatically, with P. falciparum peaking at 33,153 in 1994 and decreasing 55-fold to 605 in 2011, and P. vivax peaking at 15,857 in 1995 and decreasing 25-fold to 628 in 2011. Notifications of P. malariae/P. knowlesi also demonstrated a peak in the mid-1990s (614 in 1994) before decreasing to ≈ 100/year in the late 1990s/early 2000s. However, P. malariae/P. knowlesi notifications increased >10-fold between 2004 (n = 59) and 2011 (n = 703). In 1992 P. falciparum, P. vivax and P. malariae/P. knowlesi monoinfections accounted for 70%, 24% and 1% respectively of malaria notifications, compared to 30%, 31% and 35% in 2011. The increase in P. malariae/P. knowlesi notifications occurred state-wide, appearing to have begun in the southwest and progressed north-easterly.
CONCLUSIONS: A significant recent increase has occurred in P. knowlesi notifications following reduced transmission of the human Plasmodium species, and this trend threatens malaria elimination. Determination of transmission dynamics and risk factors for knowlesi malaria is required to guide measures to control this rising incidence.

Matched MeSH terms: Incidence

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