Chloroquine resistance (CQR) in falciparum malaria was identified to be associated with several mutations in the chloroquine resistance transporter gene (pfcrt) that encodes the transmembrane transporter in digestive vacuole membrane of the parasite. This study aimed to investigate the point mutations across the full-length pfcrt in Plasmodium falciparum isolates in Sabah, Malaysia. A total of 31 P. falciparum positive samples collected from Keningau, Kota Kinabalu, and Kudat, Sabah, were analyzed. pfcrt was PCR amplified and cloned prior to sequence analysis. This study showed that all the previously described 10 point mutations associated with CQR at codons 72, 74, 75, 76, 97, 220, 271, 326, 356, and 371 were found with different prevalence. Besides, two novel point mutations, I166V and H273N, were identified with 22.5% and 19.3%, respectively. Three haplotypes, namely, CVMNK (29%), CVIET (3.2%), and SVMNT (67.7%), were identified. High prevalence of SVMNT among P. falciparum isolates from Sabah showed that these isolates are closer to the P. falciparum isolates from Papua New Guinea rather than to the more proximal Southeast Asian CVIET haplotype. Full-length analysis of pfcrt showed that chloroquine resistant P. falciparum in Sabah is still prevalent despite the withdrawal of chloroquine usage since 1979.
Iron deficiency anaemia (IDA) is the most prevalent micronutrient deficiency in the world affecting the general health and wellbeing of millions. In Malaysia, moderately high prevalences of anaemia have been reported amongst infants, young children and women of childbearing age. Data is scant for the adolescents. This study was undertaken to assess the iron status and dietary intake of 165 adolescents, comprising 74 male and 91 female subjects, aged 12 to 19 years, from the rural communities in Tuaran District of Sabah, Malaysia. Convenience sampling was used for the selection of study subjects. Multiple iron status indicators namely, serum ferritin (SF), transferrin saturation (TS), mean corpuscular volume (MCV) and haemoglobin (Hb) were determined for the study. The mean age of the subjects was 15.2 +/-2.1 years. While the majority of the subjects (77.6%) had normal body mass index (BMI) values, 17.6% were underweight and 4.8% overweight. About 35% to 40% of the subjects showed deficient values for haematocrit, serum ferritin, serum iron, mean corpuscular haemoglobin (MCH), mean corpuscular volume (MCV) and transferrin saturation (TS), and 20% were anaemic (Hb <12 g/L). Using the multiple criteria of iron status indicators, the prevalence of iron depletion, iron deficiency and IDA in the male and female adolescents were 5.4% vs. 6.6%, 18.9% vs. 26.4% and 5.4% vs. 26.4%, respectively. Iron deficiency anaemia (85.0%) contributed largely to the prevalence of anaemia. The dietary iron intake of the adolescents was unsatisfactory, with approximately 98% of subjects failing to meet the Malaysian RDA level. Almost all the female subjects (91%) had dietary iron intake below two-thirds of the RDA level compared with a much smaller proportion for the male adolescents (68%). The prevalence of IDA in the present study population, especially in the female adolescents, appears to be a significant public health problem. Priority should therefore be given to the eradication of iron deficiency in adolescents from low-income areas by dietary modification and micronutrient supplementation amongst female adolescents.
Dietary intakes and lifestyle habits during adolescence may predict the occurrence of obesity and other diet-related chronic diseases later in life. The purpose of this study was to determine dietary intake of adolescents in a fishing community in Tuaran District, Sabah. A total of 199 apparently healthy adolescents comprising 94 male and 105 female subjects were purposively selected for the study. The mean age of the subjects was 15.2 f 2.2 years with female subjects having a higher mean age of 15.7 f 2.4 years compared to the males (14.6 k1.8 years). The mean BMI of the subjects was 18.4 f 2.9 kg/m2 with females having a significantly higher BMI (18.9 f 2.8 kg/m2) than the males (17.8 f 3.0 kg/m2). Based on the WHO classification (WHO, 1995), 19.6% of the subjects could be classified as thin while 4.5% were at risk of overweight. Overall for both sexes, intake of energy and most nutrients were below the Malaysian recommended nutrient intake (RNI) levels for adolescents, with the exception of vitamin C and niacin. The male subjects showed higher mean intake for vitamin A, thiamine, niacin and vitamin C than the females. Calcium and iron intake ranked among the lowest levels, at 33.4% and 47.2% respectively of the RNI values for both sexes. The main sources of energy were rice, flour products and tubers while fish and seafood were the chief sources of protein. Majority of the subjects (84%) reported taking breakfast daily, which often consisted of fried noodles, fried banana, doughnuts and coffee. Consumption of snacks was popular and commonly consumed snacks were bread, biscuits, and fried banana. The present study revealed that 25.5% and 14.3% of the male and female adolescents respectively were thin, with majority of them consuming inadequate levels of energy and several key nutrients. The results underscore the need for adolescents to be targeted for nutrition and health education as they go through a period of marked physical, physiological and psychological changes.