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Current prevalence of Opisthorchis viverrini infection and associated risk factors in Nakhon Phanom Province, Northeastern Thailand

Chuangchaiya S, Navanesan S, Jaichuang S, Rahim MAFA, Idris ZM

Trop Biomed, 2020 Dec 01;37(4):986-999.
PMID: 33612751 DOI: 10.47665/tb.37.4.986

Opisthorchiasis caused by Opisthorchis viverrini infection is a major public health concern in Thailand. Despite many decades of national campaigns in place to reduce and control opisthorchiasis in Thailand, the infections remain to exist particularly in the northern and northeastern parts of the country. This study aimed to evaluate the current prevalence of O. viverrini infection in rural communities in northeast Thailand. A cross-sectional survey was conducted between February and October 2018 in three districts (Na Kae, That Phanom and Wang Yang) in Nakhon Phanom Province, Thailand. Demographic data were collected using a standardised questionnaire. Stool samples were collected and processed using the Kato-Katz technique to determine the presence of O. viverrini and other intestinal parasites. In total, 564 individuals were enrolled. The overall intestinal helminth infections were 15.2% (95% CI: 12.4-18.5). Species distribution included a majority of O. viverrini mono-infections (12.9%), followed by Strongyloides stercoralis (1.4%) and Taenia spp. (0.4%). The prevalence of O. viverrini was significantly higher in Wang Yang district (P = 0.022), in males (P = 0.004) and those previously positive with helminth infections (P<0.001) and received treatment of anti-helminths (P<0.001), than in their counterparts. Multivariate regression analysis revealed that being male (adjusted odds ratio [aOR] 1.77, P = 0.035) and those who previously tested positive for helminth infections (aOR 8.69, P<0.001) were significantly associated with a higher odd of O. viverrini infections, but lower in those who had previous stool examination (aOR 0.22, P = 0.001). This study demonstrated that the updated prevalence of O. viverrini infection is still high in rural communities in northeast Thailand. The data of this study will be useful to guide and improve strategies for future O. viverrini and other helminths prevention and control in this region.
Fulltext Malaria distribution and performance of malaria diagnostic methods in Malaysia (1980-2019): a systematic review

Rahim MAFA, Munajat MB, Idris ZM

Malar J, 2020 Nov 07;19(1):395.
PMID: 33160393 DOI: 10.1186/s12936-020-03470-8

BACKGROUND: Malaysia has already achieved remarkable accomplishments in reaching zero indigenous human malaria cases in 2018. Prompt malaria diagnosis, surveillance and treatment played a key role in the country's elimination success. Looking at the dynamics of malaria distribution during the last decades might provide important information regarding the potential challenges of such an elimination strategy. This study was performed to gather all data available in term of prevalence or incidence on Plasmodium infections in Malaysia over the last four decades.
METHODS: A systematic review of the published English literature was conducted to identify malaria distribution from 1980 to June 2019 in Malaysia. Two investigators independently extracted data from PubMed, Scopus, Web of Science and Elsevier databases for original papers.
RESULTS: The review identified 46 epidemiological studies in Malaysia over the 39-year study period, on which sufficient information was available. The majority of studies were conducted in Malaysia Borneo (31/46; 67.4%), followed by Peninsular Malaysia (13/46; 28.3%) and in both areas (2/46; 4.3%). More than half of all studies (28/46; 60.9%) were assessed by both microscopy and PCR. Furthermore, there was a clear trend of decreases of all human malaria species with increasing Plasmodium knowlesi incidence rate throughout the year of sampling period. The summary estimates of sensitivity were higher for P. knowlesi than other Plasmodium species for both microscopy and PCR. Nevertheless, the specificities of summary estimates were similar for microscopy (40-43%), but varied for PCR (2-34%).
CONCLUSIONS: This study outlined the epidemiological changes in Plasmodium species distribution in Malaysia. Malaria cases shifted from predominantly caused by human malaria parasites to simian malaria parasites, which accounted for the majority of indigenous cases particularly in Malaysia Borneo. Therefore, malaria case notification and prompt malaria diagnosis in regions where health services are limited in Malaysia should be strengthened and reinforced to achieving the final goal of malaria elimination in the country.
Fulltext Perceptions and prevention practices on malaria among the indigenous Orang Asli community in Kelantan, Peninsular Malaysia

Munajat MB, Rahim MAFA, Wahid W, Seri Rakna MIM, Divis PCS, Chuangchaiya S, et al.

Malar J, 2021 Apr 27;20(1):202.
PMID: 33906645 DOI: 10.1186/s12936-021-03741-y

BACKGROUND: Malaysia is on track towards malaria elimination. However, several cases of malaria still occur in the country. Contributing factors and communal aspects have noteworthy effects on any malaria elimination activities. Thus, assessing the community's knowledge, attitudes and practices (KAP) towards malaria is essential. This study was performed to evaluate KAP regarding malaria among the indigenous people (i.e. Orang Asli) in Peninsular Malaysia.
METHODS: A household-based cross-sectional study was conducted in five remote villages (clusters) of Orang Asli located in the State of Kelantan, a central region of the country. Community members aged six years and above were interviewed. Demographic, socio-economic and KAP data on malaria were collected using a structured questionnaire and analysed using descriptive statistics.
RESULTS: Overall, 536 individuals from 208 households were interviewed. Household indoor residual spraying (IRS) coverage and bed net ownership were 100% and 89.2%, respectively. A majority of respondents used mosquito bed nets every night (95.1%), but only 50.2% were aware that bed nets were used to prevent malaria. Nevertheless, almost all of the respondents (97.9%) were aware that malaria is transmitted by mosquitoes. Regarding practice for managing malaria, the most common practice adopted by the respondents was seeking treatment at the health facilities (70.9%), followed by self-purchase of medication from a local shop (12.7%), seeking treatment from a traditional healer (10.5%) and self-healing (5.9%). Concerning potential zoonotic malaria, about half of the respondents (47.2%) reported seeing monkeys from their houses and 20.1% reported entering nearby forests within the last 6 months.
CONCLUSION: This study found that most populations living in the villages have an acceptable level of knowledge and awareness about malaria. However, positive attitudes and practices concerning managing malaria require marked improvement.
Fulltext Evidence of Submicroscopic Plasmodium knowlesi Mono-Infection in Remote Indigenous Communities in Kelantan, Peninsular Malaysia

Dian ND, Muhammad AB, Azman EN, Eddie NA, Azmi NI, Yee VCT, et al.

Am J Trop Med Hyg, 2023 Nov 01;109(5):1081-1085.
PMID: 37748768 DOI: 10.4269/ajtmh.23-0184

Malaysia has maintained zero cases of indigenous human malaria since 2018. However, zoonotic malaria is still prevalent in underdeveloped areas and hard-to-reach populations. This study aimed to determine the prevalence of malaria among remote indigenous communities in Peninsular Malaysia. A cross-sectional survey was conducted in six settlements in Kelantan state, from June to October 2019. Blood samples were tested for malaria using microscopy and nested polymerase chain reaction (nPCR) targeting the Plasmodium cytochrome c oxidase subunit III (cox3) gene. Of the 1,954 individuals who appeared healthy, no malaria parasites were found using microscopy. However, nPCR revealed seven cases of Plasmodium knowlesi mono-infection (0.4%), and six out of seven infections were in the group of 19 to 40 years old (P = 0.026). No human malaria species were detected by nPCR. Analysis of the DNA sequences also showed high similarity that reflects common ancestry to other P. knowlesi isolates. These findings indicate low submicroscopic P. knowlesi infections among indigenous communities in Malaysia, requiring PCR-based surveillance to support malaria control activities in the country.