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Preventing the next pandemic

Wolfe N

Sci. Am., 2009 Apr;300(4):76-81.
PMID: 19363924
Matched MeSH terms: Disease Outbreaks/prevention & control*; Virus Diseases/prevention & control
Fulltext The prevalence of acute respiratory symptoms and role of protective measures among Malaysian hajj pilgrims

Deris ZZ, Hasan H, Sulaiman SA, Wahab MS, Naing NN, Othman NH

J Travel Med, 2010 Mar-Apr;17(2):82-8.
PMID: 20412173 DOI: 10.1111/j.1708-8305.2009.00384.x

BACKGROUND: Respiratory symptoms including cough, runny nose, sore throat, and fever are the most common clinical manifestations faced by hajj pilgrims in Mecca. The aim of the study was to determine the prevalence of respiratory symptoms among Malaysian hajj pilgrims and the effect of a few protective measures taken by hajj pilgrims to reduce respiratory symptoms.
METHODS: A cross-sectional study was conducted by distributing survey forms to Malaysian hajj pilgrims at transit center before flying back to Malaysia. The recruitment of respondents to the survey was on a voluntary basis.
RESULTS: A total of 387 survey forms were available for analysis. The mean age was 50.4 +/- 11.0 years. The common respiratory symptoms among Malaysian hajj pilgrims were: cough 91.5%, runny nose 79.3%, fever 59.2%, and sore throat 57.1%. The prevalence of hajj pilgrims with triad of cough, subjective fever, and sore throat were 40.1%. The symptoms lasted less than 2 weeks in the majority of cases. Only 3.6% did not suffer from any of these symptoms. Seventy-two percent of hajj pilgrims received influenza vaccination before departure and 72.9% wore facemasks. Influenza vaccination was not associated with any of respiratory symptoms but it was significantly associated with longer duration of sore throat. Wearing masks was significantly associated with sore throat and longer duration of sore throat and fever.
CONCLUSIONS: The prevalence of respiratory symptoms was high among Malaysian hajj pilgrims and the current protective measures seemed inadequate to reduce it. Beside standardization of the term used in hajj studies, more collaborative effort should be taken to reduce respiratory symptoms. The hajj authority should prepare for the challenge of pandemic influenza by providing more healthcare facilities and implementation of more strict measures to reduce the transmission of pandemic influenza strain among hajj pilgrims.

Matched MeSH terms: Influenza, Human/prevention & control; Respiratory Tract Diseases/prevention & control*
Predictors associated with the willingness to take human papilloma virus vaccination

Naing C, Pereira J, Abe T, Eh Zhen Wei D, Rahman Bajera IB, Kavinda Perera UH

J Community Health, 2012 Apr;37(2):288-93.
PMID: 21928103 DOI: 10.1007/s10900-011-9473-4

Human papilloma virus vaccine is considered to be the primary form of cervical cancer prevention. The objectives were (1) to determine knowledge about, and perception of human papilloma virus infection in relation to cervical cancer, (2) to explore the intention of the community to be vaccinated with human papilloma virus vaccine, and (3) to identify variables that could predict the likelihood of uptake of the vaccine. A cross-sectional survey was carried out in a semi-urban Town of Malaysia, using a pre-tested structured questionnaire. Summary statistics, Pearson chi-square test and a binary logistic regression were used for data analysis. A total of 232 respondents were interviewed. Overall, only a few had good knowledge related to human papilloma virus (14%) or vaccination (8%). Many had misconceptions that it could be transmitted through blood transfusion (57%). Sixty percent had intention to take vaccination. In the binary logistic model, willingness to take vaccination was significant with 'trusts that vaccination would be effective for prevention of cervical cancer' (P = 0.001), 'worries for themselves' (P < 0.001) or 'their family members' (P = 0.003) and 'being Indian ethnicity' (P = 0.024). The model could fairly predict the likelihood of uptake of the vaccine (Cox & Snell R(2) = .415; Nagelkerke R(2) = 0.561). Results indicate that intensive health education dispelling misconception and risk perception towards human papilloma virus infection and cervical cancer would be helpful to increase the acceptability of vaccination program.

Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control*; Papillomavirus Infections/prevention & control*
Protecting children from violence and maltreatment: a qualitative comparative analysis assessing the implementation of U.N. CRC Article 19

Svevo-Cianci KA, Hart SN, Rubinson C

Child Abuse Negl, 2010 Jan;34(1):45-56.
PMID: 20060588 DOI: 10.1016/j.chiabu.2009.09.010

(1) To identify which United Nations Convention on the Rights of the Child (CRC) recommended child protection (CP) measures, such as policy, reporting systems, and services for child abuse and neglect (CAN) victims, individually or in combination, were most important in establishing a basic level of child protection in 42 countries; and (2) to assess whether these measures were necessary or sufficient to achieve basic child protection in developing and industrialized countries.

Matched MeSH terms: Child Abuse/prevention & control*; Violence/prevention & control*
Fulltext Support for and reported compliance among smokers with smoke-free policies in air-conditioned hospitality venues in Malaysia and Thailand: findings from the International Tobacco Control Southeast Asia Survey

Yong HH, Foong K, Borland R, Omar M, Hamann S, Sirirassamee B, et al.

Asia Pac J Public Health, 2010 Jan;22(1):98-109.
PMID: 20032039 DOI: 10.1177/1010539509351303

This study examined support for and reported compliance with smoke-free policy in air-conditioned restaurants and other similar places among adult smokers in Malaysia and Thailand. Baseline data (early 2005) from the International Tobacco Control Southeast Asia Survey (ITC-SEA), conducted face-to-face in Malaysia and Thailand (n = 4005), were used. Among those attending venues, reported total smoking bans in indoor air-conditioned places such as restaurants, coffee shops, and karaoke lounges were 40% and 57% in Malaysia and Thailand, respectively. Support for a total ban in air-conditioned venues was high and similar for both countries (82% Malaysian and 90% Thai smokers who believed there was a total ban), but self-reported compliance with bans in such venues was significantly higher in Thailand than in Malaysia (95% vs 51%, P < .001). As expected, reporting a ban in air-conditioned venues was associated with a greater support for a ban in such venues in both countries.

Matched MeSH terms: Smoking/prevention & control; Tobacco Smoke Pollution/prevention & control*
Figure-of-eight vs. interrupted sternal wire closure of median sternotomy

Ramzisham AR, Raflis AR, Khairulasri MG, Ooi Su Min J, Fikri AM, Zamrin MD

Asian Cardiovasc Thorac Ann, 2009 Dec;17(6):587-91.
PMID: 20026533 DOI: 10.1177/0218492309348948

Sternal dehiscence is a rare but devastating complication following median sternotomy for cardiac surgery. The optimal technique for sternal closure is unclear. We conducted this prospective randomized trial to compare the incidence of sternal dehiscence after figure-of-8 and simple interrupted suturing in patients undergoing coronary artery bypass grafting. Between January 2007 and June 2008, 98 patients had figure-of-8 suturing and 97 had interrupted sutures. The mean age of the patients was 60.9 +/- 7.6 years. The overall sternal dehiscence rate was 8%; 7 cases in the in figure-of-8 group and 9 in the interrupted group. Thirteen patients had no wound infection and healed with conservative treatment. Only 3 patients had sternal dehiscence with infection: 2 with simple interrupted closure and 1 with figure-of-8 sternal closure. There was no significant difference in rates of sternal dehiscence between the 2 groups. It was concluded that figure-of-8 sternal suturing is equally effective as simple interrupted suturing in preventing sternal dehiscence.

Matched MeSH terms: Surgical Wound Dehiscence/prevention & control*; Surgical Wound Infection/prevention & control
Ethnically diverse female university students' knowledge and attitudes toward human papillomavirus (HPV), HPV vaccination and cervical cancer

Wong LP, Sam IC

Eur J Obstet Gynecol Reprod Biol, 2010 Jan;148(1):90-5.
PMID: 19910102 DOI: 10.1016/j.ejogrb.2009.10.002

OBJECTIVE:
Cervical HPV is the most common sexually transmitted disease among college-age women. This study aimed to assess knowledge and attitudes towards HPV infection, HPV vaccination and cervical cancer among female university students, to provide insight into development of HPV educational information.

STUDY DESIGN:
A cross-sectional survey using a convenience sample. A total of 1083 ethnically diverse female students attending a public university were approached and 650 were interviewed.

RESULTS:
Knowledge regarding HPV, HPV vaccination, cervical screening and cervical cancer risk factors was remarkably poor. Across the sample, the mean total knowledge score (14-item) was only 3.25 (S.D. +/-2.41; 95% CI 3.07-3.44). Only 10.3% had heard of the newly released HPV vaccine. Approximately 48% of participants indicated an intention to receive an HPV vaccine. Intention to receive an HPV vaccine was significantly associated with knowledge of HPV and genital warts (OR 1.53; 95% CI 1.25-1.88), and knowledge of cervical screening and cervical cancer risk factors (OR 1.21; 95% CI 1.11-1.33). Of those who refused HPV vaccination, 50.9% doubted the safety and efficacy of the new vaccine, and 41.5% perceived themselves as not at risk of HPV infection.

CONCLUSION:
The findings suggest that providing education about the etiology of cervical cancer and the HPV link is an essential component to enhance HPV vaccine uptake.

Matched MeSH terms: Condylomata Acuminata/prevention & control; Papillomavirus Infections/prevention & control*
Identification of immunogenic proteins from Burkholderia cepacia secretome using proteomic analysis

Mariappan V, Vellasamy KM, Thimma JS, Hashim OH, Vadivelu J

Vaccine, 2010 Feb 3;28(5):1318-24.
PMID: 19944788 DOI: 10.1016/j.vaccine.2009.11.027

Burkholderia cepacia is an opportunistic human pathogen associated with lung infections. Secretory proteins of B. cepacia are known to be involved in virulence and may mediate important host-pathogen interactions. In the present study, secretory proteins isolated from B. cepacia culture supernatant were separated using two-dimensional gel electrophoresis, followed by Western blot analysis to identify the immunogenic proteins. Mice antibodies raised to B. cepacia inactivated whole bacteria, outer membrane protein and culture filtrate antigen detected 74, 104 and 32 immunogenic proteins, respectively. Eighteen of these immunogenic proteins which reacted with all three antibodies were identified and might be potential molecules as a diagnostic marker or a putative candidate vaccine against B. cepacia infections.

Matched MeSH terms: Lung Diseases/prevention & control; Burkholderia Infections/prevention & control
Fulltext Effects of liquid metabolite combinations produced by Lactobacillus plantarum on growth performance, faeces characteristics, intestinal morphology and diarrhoea incidence in postweaning piglets

Thu TV, Loh TC, Foo HL, Yaakub H, Bejo MH

Trop Anim Health Prod, 2011 Jan;43(1):69-75.
PMID: 20632092 DOI: 10.1007/s11250-010-9655-6

A study was carried out to investigate the effects of feeding liquid metabolite combinations produced by Lactobacillus plantarum strains on growth performance, diarrhoea incidence, faecal pH, microfloral counts, short-chain fatty acids (SCFA) and intestinal villus height and crypt depth of postweaning piglets. A total of 120 piglets (26 days old) were randomly assigned evenly into five treatment groups treated with same basal diet: (1) -ve control (free antibiotic); (2) + ve control (0.03% of chlortetracycline); (3) Com 1 (0.3% metabolite of TL1, RG11 and RI11 strains); (4) Com 2 (0.3% metabolite of TL1, RG14 and RS5 strains); (5) Com 3 (0.3% metabolite of RG11, RG14 and RI11 strains). After 5 weeks, the average daily feed intake was not significantly different (P > 0.05) among the treatments and feed conversion ratio was the highest (P control group. In addition, diarrhoea incidence was reduced when piglets were fed with metabolite combinations. Faecal lactic acid bacteria (LAB) counts were significantly higher (P control group. In contrast, total faecal SCFA of Com 2 were significantly higher (P control group. The villus height of duodenum was higher (P control and Com 2 groups as compared to -ve control group. The results obtained in this study showed that feeding metabolite combinations could improve growth performance, and increase the population of gut LAB and faecal SCFA of postweaning piglets.

Matched MeSH terms: Diarrhea/prevention & control; Swine Diseases/prevention & control*
Fulltext Live recombinant Lactococcus lactis vaccine expressing aerolysin genes D1 and D4 for protection against Aeromonas hydrophila in tilapia (Oreochromis niloticus)

Anuradha K, Foo HL, Mariana NS, Loh TC, Yusoff K, Hassan MD, et al.

J Appl Microbiol, 2010 Nov;109(5):1632-42.
PMID: 20602654 DOI: 10.1111/j.1365-2672.2010.04789.x

To evaluate a live recombinant Lactococcus lactis vaccine expressing aerolysin genes D1 (Lac-D1ae) and/or D4 (Lac-D4ae) in protection against Aeromonas hydrophila in tilapia (Oreochromis niloticus).

Matched MeSH terms: Fish Diseases/prevention & control*; Gram-Negative Bacterial Infections/prevention & control
Fusion of HSP70 gene of Mycobacterium tuberculosis to hemagglutinin (H5) gene of avian influenza virus in DNA vaccine enhances its potency

Rasoli M, Omar AR, Aini I, Jalilian B, Syed Hassan SH, Mohamed M

Acta Virol., 2010;54(1):33-9.
PMID: 20201612

A series of plasmids containing the HSP70 gene of Mycobacterium tuberculosis fused to the hemagglutinin (H5) gene of H5N1 avian influenza virus (AIV) (H5-HSP70 (heat shock protein 70) vaccine) or individual H5 gene (H5 vaccine) or HSP70 gene (HSP70 vaccine) were constructed based on the plasmid pcDNA3.1. Expression of H5 gene in Vero cells in vitro and in chickens in vivo was confirmed following their transfection and immunization with H5 or H5-HSP70 vaccines. Controls consisted of HSP70 vaccine, empty plasmid pcDNA3.1 and co-administered H5 and HSP70 vaccines. H5-HSP70 vaccine produced in chicken higher hemagglutination inhibition (HI) antibody titer than H5 vaccine. However, the increase was not statistically significant. We have demonstrated for the first time that the H5 DNA vaccine with fused HSP70 gene may produce an enhanced induction of humoral immune response to AIV in chickens.

Matched MeSH terms: Influenza in Birds/prevention & control; Poultry Diseases/prevention & control
Antinociceptive and anti-inflammatory properties of Corchorus capsularis leaves chloroform extract in experimental animal models

Zakaria ZA, Sulaiman MR, Gopalan HK, Abdul Ghani ZD, Raden Mohd Nor RN, Mat Jais AM, et al.

Yakugaku Zasshi, 2007 Feb;127(2):359-65.
PMID: 17268156

The antinociceptive and anti-inflammatory properties of Corchorus capsularis leaves chloroform extract were investigated in experimental animal models. The antinociceptive activity was measured using the writhing, hot plate and formalin tests, while the anti-inflammatory activity was measured using the carrageenan-induced paw edema test. The extract, obtained after 72 h soaking of the air-dried leaves in chloroform followed by in vacuo evaporation to dryness, was weighed and prepared by serial dilution in DMSO in the doses of 20, 100 and 200 mg/kg. The extract was administered (s.c.) 30 min prior to subjection to the respective assays. The extract was found to exhibit significant (p < 0.05) antinociceptive and anti-inflammatory activities. As a conclusion, the present study confirmed the traditional claims of using C. capsularis to treat various ailments related to inflammation and pain.

Matched MeSH terms: Edema/prevention & control*; Pain/prevention & control*
Protective effect following intranasal exposure of goats to live Pasteurella multocida B:2

Zamri-Saad M, Ernie ZA, Sabri MY

Trop Anim Health Prod, 2006 Oct-Nov;38(7-8):541-6.
PMID: 17265769

This study aimed to determine the effect of intranasal exposure to low doses of Pasteurella multocida B:2 on survival of goats challenged with high doses of the same organism. Eighteen goats were selected and divided into three groups. Goats of group 1 were exposed intranasally twice, with a two-week interval, to 7 x 10(6) cfu/ml of live P. multocida B:2. Goats of group 2 were not exposed to P. multocida B:2 but were kept together with the exposed group 1. Goats of group 3 remained as unexposed controls and were kept separated from the other two groups. Serum samples were collected at weekly intervals to determine the antibody levels. At week 5 post exposure, all goats were challenged subcutaneously with 3.7 x 10(10) cfu/ml of live P. multocida B:2. Following challenge exposure, 8 (67%) goats (4 goats from each of groups 1 and 2) were killed owing to haemorrhagic septicaemia. Four goats were killed peracutely within 48 h post challenge, while the other four goats were killed acutely between 2 and 4 days post challenge. None of the goats of group 3 were killed for haemorrhagic septicaemia. Goats of groups 1 and 2 showed significantly (p < 0.05) higher antibody levels following the first intranasal exposure to P. multocida B:2. However, only group 1 retained the significantly (p < 0.05) high antibody levels following a second intranasal exposure, and remained significantly (p < 0.05) higher than groups 2 and 3 at the time of challenge. P. multocida B:2 was successfully isolated from various organs of goats that were killed between 1 and 4 days post challenge.

Matched MeSH terms: Pasteurella Infections/prevention & control; Goat Diseases/prevention & control*
Managing complications of radiation therapy in head and neck cancer patients: Part II. Management of radiation-induced caries

Chai WL, Ngeow WC, Ramli R, Rahman RA

Singapore Dent J, 2006 Dec;28(1):4-6.
PMID: 17378334

Head and neck cancer is becoming a more recognizable pathology to the general population and dentists. The modes of treatment include surgery and/or radiation therapy. Where possible, pretreatment dental assessment shall be provided for these patients before they undergo radiation therapy. There are occasions, however, whereby head and neck cancer patients are not prepared optimally for radiation therapy. Because of this, they succumb to complicated oral complications after radiation therapy. The management of xerostomia has been reviewed in Part I of this series. In this article, the management of dental caries, a sequalae of xerostomia following radiation therapy is reviewed.

Matched MeSH terms: Dental Caries/prevention & control; Radiation Injuries/prevention & control
[The 2005-2006 influenza season in the Netherlands and the vaccine composition for the 2006-2007 season]

Rimmelzwaan GF, de Jong JC, Donker GA, Meijer A, Fouchier RA, Osterhaus AD

Ned Tijdschr Geneeskd, 2006 Oct 7;150(40):2209-14.
PMID: 17061434

The first sign of influenza activity in the Netherlands during the 2005-2006 influenza season was the isolation of influenza viruses in the last week of 2005. From Week 1 of 2006 onwards, an increase in clinical influenza activity was also observed that did not return to baseline levels until Week 15. Two waves of influenza activity were observed with peak incidences of 13.8 and 9.8 influenza-like illnesses per 10,000 inhabitants on Weeks 7 and 12, respectively. The first wave of influenza was caused primarily by influenza B viruses, whereas the second wave was caused predominantly by influenza A/H3N2 viruses. The influenza B viruses appeared to belong to two different phylogenetic lineages and were antigenically distinguishable from the vaccine strain. The isolated influenza A/H3N2 viruses were closely related to the vaccine strain for this subtype and only minor antigenic differences with the vaccine strain were observed for a limited number of isolates. Only a small number of influenza A/H1N1 viruses were isolated, which all closely resembled the H1N1 vaccine strain. For the 2006-2007 influenza season, the World Health Organization has recommended the following vaccine composition: A/Wisconsin/67/05 (H3N2), A/New Caledonia/20/99 (H1N1) and B/Malaysia/2506/05.

Matched MeSH terms: Disease Outbreaks/prevention & control*; Influenza, Human/prevention & control*
Fulltext Alteration of foot temperature in diabetic neuropathy: is it another piece of puzzle?

Naicker AS, Roohi SA, Lee CS, Chan WH, Tay LS, Din XJ, et al.

Med J Malaysia, 2006 Feb;61 Suppl A:10-3.
PMID: 17042221

Poor glycaemic control and the duration of diabetes mellitus are known to accelerate development and progression of neuropathy. Diabetic co-morbidities: hypertension and hyperlipidaemia, have been postulated to associate with development of neuropathy. A diabetic foot with low temperature and frequent exposure to low temperature environment has recently been hypothesized to be at higher risk to develop early neuropathy. This cross-sectional study is undertaken to identify risk factors for diabetic neuropathy and the association between foot temperature and development of diabetic neuropathy by using simple clinical examination in the outpatient setting. From April 18, to April 30, 2005, universal sampling method was used to select 134 diabetic patients (type 1 or type 2 for >1 year) with peripheral neuropathy. Excluded are those with chronic alcoholism, drug-induced neuropathy, dietary history of vitamin B deficiency and family history of porphyria and hereditary sensorimotor neuropathy. The patient's duration of diabetes, glycaemic control status and the presence of co-morbids: hypertension and hyperlipidemia, were recorded. The temperature of the foot was measured by using thermo buddy. Of 134 patients representing Malaysian ethnic distribution with an equal number of males and females, 20.1% were in the age group of 61 to 65 years and, 85.1% and 67.9% belonged to lower socioeconomic and educational groups respectively. Associations between diabetic neuropathy and glycaemic control (p = 0.018) and duration of diabetes (p < 0.05) were significant. However, hypertension, hyperlipidaemia and low foot temperature were not significantly associated with development of diabetic neuropathy. Poor glycaemic control is significantly associated with diabetic neuropathy. Foot temperature alteration is merely an effect of autonomic neuropathy with a cold foot is attributed to co-existing peripheral arterial disease.

Study site: Pusat Perubatan Primer Bandar Tasik Selatan, Kuala Lumpur, Malaysia

Matched MeSH terms: Diabetic Neuropathies/prevention & control*; Diabetic Foot/prevention & control*
Bone health in urban midlife Malaysian women: risk factors and prevention

Lim PS, Ong FB, Adeeb N, Seri SS, Noor-Aini MY, Shamsuddin K, et al.

Osteoporos Int, 2005 Dec;16(12):2069-79.
PMID: 16234999 DOI: 10.1007/s00198-005-2003-4

The aim of this study was to identify risk factors associated with osteoporosis in urban midlife Malaysian women and to assess the effectiveness of lifestyle intervention in bone loss prevention with hormone replacement therapy (HRT) as a positive control. A total of 514 disease-free, uterus-intact, non-HRT-using women aged 45 years and older were recruited into the study. After initial bone mineral density (BMD) assessments, they were randomized into three groups: GI (control), G2 (lifestyle intervention), and G3 (lifestyle intervention with HRT). The study group was composed of 67.5% Chinese, 27.8% Malay, and 4.2% Indians with a mean age of 51.07+/-5.28 years. Two-fifths were postmenopausal, and the prevalence of osteoporosis was 24.1%, seen predominantly at the hip. Postmenopausal women had significantly lower mean BMD and a higher incidence of osteoporosis compared with the premenopausal women, 42.1% vs. 11.1% (p<0.0005). A lower incidence of osteoporosis was found in women who took calcium supplementation regularly as opposed to those who do not, 18.7% vs. 29.3% (p=0.036). Age and a greater postmenopausal duration showed a significant negative association with BMD, whereas higher family income, weight, body mass index, and waist and hip circumference were positively correlated. After 18-20 months, the effect of intervention was assessed based on BMD values of 279 women at baseline and after intervention. Lifestyle intervention alone was effective in premenopausal women, preventing over 90% of spinal bone loss compared with the controls, who lost 11.6% (0.046 g/cm2) bone mass with similar losses of hip bone, 2.0% (0.026 g/cm2) vs. 1.5% (0.020 g/cm2). Premenopausal women on HRT also showed a substantial decrease in spine and hip BMD, 18.6% (0.081 g/cm2) and 9.0% (0.122 g/cm2), respectively. The lifestyle intervention program retarded postmenopausal bone loss by 21% and 37% compared with controls, who lost 9.6% (0.141 g/cm2) and 6.0% (0.138 g/cm2) bone mass at the spine and hip. In comparison, lifestyle intervention with HRT increased postmenopausal BMD by 12.7% (0.216 g/cm2) at the spine and 1.9% (0.042 g/cm2) at the hip. The changes in hip BMD were influenced by current age, ethnicity, and income, while intervention had the strongest effect on spine BMD changes. In conclusion, lifestyle intervention prevented spinal bone loss in premenopausal women and retarded postmenopausal spine and hip bone loss compared with controls. The benefits of physical activity on spine and hip BMD highlight its potential as a safe and cost-effective alternative to HRT, which is not advocated because of its potential adverse effects.

Matched MeSH terms: Osteoporosis/prevention & control*; Osteoporosis, Postmenopausal/prevention & control
Perceptions and opinions regarding human papilloma virus vaccination among young women in Malaysia

Al-Naggar RA, Al-Jashamy K, Chen R

Asian Pac J Cancer Prev, 2010;11(6):1515-21.
PMID: 21338190

OBJECTIVE: The objective of this study is to explore the perceptions and opinions of young women about human papilloma virus (HPV) vaccination and associated barriers.
METHODOLOGY: This qualitative in-depth interview study was conducted in January 2010 with 30 university students from different faculties, i.e.:International Medical School (IMS), Faculty of Health and Life Sciences (FHLS), Faculty of Business Management and Professional Studies (FBMP) and Faculty of Information Sciences and Engineering (FISE) of the Management and Science University (MSU), Shah Alam, Malaysia. After consent was obtained from all participants, the interviewer wrote down the conversations during the interview sessions. The data obtained were classified into various categories and analyzed manually.
RESULTS: The majority of participants 25 (83%) had heard about cervical cancer, while 16 (53.3%) have never heard of HPV. Only five participants (17%) mentioned that HPV is the cause of cervical cancer. Ten participants (33.3%) did not know any causes. The majority 16 (53.3%) did not know the mode of HPV transmission. The majority of participants 22 (73.3%) mentioned that they had not been vaccinated against HPV. Out of 22, 16 (53.3%) agreed to be vaccinated in the future to protect themselves from cervical cancer and five (17%) participants mentioned they are not willing because of the uncertain safety of the available vaccines and their side effects.
CONCLUSION: This study showed relatively poor knowledge about HPV and its vaccines, pointing to urgency of educational campaigns aimed at students in the public and government universities to promote HPV vaccination among this highly eligible population.

Matched MeSH terms: Uterine Cervical Neoplasms/prevention & control; Papillomavirus Infections/prevention & control*
Suppression of DMBA/croton oil-induced mouse skin tumor promotion by Ardisia Crispa root hexane extract

Roslida A, Fezah O, Yeong LT

Asian Pac J Cancer Prev, 2011;12(3):665-9.
PMID: 21627361

Ardisia crispa (Family: Myrsinaceae) has been used as a traditional medicine for various ailments. Previous studies showed that Ardisia crispa possesses antimetastatic and anti-inflammatory properties. Nevertheless, research done on the plant is still limited. Therefore, the present study was designed to evaluate the suppression effect of Ardisia crispa root hexane (ACRH) extract on 7, 12-dimethylbenz (α) anthracene (DMBA)-induced mice skin tumor promotion in ICR mice with topical application twice weekly for 10 weeks. Results showed significant difference between treatment groups (mice treated with 30 mg/kg, 100 mg/kg and 300 mg/kg of ACRH extract; denoted as group I, II and III respectively) for tumor incidence and tumor burden (P<0.05). Significant reduction in tumor incidence (20%), tumor burden (1.5 ± 0.50), tumor volume (2.49 ± 1.70) and delayed latency period of tumor formation was observed in group I (30 mg/kg) in comparison to carcinogen control. This study indicates that ACRH extract could be a promising skin tumor promotion suppressing agent at a lower dosage (30 mg/kg). Further studies are required to elucidate the underlying mechanism(s) leading to this effect.

Matched MeSH terms: Papilloma/prevention & control*; Skin Neoplasms/prevention & control*
Epidemiology and control of chikungunya fever in Singapore

Ho K, Ang LW, Tan BH, Tang CS, Ooi PL, James L, et al.

J Infect, 2011 Apr;62(4):263-70.
PMID: 21315108 DOI: 10.1016/j.jinf.2011.02.001

OBJECTIVES: We conducted an epidemiological review of the chikungunya fever situation in Singapore and described the measures taken to prevent the chikungunya virus from becoming entrenched in the tropical city-state.
METHODS: All laboratory-confirmed cases and outbreak investigation reports maintained by the Communicable Diseases Division, Ministry of Health, and Aedes mosquito surveillance data obtained by the National Environment Agency during the period 2006 and 2009 were reviewed and analysed.
RESULTS: Sporadic cases were imported into Singapore until the first local transmission occurred in an urban area where Aedes aegypti was the predominant vector. Subsequent introduction of a mutant viral strain (A226V) in early 2008 resulted in the rapid spread to suburban and rural areas where Aedes albopictus was the primary vector. 1072 cases including 812 (75.7%) indigenous cases were reported. The main sources of importation were India and Malaysia. Foreign contract workers were identified as high-risk for indigenous infections.
CONCLUSIONS: The disease was successfully brought under control through aggressive vector control measures directed at A. albopictus. Although the incidence has sharply declined since January 2009, a high degree of vigilance is maintained to prevent a recurrence of epidemic transmission which can occur even with a well-established nationwide mosquito control programme.

Matched MeSH terms: Disease Outbreaks/prevention & control*; Alphavirus Infections/prevention & control

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