Non-Infectious Complications in B-Lymphopenic Common Variable Immunodeficiency

BACKGROUND AND OBJECTIVE

Common variable immunodeficiency (CVID) is considered the most symptomatic type of inborn errors of immunity in humans. Along with infectious complications, which have numerous consequences, non-infectious complications are also a major challenge among CVID patients.

METHODS

All registered CVID patients in the national database were included in this retrospective cohort study. Patients were divided into two groups based on the presence of B-cell lymphopenia. Demographic characteristics, laboratory findings, non-infectious organ involvements, autoimmunity, and lymphoproliferative diseases were evaluated.

RESULTS

Among 387 enrolled patients, 66.4% were diagnosed with non-infectious complications; however, 33.6% had only infectious presentations. Enteropathy, autoimmunity, and lymphoproliferative disorders were reported in 35.1%, 24.3%, and 21.4% of patients, respectively. Some complications, including autoimmunity and hepatosplenomegaly, were reported to be significantly higher among patients with B-cell lymphopenia. Among organ involvement, dermatologic, endocrine and musculoskeletal systems were predominantly affected in CVID patients with B-cell lymphopenia. Among autoimmune manifestations, the frequency of rheumatologic, hematologic, and gastrointestinal autoimmunity was reported to be higher compared to other types of autoimmunity independent from the B cell-lymphopenia. Furthermore, hematological cancers, particularly lymphoma, were slightly introduced as the most common type of malignancy. Meanwhile, the mortality rate was 24.5%, and respiratory failure and malignancies were reported as the most common cause of death in our patients without significant differences between the two groups.

CONCLUSION

Considering that some of the non-infectious complications might be associated with B-cell lymphopenia, therefore, regular patient monitoring and follow-up along with proper medications (besides immunoglobulins replacement therapy) are highly recommended to prevent further sequels and increase the patients' quality of life.

Spatial dispersal of <em>Aedes albopictus</em> mosquitoes captured by the modified sticky ovitrap in Selangor, Malaysia

Dengue is a major mosquito-borne disease in many tropical and sub-tropical countries worldwide, with entomological surveillance and control activities as the key management approaches. This study aimed to explore the spatial dispersal of the vector Aedes albopictus, captured by the modified sticky ovitrap (MSO) in residential areas with low-rise buildings in Selangor, Malaysia. Distribution maps were created and shown as temporally distinguished classes based on hotspot analysis by Getis-Ord; spatial autocorrelation assessed by semivariograms using the exponential Kernel function; and universal Kriging showing areas with estimated high and low vector densities. Distribution, hotspot and interpolated maps were analysed based on the total number of mosquitoes by month and week. All maps in the present study were generated and visualised in ArcMap. Spatial autocorrelation of Ae. albopictus based on the monthly occurrence of Ae. albopictus was found in March, April, October, November and December 2018, and when based on the weekly numbers, in weeks 1, 2, 3, 5, 7, 12, 14, 25, 26, 27, 31, 33, 42, 49 and 52. Semivariograms, based on the monthly and weekly numbers of Ae. albopictus, indicated spatial autocorrelation of the species extending between 50 and 70 m. The mosquito density maps reported in this study may provide beneficial information to facilitate implementation of more efficient entomological control activities.

Assessing the role of urban green spaces for human well-being: a systematic review

Human has been evolving in a natural environment over a long time; thus, he is habitual to adapt it. Green spaces are obligatory landscapes in an urban structure that provide a natural environment and accelerate other life events. In contrast, unplanned urbanization, and conversion from green to grey structures have damaged natural environmental resources. Studies through different angles have highlighted the importance of urban green spaces for human well-being but now need to identify their role according to the potential. The demands of urban green spaces may differ with the change of population size, types of grey structure, urban expansion, the altitude of the place, and geographical location. Therefore, this systematic review aims to analyse the significance of urban green spaces for human well-being. The study opted for a systematic process during the selection and organization of studies for this review. After analysing, 46 studies were finalized with the consensus of three review authors. Accordingly, literature was analysed under the central theme of "Urban Green Spaces for Human Well-being." Human Well-being was assessed under six sub-themes; physical, psychological, mental, social, subjective, and environmental well-being. The review concluded that urban green spaces are the primary pillar for a sustainable urban place and human well-being due to highly positive and positive correlations. Moreover, the study did not find any demarcation line between green spaces and grey structures according to any specific need. Therefore, the study suggested that the role of urban green spaces for human well-being should be analysed according to their potential and required optimal ratio under different communities' urban specific environments and social behaviour.

A study of drying parameters on drying time and colour quality of grated coconut using tumbling mechanism in convective dryer

A small scale convective dryer with tumbling mechanism was specially constructed for drying grated coconut. This new drying mechanism was evaluated in term of drying behaviour and colour quality of the final product. Three main factors that involved were hot air temperature, rotational speed (rpm) and air velocity. Every combined parameter of a sample was compared to each other and also with freshly grated coconut. It was found that the combination of 60°C, 6 rpm and 4.31 ms-1 had the shortest drying time as well as the highest drying rate among other combinations. In contrast, combination factors of 50° C, 3 rpm and 2.06 ms-1 had the lowest drying rate. Three main factors; temperature, rotational speed and air velocity were significantly contributed to the response of drying time as (p<0.05). Drying rate also increased with increase in temperature, rotational speed and air velocity. In term of colour analysis (L*, a*, b*), there was a significant difference among dried grated coconut samples. Nevertheless, sample 60˚C, 3 rpm and 4.31 ms-1 and 50˚C, 3 rpm and 4.31 ms-1 showed no significant different (p>0.05) in lightness when compared to freshly grated coconut hence excellent in retaining its original appearance. On top of that, sample (60˚C, 3 rpm and 4.31 ms-1 ) also achieved considerable drying rate with an acceptable drying time of 135 mins.

Petrifilm™ Rapid S. aureus Count Plate Method for Rapid Enumeration of Staphylococcus aureus in Selected Foods: Collaborative Study

A rehydratable dry-film plating method for Staphylococcus aureusin foods, the 3M™ Petrifilm™ Rapid S. aureus Count Plate method, was compared with AOAC® Official MethodSM 975.55 (Staphylococcus aureus in Foods). Nine foods—instant nonfat dried milk, dry seasoned vegetable coating, frozen hash browns, frozen cooked chicken patty, frozen ground raw pork, shredded cheddar cheese, fresh green beans, pasta filled with beef and cheese, and egg custard—were analyzed for S. aureus by 13 collaborating laboratories. For each food tested, the collaborators received 8 blind test samples consisting of a control sample and 3 levels of inoculated test sample, each in duplicate. The mean log counts for the methods were comparable for pasta filled with beef and cheese; frozen hash browns; cooked chicken patty; egg custard; frozen ground raw pork; and instant nonfat dried milk. The repeatability and reproducibility variances of the Petrifilm Rapid S. aureus Count Plate method were similar to those of the standard method.

Mosquito Biology and Mosquito-Borne Disease Awareness Among Island Communities In Malaysia

Mosquito-borne diseases have been increasing at an alarming rate over the past decades. In Malaysia, one finds several important mosquito-borne diseases such as Japanese encephalitis, dengue, malaria, and chikungunya. Mosquito surveillance and control programs are the most effective way of detecting and controlling mosquito-borne diseases, but these programs are less effective without an aware and well-informed general public. In 2014 we used a questionnaire to evaluate the extent of awareness of basic mosquito biology and mosquito-borne diseases in 6 villages, Kampung Masjid, Kampung Teluk Gedung, Kampung Teluk Dalam, Kampung Ujung Kelawai, Kampung Sungai Pinang Besar, and Kampung Sungai Pinang Kechil on Pangkor Island, Malaysia. A total of 1,012 individuals responded to the questionnaire, consisting of 790 Malay (78.1%), 164 Chinese (16.2%), and 58 Indian (5.7%). More than 60% (Malay = 73.7%, Chinese = 64.0%, Indian = 79.3%) of the respondents were familiar with basic mosquito biology and practiced personal protection against mosquito bites, and the association was statistically significant (P = 0.02). However, the majority of the respondents had limited knowledge on mosquito-borne diseases, and this varied significantly among the 3 ethnic groups (P = 0.0001). Our recommendations are to improve and intensify public health education outreach programs to the island residents and to encourage community participation in vector control programs.

Erratum to: 36th International Symposium on Intensive Care and Emergency Medicine: Brussels, Belgium. 15-18 March 2016

[This corrects the article DOI: 10.1186/s13054-016-1208-6.].

Caesarean delivery and its correlates in Northern Region of Bangladesh: application of logistic regression and cox proportional hazard model

BACKGROUND

Caesarean delivery (C-section) rates have been increasing dramatically in the past decades around the world. This increase has been attributed to multiple factors such as maternal, socio-demographic and institutional factors and is a burning issue of global aspect like in many developed and developing countries. Therefore, this study examines the relationship between mode of delivery and time to event with provider characteristics (i.e., covariates) respectively.

METHODS

The study is based on a total of 1142 delivery cases from four private and four public hospitals maternity wards. Logistic regression and Cox proportional hazard models were the statistical tools of the present study.

RESULTS

The logistic regression of multivariate analysis indicated that the risk of having a previous C-section, prolonged labour, higher educational level, mother age 25 years and above, lower order of birth, length of baby more than 45 cm and irregular intake of balanced diet were significantly predict for C-section. With regard to survival time, using the Cox model, fetal distress, previous C-section, mother's age, age at marriage and order of birth were also the most independent risk factors for C-section. By the forward stepwise selection, the study reveals that the most common factors were previous C-section, mother's age and order of birth in both analysis. As shown in the above results, the study suggests that these factors may influence the health-seeking behaviour of women.

CONCLUSIONS

Findings suggest that program and policies need to address the increase rate of caesarean delivery in Northern region of Bangladesh. Also, for determinant of risk factors, the result of Akaike Information Criterion (AIC) indicated that logistic model is an efficient model.

Mapping and modelling the geographical distribution of soil-transmitted helminthiases in Peninsular Malaysia: implications for control approaches

Soil-transmitted helminth (STH) infections in Malaysia are still highly prevalent, especially in rural and remote communities. Complete estimations of the total disease burden in the country has not been performed, since available data are not easily accessible in the public domain. The current study utilised geographical information system (GIS) to collate and map the distribution of STH infections from available empirical survey data in Peninsular Malaysia, highlighting areas where information is lacking. The assembled database, comprising surveys conducted between 1970 and 2012 in 99 different locations, represents one of the most comprehensive compilations of STH infections in the country. It was found that the geographical distribution of STH varies considerably with no clear pattern across the surveyed locations. Our attempt to generate predictive risk maps of STH infections on the basis of ecological limits such as climate and other environmental factors shows that the prevalence of Ascaris lumbricoides is low along the western coast and the southern part of the country, whilst the prevalence is high in the central plains and in the North. In the present study, we demonstrate that GIS can play an important role in providing data for the implementation of sustainable and effective STH control programmes to policy-makers and authorities in charge.

Spatial distribution of malaria in Peninsular Malaysia from 2000 to 2009

BACKGROUND

Malaria is still an endemic disease of public health importance in Malaysia. Populations at risk of contracting malaria includes indigenous people, traditional villagers, mobile ethnic groups and land scheme settlers, immigrants from malaria endemic countries as well as jungle workers and loggers. The predominant species are Plasmodium falciparum and P. vivax. An increasing number of P. knowlesi infections have also been encountered. The principal vectors in Peninsular Malaysia are Anopheles maculatus and An. cracens. This study aims to determine the changes in spatial distribution of malaria in Peninsular Malaysia from year 2000-2009.

METHODS

Data for the study was collected from Ministry of Health, Malaysia and was analysed using Geographic Information System (GIS).

RESULTS

Changes for a period of 10 years of malaria spatial distribution in 12 states of Peninsular Malaysia were documented and discussed. This is illustrated by digital mapping according to five variables; incidence rate (IR), fatality rate (FR), annual blood examination rate (ABER), annual parasite index (API) and slide positivity rate (SPR).

CONCLUSION

There is a profound change in the spatial distribution of malaria within a 10-year period. This is evident from the digital mapping of the infection in Peninsular Malaysia.

Vertical infestation of the dengue vectors Aedes aegypti and Aedes albopictus in apartments in Kuala Lumpur, Malaysia

Dengue is a serious public health problem in Malaysia. The aim of this study was to compare the vertical infestation of Aedes population in 2 apartments in Kuala Lumpur with different status of dengue incidence (i.e., high-dengue-incidence area and area with no reported dengue cases). The study was also conducted to assess the relationship between environmental factors such as rainfall, temperature, and humidity and Aedes population that may influence Aedes infestation. Surveillance with a mosquito larvae trapping device was conducted for 28 continuous weeks (January to July 2012) in Vista Angkasa (VA) and Inderaloka (IL) apartments located in Kuala Lumpur, Malaysia. The results indicated that both Aedes spp. could be found from ground to higher floor levels of the apartments, with Aedes aegypti being more predominant than Ae. albopictus. Data based on mixed and single breeding of Aedes spp. on different floors did not show any significant difference. Both rainfall (R3; i.e., the amount of rainfall collected during the previous 3 wk before the surveillance period began) and RH data showed significant relationship with the number of Aedes larvae collected in VA and IL. No significant difference was found between the numbers of Aedes larvae in both study areas as well as maximum and minimum temperatures. Results also indicated adaptations of Ae. aegypti to the ecosystem at each elevation of high-rise buildings, with Ae. albopictus staying inside of apartment units.