1
|
Chin KL, Suing EJ, Andong R, Foo CH, Chan SK, Jani J, Ahmed K, Mustapha ZA. First whole genome sequencing data of a Mycobacterium tuberculosis STB-T1A strain isolated from a spinal tuberculosis patient in Sabah, Malaysia. Data Brief 2024; 54:110476. [PMID: 38725551 PMCID: PMC11079456 DOI: 10.1016/j.dib.2024.110476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 04/22/2024] [Indexed: 05/12/2024] Open
Abstract
Spinal tuberculosis, also referred to as Pott's disease, presents a significant risk of severe paralysis if not promptly detected and treated, owing to complications such as spinal cord compression and deformity. This article presents the genetic analysis of a Mycobacterium tuberculosis STB-T1A strain, isolated from the spine of a 29-year-old female diagnosed with spinal tuberculosis. Genomic DNA was extracted from pure culture and subjected to sequencing using the Illumina NovaSeq 6000 sequencing system. The genome of the M. tuberculosis STB-T1A strain spans 4,367,616 base pairs with a G+C content of 65.56 % and 4174 protein-coding genes. Comparative genomic analysis, conducted via single nucleotide polymorphism (SNP)-based phylogenetic analysis using the Maximum Likelihood method, revealed that the strain falls within the Indo-Oceanic lineage (Lineage 1). It clusters with the M. tuberculosis 43-16836 strain, which was isolated from the cerebrospinal fluid of a patient with tuberculous meningitis in Thailand. The complete genome sequence has been deposited at the National Center for Biotechnology Information (NCBI) GenBank database with the accession number JBBMVZ000000000.
Collapse
Affiliation(s)
- Kai Ling Chin
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Eraniyah Jastan Suing
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Ruhini Andong
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Choong Hoon Foo
- Department of Orthopaedics, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Sook Kwan Chan
- Department of Orthopaedics, Queen Elizabeth Hospital, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Jaeyres Jani
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Zainal Arifin Mustapha
- Department of Medical Education, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| |
Collapse
|
2
|
Naserrudin NA, Adhikari B, Culleton R, Hod R, Saffree Jeffree M, Ahmed K, Hassan MR. Exploring community participation in vectorborne disease control in Southeast Asia: a scoping review protocol. BMJ Open 2024; 14:e079963. [PMID: 38740505 PMCID: PMC11097889 DOI: 10.1136/bmjopen-2023-079963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Accepted: 04/29/2024] [Indexed: 05/16/2024] Open
Abstract
INTRODUCTION Vector borne diseases (VBDs) present significant public health challenges in Southeast Asia (SEA), and the increasing number of cases threatens vulnerable communities. Inadequate vector control and management have been linked to the spread of VBDs. To address these issues, community participation has been proposed as a promising approach to enhance health programmes and control of VBDs. This article outlines a protocol for a scoping review of the published literature on community-participation approaches to control VBDs in the SEA region. The primary research question is 'How does community participation complement the control of VBDs in SEA?' This review aims to provide an overview of various approaches and identify barriers and facilitators to effective implementation. METHODS AND ANALYSIS The research questions will guide the scoping review. In stage 1, peer-reviewed publications from PubMed, Web of Science and Scopus will be searched using predefined search terms related to community-based approaches and VBDs in the SEA region, English, Indonesian and Malay published between 2012 and 2022. In stage 2, the references from relevant articles will be screened for eligibility. In stage 3, eligible articles will be charted in Microsoft Excel to facilitate the review process, and studies will be characterised based on the investigated diseases; this review will also highlight the methodological context of these studies. In stage 4, a thematic analysis will be conducted to derive meaningful findings from the dataset relevant to the research inquiry, followed by writing the results in stage 5. This scoping review aims to be the first to explore community participation in VBD control in the SEA population, providing valuable insights for future research and stakeholders involved in disease control. ETHICS AND DISSEMINATION This scoping review does not require ethical approval because the methodology synthesises information from available articles. This review is planned for dissemination in academic journals, conference presentations and shared with stakeholders as part of knowledge sharing among those involved in VBD control.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Center for Health Services Research, Institutes of Health Systems Research, National Institutes of Health, Ministry of Health, Selangor, Shah Alam, Malaysia
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| |
Collapse
|
3
|
Ahmed K, Thornton M, Taylor SJG. Mechanical load applied by Intraosseous Transcutaneous Amputation Prosthesis (ITAP) during walking on level and sloped treadmill: A case study. Med Eng Phys 2024; 124:104097. [PMID: 38418026 DOI: 10.1016/j.medengphy.2023.104097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 03/01/2024]
Abstract
This proof of concept study presents a method to collect and analyse kinetic data from one participant with a transfemoral amputation fitted with a percutaneous osseointegrated implant walking on a level and sloped treadmill. We describe the construction of and results from a bespoke wireless six axis load cell built into one participant's prosthetic assembly. The load cell does not clinically compromise the participant in any way and is an initial milestone in the development of a light-weight wireless load cell for use with percutaneous osseointegrated implants. In this case, it is the first time that kinetic data from a participant fitted with an Intraosseous Transcutaneous Amputation Prosthesis has been published. We propose that the data can be used to model the load transfer to the host bone, with several clinically significant applications. The raw dynamic data are made available and quasi-static load cases for each functional phase of gait are presented. Peak forces obtained in the medio-lateral (X), cranio-caudal (Y) and antero-posterior (Z) axes over level ground respectively were -243.8 N (0.24 BW), 1321.5 N (1.31 BW) and -421.8 N (0.42 BW); uphill were -141.0 N (0.14 BW), 1604.2 N (1.59 BW), -498.1 N (0.49 BW); downhill were -206.0 N (0.20 BW), 1103.9 N (1.09 BW), -547.2 N (0.54 BW). The kinetics broadly followed able bodied gait patterns with some gait strategies consistent in participants with other implant designs or prosthetic socket connections, for example offloading the artificial limb downhill.
Collapse
Affiliation(s)
- K Ahmed
- Department of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK; Center for Bionics and Pain Research, Mölndals Sjukhus, 431 30 Sweden.
| | - M Thornton
- Department of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK; Motor Learning Laboratory, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| | - S J G Taylor
- Department of Orthopaedics and Musculoskeletal Science, Division of Surgery and Interventional Science, University College London, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK
| |
Collapse
|
4
|
Maluda MCM, Johnson E, Robinson F, Jikal M, Fong SY, Saffree MJ, Fornace KM, Ahmed K. The incidence, and spatial trends of cholera in Sabah over 15 years: Repeated outbreaks in coastal areas. PLOS Glob Public Health 2024; 4:e0002861. [PMID: 38289918 PMCID: PMC10826939 DOI: 10.1371/journal.pgph.0002861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 01/07/2024] [Indexed: 02/01/2024]
Abstract
Vibrio cholerae remains a notable public health challenge across Malaysia. Although the Malaysian state of Sabah is considered a cholera-affected area, gaps remain in understanding the epidemiological trends and spatial distribution of outbreaks. Therefore, to determine longitudinal and spatial trends in cholera cases data were obtained from the Sabah State Health Department for all notified cases of cholera between 2005-2020. A cholera outbreak is defined as one or more confirmed cases in a single locality with the evidence of local transmission. All records were geolocated to village level. Satellite-derived data and generalised linearized models were used to assess potential risk factors, including population density, elevation, and distance to the sea. Spatiotemporal clustering of reported cholera cases and zones of increased cholera risk were evaluated using the tau statistic (τ) at 550m, 5km and 10km distances. Over a 15-year period between 2005-2020, 2865 cholera cases were recorded in Sabah, with a mean incidence rate of 5.6 cases per 100,000 (95% CI: 3.4-7.9). From 2015-2020, 705 symptomatic cases and 727 asymptomatic cases were reported. Symptomatic cases primarily occurred in local Malaysian populations (62.6%, 441/705) and in children and adolescents under 15-years old (49.4%, 348/705). On average, cases were reported in areas with low population density (19.45 persons/km2), low elevations (19.45m) and near coastal areas. Spatiotemporal clustering of cholera cases was identified up to 3.5km, with increased village-level cholera risk within 500m and 5 days of initial case presentation to a health facility (Risk Ratio = 9.7, 95% CI: 7.5-12.4). Cholera incidence has high spatial and temporal heterogeneity within Sabah, with some districts experiencing repeated outbreaks. Cholera cases clustered across space and time, with village-level risk of cholera highest within 5 days and within close proximity to primary case villages, suggesting local transmission.
Collapse
Affiliation(s)
- Marilyn Charlene Montini Maluda
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Emilia Johnson
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
| | - Fredie Robinson
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Muhammad Jikal
- Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Siat Yee Fong
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohammad Jeffree Saffree
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kimberly M. Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, United Kingdom
- Faculty of Infectious and Tropical Diseases and Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, United Kingdom
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan
| |
Collapse
|
5
|
Naserrudin NA, Adhikari B, Culleton R, Hod R, Jeffree MS, Ahmed K, Hassan MR. Knowledge, compliance, and challenges in anti-malarial products usage: a systematic review of at-risk communities for zoonotic malaria. BMC Public Health 2024; 24:317. [PMID: 38287308 PMCID: PMC10823597 DOI: 10.1186/s12889-024-17792-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Accepted: 01/16/2024] [Indexed: 01/31/2024] Open
Abstract
BACKGROUND Zoonotic malaria is a growing public health threat in the WHO Southeast Asia (SEA) and Western Pacific (WP) regions. Despite vector-control measures, the distribution of Macaque fascicularis and M. nemestrina, and Anopheles mosquitoes carrying non-human simian malaria parasites poses challenges to malaria elimination. The systematic review assesses the literature on knowledge and malaria-preventive practices in zoonotic malaria-affected areas across the WHO SEA and WP, aiming to identify challenges for malaria control. METHODS Peer-reviewed articles published in English, Malay and Indonesian between January 2010 and December 2022 were searched in OVID Medline, Scopus, Web of Science, and Google Scholar. Studies of any design-excluding reviews, conference proceedings, and reports from all WHO SEA and WP countries vulnerable to zoonotic malaria-were included. Backwards-reference screening and thematic analysis were conducted. RESULTS Among 4,174 initially searched articles, 22 peer-reviewed articles met the inclusion criteria. An additional seven articles were identified through backwards-reference screening, resulting in a total of 29 articles for this review. Half of these studies were conducted in Cambodia, Myanmar, Malaysia, and Thailand, mainly in forests and remote communities. The review highlighted inconsistencies in the operationalization of knowledge, and five major themes were identified related to knowledge: causation and transmission, symptoms, treatment, severity and complications, and malaria prevention. While participants generally had some understanding of malaria causation/transmission, minority and indigenous ethnic groups demonstrated limited knowledge and held misconceptions, such as attributing malaria to drinking dirty water. Preventive practices included traditional and non-traditional or modern methods-with a preference for traditional approaches to avoid mosquito bites. Challenges to malaria control included feasibility, cost, and access to healthcare services. CONCLUSION This review provides insights into knowledge, local understandings, and preventive practices related to malaria in the WHO SEA and WP regions. The findings highlight the need for future research to explore the knowledge of at-risk communities regarding zoonotic malaria, their perceive threat of the disease and factors exposing them to zoonotic malaria. New strategies must be developed for zoonotic malaria programs tailored to local contexts, emphasizing the significance of community participation, health education, and socio-behavioural change initiatives. It is important to consider the interconnectedness of human health, environmental and non-human primates conservation. Socio-cultural nuances should also be carefully considered in the design and implementation of these programs to ensure their effect tailored to local contexts.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Institute for Health Systems Research, National Institutes of Health, Ministry of Health, Setia Alam, Shah alam, 40170, Malaysia
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, 88400, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, 56000, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia.
| |
Collapse
|
6
|
Philip N, Ahmed K. Leptospirosis in Malaysia: current status, insights, and future prospects. J Physiol Anthropol 2023; 42:30. [PMID: 38087323 PMCID: PMC10714552 DOI: 10.1186/s40101-023-00347-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 11/16/2023] [Indexed: 12/18/2023] Open
Abstract
Among zoonotic infections, leptospirosis has a worldwide distribution and high prevalence in tropical regions. It has a broad clinical presentation from mild to severe, life-threatening infection. Leptospires, the etiological agent of leptospirosis, are found in varied ecological niches and animal species, providing a significant source of human infection. This review aims to provide the current status of leptospirosis in Malaysia and the direction for future studies. The literature search for this review was performed using PubMed, Web of Sciences, and Google Scholar databases. The incidence of leptospirosis in Malaysia from 2004 to 2020 varied; however, a large number of cases occurred during floods. Leptospira has been isolated from wild and domestic animals as well as from the environment; among them, several novel species have been identified. In Malaysia, leptospirosis infection and death were mostly associated with recreational and non-recreational water activities. Despite the endemicity of leptospirosis, the public's knowledge, attitude, and practice level are relatively low in this country. More studies are needed in Malaysia to explore the extent of leptospirosis in different settings and locations.
Collapse
Affiliation(s)
- Noraini Philip
- School of Biological Sciences, Universiti Sains Malaysia, Penang, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, University Malaysia Sabah, Kota Kinabalu, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan.
| |
Collapse
|
7
|
Fornace KM, Zorello Laporta G, Vythilingham I, Chua TH, Ahmed K, Jeyaprakasam NK, de Castro Duarte AMR, Amir A, Phang WK, Drakeley C, Sallum MAM, Lau YL. Simian malaria: a narrative review on emergence, epidemiology and threat to global malaria elimination. Lancet Infect Dis 2023; 23:e520-e532. [PMID: 37454671 DOI: 10.1016/s1473-3099(23)00298-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/19/2023] [Accepted: 04/28/2023] [Indexed: 07/18/2023]
Abstract
Simian malaria from wild non-human primate populations is increasingly recognised as a public health threat and is now the main cause of human malaria in Malaysia and some regions of Brazil. In 2022, Malaysia became the first country not to achieve malaria elimination due to zoonotic simian malaria. We review the global distribution and drivers of simian malaria and identify priorities for diagnosis, treatment, surveillance, and control. Environmental change is driving closer interactions between humans and wildlife, with malaria parasites from non-human primates spilling over into human populations and human malaria parasites spilling back into wild non-human primate populations. These complex transmission cycles require new molecular and epidemiological approaches to track parasite spread. Current methods of malaria control are ineffective, with wildlife reservoirs and primarily outdoor-biting mosquito vectors urgently requiring the development of novel control strategies. Without these, simian malaria has the potential to undermine malaria elimination globally.
Collapse
Affiliation(s)
- Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK; Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore; Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK.
| | - Gabriel Zorello Laporta
- Graduate Research and Innovation Program, Centro Universitario FMABC, Santo André, São Paulo, Brazil
| | | | | | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia; Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Nantha K Jeyaprakasam
- Biomedical Science Programme, Center for Toxicology and Health Risk Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Ana Maria Ribeiro de Castro Duarte
- Laboratory of Protozoology, Institute of Tropical Medicine of São Paulo, Universidade de São Paulo, São Paulo, Brazil; Instituto Pasteur, Secretaria de Estado da Saude de São Paulo, São Paulo, Brazil
| | - Amirah Amir
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Wei Kit Phang
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Maria Anice M Sallum
- Departamento de Epidemiologia, Faculdade de Saude Publica, Universidade de São Paulo, São Paulo, Brazil
| | - Yee Ling Lau
- Department of Parasitology, Universiti Malaya, Kuala Lumpur, Malaysia
| |
Collapse
|
8
|
Naserrudin NA, Lin PYP, Monroe A, Baumann SE, Adhikari B, Miller AC, Sato S, Fornace KM, Culleton R, Cheah PY, Hod R, Jeffree MS, Ahmed K, Hassan MR. Disentangling the intersection of inequities with health and malaria exposure: key lessons from rural communities in Northern Borneo. Malar J 2023; 22:343. [PMID: 37946259 PMCID: PMC10636872 DOI: 10.1186/s12936-023-04750-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 10/11/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The increasing incidence of Plasmodium knowlesi malaria poses a significant challenge to efforts to eliminate malaria from Malaysia. Macaque reservoirs, outdoors-biting mosquitoes, human activities, and agricultural work are key factors associated with the transmission of this zoonotic pathogen. However, gaps in knowledge regarding reasons that drive malaria persistence in rural Kudat, Sabah, Northern Borneo remain. This study was conducted to address this knowledge gap, to better understand the complexities of these entangled problems, and to initiate discussion regarding new countermeasures to address them. This study aims to highlight rural community members' perspectives regarding inequities to health relating to P. knowlesi malaria exposure. METHODS From January to October 2022, a study using qualitative methods was conducted in four rural villages in Kudat district of Sabah, Malaysia. A total of nine in-depth interviews were conducted with community and faith leaders, after the completion of twelve focus group discussions with 26 photovoice participants. The interviews were conducted using the Sabah Malay dialect, audio-recorded, transcribed, and translated into English. The research team led the discussion and analysis, which was approved by participants through member checking at the community level. RESULTS Participants identified disparity in health as a key issue affecting their health and livelihoods. Injustice in the social environment was also identified as a significant challenge, including the importance of listening to the voices of affected communities in disentangling the social and economic phenomena that can impact malaria control. Specific concerns included inadequate access to health-related resources and degradation of the environment. Participants recommended improving access to water and other necessities, increasing the availability of malaria control commodities in healthcare facilities, and developing sustainable programs to reduce socioeconomic disparities. CONCLUSION Inequities to health emerged as a key concern for malaria control in rural Kudat, Sabah. A locally targeted malaria programme cantered on improving the social and economic disparities associated with health outcomes, could be a potential strategy for malaria prevention in such areas. Community-level perspectives gathered from this study can be used as a foundation for future discussions and dialogues among policymakers and community members for achieving greater transparency, improving social equity, and interoperability in addressing P. knowlesi malaria control.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | | | - Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Phaik Yeong Cheah
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- The Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Sabah, Malaysia.
| |
Collapse
|
9
|
Naserrudin NA, Jiee SF, Habil B, Jantim A, Mohamed AFB, Dony JJF, Ibrahim SSA, Fornace KM, Hassan MR, Jeffree MS, Hod R, Culleton R, Ahmed K. The public health response to a Plasmodium malariae outbreak in Penampang district, Sabah during a COVID-19 movement control order. Malar J 2023; 22:292. [PMID: 37789320 PMCID: PMC10546630 DOI: 10.1186/s12936-023-04693-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 08/29/2023] [Indexed: 10/05/2023] Open
Abstract
BACKGROUND Since 2018, no indigenous human malaria cases has been reported in Malaysia. However, during the recent COVID-19 pandemic the World Health Organization is concerned that the pandemic might erode the success of malaria control as there are reports of increase malaria cases in resource limited countries. Little is known how the COVID-19 pandemic has impacted malaria in middle-income countries like Malaysia. Here the public health response to a Plasmodium malariae outbreak occurred in a village in Sabah state, Malaysia, during a COVID-19 movement control order is reported. METHODS An outbreak was declared following the detection of P. malariae in July 2020 and active case detection for malaria was performed by collecting blood samples from residents residing within 2 km radius of Moyog village. Vector prevalence and the efficacy of residual insecticides were determined. Health awareness programmes were implemented to prevent future outbreaks. A survey was conducted among villagers to understand risk behaviour and beliefs concerning malaria. RESULTS A total of 5254 blood samples collected from 19 villages. Among them, 19 P. malariae cases were identified, including the index case, which originated from a man who returned from Indonesia. His return from Indonesia and healthcare facilities visit coincided with the movement control order during COVID-19 pandemic when the healthcare facilities stretched its capacity and only serious cases were given priority. Despite the index case being a returnee from a malaria endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities. All cases were symptomatic and uncomplicated except for a pregnant woman with severe malaria. There were no deaths; all patients recovered following treatment with artemether-lumefantrine combination therapy. Anopheles balabacensis and Anopheles barbirostris were detected in ponds, puddles and riverbeds. The survey revealed that fishing and hunting during night, and self-treatment for mild symptoms contributed to the outbreak. Despite the index case being a returnee from a malaria-endemic area presenting with mild fever, no malaria test was performed at local healthcare facilities. CONCLUSION The outbreak occurred during a COVID-19 movement control order, which strained healthcare facilities, prioritizing only serious cases. Healthcare workers need to be more aware of the risk of malaria from individuals who return from malaria endemic areas. To achieve malaria elimination and prevention of disease reintroduction, new strategies that include multisectoral agencies and active community participation are essential for a more sustainable malaria control programme.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - Sam Froze Jiee
- Department of Community Medicine and Public Health, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Malaysia
| | - Bobby Habil
- Penampang District Health Office, Ministry of Health, Kota Kinabalu, Malaysia
| | - Anisah Jantim
- Penampang District Health Office, Ministry of Health, Kota Kinabalu, Malaysia
| | | | | | | | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases and Centre for Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | - Kamruddin Ahmed
- Borneo Medical Health and Research Centre,, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia.
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan.
| |
Collapse
|
10
|
Fornace KM, Drakeley CJ, Lindblade KA, Jelip J, Ahmed K. Zoonotic malaria requires new policy approaches to malaria elimination. Nat Commun 2023; 14:5750. [PMID: 37717079 PMCID: PMC10505154 DOI: 10.1038/s41467-023-41546-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023] Open
Abstract
WHO guidelines for classification of malaria elimination in a country require that the risk of human infection from zoonotic, as well as nonzoonotic, malaria parasites is negligible. In this Comment, the authors discuss the implications of this policy for countries, such as Malaysia, with no recent reported nonzoonotic cases but ongoing zoonotic transmission.
Collapse
Affiliation(s)
- Kimberly M Fornace
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK.
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Chris J Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | | | | | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Research Center for Global and Local Infectious Diseases, Oita University, Oita, Japan
| |
Collapse
|
11
|
Dutta M, Kadirvel G, Borah P, Sinha S, Ahmed K, Hazarika G, Sharma R, Choudhury H, Deori S, Das Gupta M, Biswas RK, Tamuly S, Barua PM, Hussain J. Effect of membrane stabilizers on semen quality and sperm membrane protein expression during cryopreservation of goat semen. Cryo Letters 2023; 44:299-306. [PMID: 38032310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
BACKGROUND Semen cryopreservation is a complex process during which there is alteration in the expression of sperm and seminal plasma proteins, molecular weight of protein or loss of membrane proteins during the process. In order to compensate for these changes, different membrane stabilizers are used in freezing semen extenders. However, there is scarcity of such studies during cryopreservation of goat semen. OBJECTIVE To investigate the effect of membrane stabilizers on sperm membrane protein expression during cryopreservation of goat semen. MATERIALS AND METHODS A total of 36 semen ejaculates from nine Assam Hill Goat bucks aged 2 to 2.5 years was collected by artificial vagina method. Three membrane stabilizers, each at two different concentrations viz. 50 and 80 mM sucrose, 50 and 100 mM trehalose, and 100 and 150 ng per mL IGF-1 (insulin-like growth factor 1 protein) were added to Tris-citric acid fructose egg yolk glycerol (TCFEYG) extender and semen samples were cryopreserved. The sperm membrane protein profile was studied in fresh and cryopreserved semen by SDS-PAGE. RESULTS SDS- PAGE of sperm membrane extract of fresh semen revealed the presence of 24 protein bands with molecular weights ranging from 10 kDa to 240 kDa. Samples supplemented with 50 mM sucrose and 80 mM sucrose revealed 21 protein bands with molecular weights ranging from 10 kDa to 240 kDa. All the 21 protein bands were same as those observed in the sperm membrane of fresh spermatozoa, except that the 23 kDa, 29 kDa and 42 kDa bands were absent in frozen semen. Similarly, frozen semen extended with 50 mM trehalose and 100 mM trehalose revealed 22 protein bands with molecular weights ranging from 10 kDa to 240 kDa, but lacking the 29 kDa and 42 kDa bands. Proteins with molecular weights of 29 kDa, 130 kDa and 240 kDa were absent in frozen semen supplemented with 100 ng per mL IGF-1 and 150 ng per mL IGF-1. CONCLUSION The present study revealed that supplementation of tris basic extender with trehalose at 100 mM and or IGF-1 at 100 ng/mL or 150 ng per mL improves the post-thaw semen characteristics and protects certain fertility related sperm membrane proteins. Doi.org/10.54680/fr23510110612.
Collapse
Affiliation(s)
- M Dutta
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - G Kadirvel
- ICAR Research Complex for NEH Region, Umiam, Meghalaya, India
| | - P Borah
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - S Sinha
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - K Ahmed
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - G Hazarika
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - R Sharma
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | | | - S Deori
- ICAR Research Complex for NEH Region, Umiam, Meghalaya, India.
| | - M Das Gupta
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - R K Biswas
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - S Tamuly
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - P M Barua
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| | - J Hussain
- College of Veterinary Science, Assam Agricultural University, Khanapara, Assam, India
| |
Collapse
|
12
|
Tahar AS, Ong EJ, Rahardja A, Mamora D, Lim KT, Ahmed K, Kulai D, Tan CS. Emergence of equine-like G3 and porcine-like G9 rotavirus strains in Sarawak, Malaysia: 2019-2021. J Med Virol 2023; 95:e28987. [PMID: 37501648 DOI: 10.1002/jmv.28987] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/10/2023] [Accepted: 07/13/2023] [Indexed: 07/29/2023]
Abstract
Rotavirus is the leading causative viral agent of pediatric acute gastroenteritis globally, infecting mostly children 5 years old and below. Data on rotavirus prevalence in Malaysia is scarce, despite the WHO's recommendation for continuous rotavirus surveillance, and has underestimated the need for national rotavirus vaccination. Characteristics of the current rotavirus strains in Malaysia have to be determined to understand the rotavirus epidemiology and vaccine compatibility. This study sought to determine the genetic relatedness of Sarawak rotavirus strains with global strains and to determine the antigenic coverage and epitope compatibility of Rotarix and RotaTeq vaccines with the Sarawak rotavirus strains via in silico analysis. A total of 89 stool samples were collected from pediatric patients (<5 years old) with acute gastroenteritis at private hospitals in Kuching, Sarawak. Rotavirus was detected using reverse transcription-polymerase chain reaction. Positive amplicons were analyzed using nucleotide sequencing before phylogenetic analyses and assessment of epitope compatibility. Genotyping revealed G1P[8] (1/13; 7.7%), G3P[8] (3/13; 23%), G9P[4] (1/13; 7.7%), and G9P[8] (3/13; 23%), G9P[X] (1/13; 7.7%), GXP[4] (1/13; 7.7%), and GXP[8] (3/13; 23%) in samples. All wild-type Sarawak rotavirus strains, with the exception of G1, showed variations in their phylogenetic and antigenic epitope characteristics.
Collapse
Affiliation(s)
- Ahmad Syatir Tahar
- Centre for Tropical and Emerging Diseases, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Eng Joe Ong
- Borneo Medical Centre, Kuching, Sarawak, Malaysia
| | | | - Dewi Mamora
- Borneo Medical Centre, Kuching, Sarawak, Malaysia
| | | | - Kamruddin Ahmed
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Dorothy Kulai
- Universiti Teknologi Mara Sarawak, Kota Samarahan, Sarawak, Malaysia
| | - Cheng Siang Tan
- Centre for Tropical and Emerging Diseases, Faculty of Medicine and Health Sciences, Universiti Malaysia Sarawak, Kota Samarahan, Sarawak, Malaysia
| |
Collapse
|
13
|
Naserrudin NA, Lin PYP, Monroe A, Culleton R, Baumann SE, Sato S, Adhikari B, Fornace KM, Hod R, Jeffree MS, Ahmed K, Hassan MR. Exploring barriers to and facilitators of malaria prevention practices: a photovoice study with rural communities at risk to Plasmodium knowlesi malaria in Sabah, Malaysia. BMC Public Health 2023; 23:1316. [PMID: 37430300 DOI: 10.1186/s12889-023-16173-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 06/22/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND The control of Plasmodium knowlesi malaria remains challenging due to the presence of macaque monkeys and predominantly outdoor-biting Anopheles mosquitoes around human settlements. This study aims to explore the barriers and facilitators related to prevention of mosquito bites among rural communities living in Sabah, Malaysia using the participatory visual method, photovoice. METHODS From January through June 2022, 26 participants were recruited from four villages in Kudat, Sabah, using purposive sampling. Participants were male and female villagers, aged > 18 years old. After photovoice training in the villages, participants documented facilitators of and barriers related to avoiding mosquito bites using their own smartphone cameras, and provided narratives for their photos. Twelve Focus Group Discussions (FGDs) sessions in three rounds were held to share and discuss the photos, and to address challenges to the avoidance of mosquito bites. All discussions were conducted in the Sabah Malay dialect, and were video and audio recorded, transcribed, and analyzed using reflexive thematic analysis. The Ideation Model, a meta-theoretical model of behaviour change, underpinned this study. RESULTS The most common types of barriers identified by participants included (I) intrapersonal factors such as low perceived threat of malaria, (II) livelihood and lifestyle activities consisting of the local economy and socio-cultural activities, and (III) physical and social environment. The facilitators were categorized into (I) intrapersonal reasons, including having the opportunity to stay indoors, especially women who are housewives, (II) social support by the households, neaighbours and healthcare workers, and (III) support from healthcare services and malaria awareness program. Participants emphasized the importance of stakeholder's support in implementing feasible and affordable approaches to P. knowlesi malaria control. CONCLUSION Results provided insights regarding the challenges to preventing P. knowlesi malaria in rural Kudat, Sabah. The participation of communities in research was valuable in expanding knowledge of local challenges and highlighting possible ways to overcome barriers. These findings may be used to improve strategies for zoonotic malaria control, which is critical for advancing social change and minimizing health disparities in malaria prevention.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA, 15261, USA
| | - Shigeharu Sato
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Bipin Adhikari
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
| | - Rozita Hod
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Public Health Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia, 88400, Sabah, Kota Kinabalu, Malaysia.
| |
Collapse
|
14
|
Dunckley M, Ahmed K, Said A, Raza M, Dighe S, Al-Temimi A. Variability in the presentation of complicated jejunal diverticulosis. JRSM Open 2023; 14:20542704231183247. [PMID: 37425033 PMCID: PMC10328167 DOI: 10.1177/20542704231183247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/11/2023] Open
Abstract
Jejunal diverticulosis is a rare disease which normally presents for the first time with acute complications, often requiring surgical intervention. The diverticulae are acquired, occurring more commonly after middle age, but their aetiology is unclear. We discuss this condition in the context of four cases which presented to our hospital as emergencies over a five year period: small bowel obstruction, gastrointestinal haemorrhage, small bowel volvulus, and visceral perforation. Our aim is to encourage clinicians to include jejunal diverticular disease as a differential diagnosis in patients with abdominal symptoms.
Collapse
Affiliation(s)
- M.G. Dunckley
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - K. Ahmed
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - A. Said
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - M. Raza
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - S. Dighe
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| | - A. Al-Temimi
- Department of General Surgery, Dartford & Gravesham NHS Trust, Dartford, Kent, DA2 8DA, UK
| |
Collapse
|
15
|
Amit LN, John JL, Mori D, Chin AZ, Mosiun AK, Ahmed K. Increase in rotavirus prevalence with the emergence of genotype G9P[8] in replacement of genotype G12P[6] in Sabah, Malaysia. Arch Virol 2023; 168:173. [PMID: 37269384 DOI: 10.1007/s00705-023-05803-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 04/19/2023] [Indexed: 06/05/2023]
Abstract
Rotaviruses are major causative agents of acute diarrhea in children under 5 years of age in Malaysia. However, a rotavirus vaccine has not been included in the national vaccination program. To date, only two studies have been carried out in the state of Sabah, Malaysia, although children in this state are at risk of diarrheal diseases. Previous studies showed that 16%-17% of cases of diarrhea were caused by rotaviruses and that equine-like G3 rotavirus strains are predominant. Because the prevalence of rotaviruses and their genotype distribution vary over time, this study was conducted at four government healthcare facilities from September 2019 through February 2020. Our study revealed that the proportion of rotavirus diarrhea increased significantly to 37.2% (51/137) after the emergence of the G9P[8] genotype in replacement of the G12P[8] genotype. Although equine-like G3P[8] strains remain the predominant rotaviruses circulating among children, the Sabahan G9P[8] strain belonged to lineage VI and was phylogenetically related to strains from other countries. A comparison of the Sabahan G9 strains with the G9 vaccine strains used in the RotaSiil and Rotavac vaccines revealed several mismatches in neutralizing epitopes, indicating that these vaccines might not be effective in Sabahan children. However, a vaccine trial may be necessary to understand the precise effects of vaccination.
Collapse
Affiliation(s)
- Lia Natasha Amit
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Jecelyn Leaslie John
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Daisuke Mori
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Abraham Zefong Chin
- Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Andau Konodan Mosiun
- Kunak District Health Office, Ministry of Health Malaysia, Kunak, Sabah, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
| |
Collapse
|
16
|
Fornace KM, Topazian HM, Routledge I, Asyraf S, Jelip J, Lindblade KA, Jeffree MS, Ruiz Cuenca P, Bhatt S, Ahmed K, Ghani AC, Drakeley C. No evidence of sustained nonzoonotic Plasmodium knowlesi transmission in Malaysia from modelling malaria case data. Nat Commun 2023; 14:2945. [PMID: 37263994 PMCID: PMC10235043 DOI: 10.1038/s41467-023-38476-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 05/02/2023] [Indexed: 06/03/2023] Open
Abstract
Reported incidence of the zoonotic malaria Plasmodium knowlesi has markedly increased across Southeast Asia and threatens malaria elimination. Nonzoonotic transmission of P. knowlesi has been experimentally demonstrated, but it remains unknown whether nonzoonotic transmission is contributing to increases in P. knowlesi cases. Here, we adapt model-based inference methods to estimate RC, individual case reproductive numbers, for P. knowlesi, P. falciparum and P. vivax human cases in Malaysia from 2012-2020 (n = 32,635). Best fitting models for P. knowlesi showed subcritical transmission (RC < 1) consistent with a large reservoir of unobserved infection sources, indicating P. knowlesi remains a primarily zoonotic infection. In contrast, sustained transmission (RC > 1) was estimated historically for P. falciparum and P. vivax, with declines in RC estimates observed over time consistent with local elimination. Together, this suggests sustained nonzoonotic P. knowlesi transmission is highly unlikely and that new approaches are urgently needed to control spillover risks.
Collapse
Affiliation(s)
- Kimberly M Fornace
- School of Biodiversity, One Health and Veterinary Medicine, University of Glasgow, Glasgow, UK.
- Saw Swee Hock School of Public Health, National University of, Singapore, Singapore.
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK.
| | - Hillary M Topazian
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Isobel Routledge
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- University of California, San Francisco, San Francisco, USA
| | - Syafie Asyraf
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Jenarun Jelip
- Vector-borne Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Kim A Lindblade
- Global Malaria Programme, World Health Organization, Geneva, Switzerland
| | | | - Pablo Ruiz Cuenca
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Samir Bhatt
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
- Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Kamruddin Ahmed
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Azra C Ghani
- MRC Centre for Global Infectious Disease Analysis, Imperial College London, London, UK
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| |
Collapse
|
17
|
Naserrudin NA, Yong PPL, Monroe A, Culleton R, Baumann SE, Sato S, Hod R, Jeffree MS, Ahmed K, Hassan MR. Seeing malaria through the eyes of affected communities: using photovoice to document local knowledge on zoonotic malaria causation and prevention practices among rural communities exposed to Plasmodium knowlesi malaria in Northern Borneo Island. Malar J 2023; 22:166. [PMID: 37237418 DOI: 10.1186/s12936-023-04603-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 05/22/2023] [Indexed: 05/28/2023] Open
Abstract
BACKGROUND Many rural communities in Malaysian Borneo and Southeast Asia are at risk of Plasmodium knowlesi malaria. Multiple factors contribute to infection, however, a deep understanding of illness causation and prevention practices among at-risk communities remains limited. This study aims to document local knowledge on malaria causation and preventive practices of rural communities in Sabah, Malaysia, using photovoice-a participatory research method. METHODS From January to June 2022, a photovoice study was conducted with rural communities in Matunggong subdistrict, Malaysia, to explore their experiences with and local knowledge of non-human primate malaria and prevention practices. The study included (1) an introductory phase in which participants were introduced to the photovoice method; (2) a documentation phase in which participants captured and narrated photos from their communities; (3) a discussion phase in which participants discussed photos and relevant topics through a series of three focus group discussions (FGDs) per village; and (4) a dissemination phase where selected photos were shared with key stakeholders through a photo exhibition. A purposively selected sample of 26 participants (adults > 18 years old, male, and female) from four villages participated in all phases of the study. The study activities were conducted in Sabah Malay dialect. Participants and the research team contributed to data review and analyses. RESULTS Rural communities in Sabah, Malaysia possess local knowledge that attributes non-human primate malaria to natural factors related to the presence of mosquitoes that bite humans and which carry "kuman-malaria" or malaria parasite. Participants revealed various preventive practises ranging from traditional practises, including burning dried leaves and using plants that produce foul odours, to non-traditional approaches such as aerosols and mosquito repellents. By engaging with researchers and policymakers, the participants or termed as co-researchers in this study, showcased their ability to learn and appreciate new knowledge and perspectives and valued the opportunity to share their voices with policymakers. The study successfully fostered a balance of power dynamics between the co-researchers, research team members and policymakers. CONCLUSION There were no misconceptions about malaria causation among study participants. The insights from study participants are relevant because of their living experience with the non-human malaria. It is critical to incorporate rural community perspectives in designing locally effective and feasible malaria interventions in rural Sabah, Malaysia. Future research can consider adapting the photovoice methodology for further research with the community toward building locally tailored-malaria strategies.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Sabah State Health Department, Ministry of Health, 88590, Kota Kinabalu, Malaysia
| | - Pauline Pau Lin Yong
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Baltimore, MD, USA
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, 791-0295, Japan
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, University of Pittsburgh School of Public Health, Pittsburgh, PA, 15261, USA
| | - Shigeharu Sato
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, 56000, Kuala Lumpur, Malaysia.
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, 88400, Kota Kinabalu, Malaysia.
| |
Collapse
|
18
|
Naserrudin NA, Hod R, Saffree Jeffree M, Ahmed K, Hassan MR. International modified Delphi study on malaria preventive behaviour: new themes, contexts and framework for future research on Plasmodium knowlesi malaria. BMJ Open 2023; 13:e067451. [PMID: 36898744 PMCID: PMC10008207 DOI: 10.1136/bmjopen-2022-067451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/12/2023] Open
Abstract
INTRODUCTION Plasmodium knowlesi malaria is a non-human simian malaria that threatens Southeast Asian rural communities. Studies indicate that non-compliant bednet usage, travelling into the forest and working as farmers and rubber tappers put communities at risk for infection. Despite guidelines, malaria incidence increases yearly and has become a public health concern. In addition to research gaps addressing factors that influence malaria prevention behaviour in these communities, there are no specific guidelines to facilitate strategies against the threat of P. knowlesi malaria. METHOD To examine potential factors that influence malaria-prevention behaviour in communities exposed to P. knowlesi malaria, 12 malaria experts participated in a modified Delphi study; every participant maintained their anonymity throughout the study. Three Delphi rounds were conducted via different online platforms between 15 November 2021 and 26 February 2022, and consensus was achieved when 70% of the participants agreed on a particular point with a 4-5 median. The results from the open-ended questions were then subjected to thematic analysis, and the dataset generated by this study was analysed using a deductive and inductive approach. RESULTS After a systematic, iterative process, knowledge and belief, social support, cognitive and environmental factors, past experience as a malaria patient, and the affordability and feasibility of a given intervention were critical contributors to malaria-prevention behaviour. CONCLUSION Future research on P. knowlesi malaria could adapt this study's findings for a more nuanced understanding of factors that influence malaria-prevention behaviour and improve P. knowlesi malaria programmes based on the expert consensus.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| |
Collapse
|
19
|
Naserrudin NA, Hassan MR, Jeffree MS, Culleton R, Hod R, Ahmed K. A systematic review of asymptomatic Plasmodium knowlesi infection: an emerging challenge involving an emerging infectious disease. Malar J 2022; 21:373. [PMID: 36474243 PMCID: PMC9724390 DOI: 10.1186/s12936-022-04339-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 10/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND In the last decade Plasmodium knowlesi has been detected in humans throughout South East Asia. The highest risk groups for this infection are males, adults and those performing forest-related work. Furthermore, asymptomatic cases of P. knowlesi malaria have been reported including among women and children. METHODS Pubmed, Scopus and the Web of Science databases for literature describing asymptomatic P. knowlesi malaria published between 2010 and 2020 were searched. A systematic literature review was conducted to identify studies reporting the prevalence and incidence of laboratory confirmed asymptomatic P. knowlesi cases in humans, their clinical and demographic characteristics, and methods used to diagnose these cases. RESULTS By analysing over 102 papers, thirteen were eligible for this review. Asymptomatic P. knowlesi infections have been detected in 0.03%-4.0% of the population depending on region, and infections have been described in children as young as 2 years old. Various different diagnostic methods were used to detect P. knowlesi cases and there were differing definitions of asymptomatic cases in these studies. The literature indicates that regionally-differing immune-related mechanisms may play a part on the prevalence of asymptomatic P. knowlesi. CONCLUSION Differing epidemiological characteristics of asymptomatic P. knowlesi malaria in different regions reinforces the need to further investigate disease transmission mechanics. Effective public health responses to changes in P. knowlesi epidemiology require proactive intervention and multisectoral collaboration.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- grid.412113.40000 0004 1937 1557Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ,grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia ,grid.415759.b0000 0001 0690 5255Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- grid.412113.40000 0004 1937 1557Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia ,grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia
| | - Mohammad Saffree Jeffree
- grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia ,grid.265727.30000 0001 0417 0814Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Richard Culleton
- grid.255464.40000 0001 1011 3808Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Japan
| | - Rozita Hod
- grid.412113.40000 0004 1937 1557Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Kamruddin Ahmed
- grid.265727.30000 0001 0417 0814Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Sabah, Kota Kinabalu, Malaysia ,grid.265727.30000 0001 0417 0814Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| |
Collapse
|
20
|
Hussain M, Ahmed K, Begum SS, Kalita MK, Borah P, Bhuyan D, Tamuly S, Medhi D, Paul V, Chakravartya P, Sarkar M. 70 Effect of seasons and additives in Arunachali yak bull semen at different stages of processing and freezing along with fresh semen characteristics. Reprod Fertil Dev 2022. [DOI: 10.1071/rdv35n2ab70] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
|
21
|
Lim KJ, John JL, Rahim SSSA, Avoi R, Hassan MR, Jeffree MS, Ibrahim MY, Ahmed K. A 1-year cross-sectional study on the predominance of influenza among hospitalized children in a tropical area, Kota Kinabalu, Sabah. J Physiol Anthropol 2022; 41:11. [PMID: 35366938 PMCID: PMC8976348 DOI: 10.1186/s40101-022-00285-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background Children are at higher risk of influenza virus infection, and it is difficult to diagnose. They are also responsible for the transmission of influenza because of their longer viral shedding compared to adults. In Malaysia, studies on influenza in children are scarce, and as a result, policy decisions cannot be formulated to control the infection. Hence, the objective of this study is to determine the prevalence and epidemiological characteristics of influenza among children with upper respiratory symptoms in the Sabah state of Malaysia. Methods A cross-sectional study with a simple random sampling was conducted among children with upper respiratory symptoms in Sabah from 1 March 2019 to 29 February 2020. Patients admitted to a pediatric ward of Sabah Women and Children’s Hospital who presented with a fever >38 °C and cough within 48 h of admission were enrolled in this study. A nasopharyngeal swab was taken, and influenza was diagnosed by lateral flow test. Clinical features of influenza-positive children were compared with children whose results were negative. Results A total of 323 nasopharyngeal samples were collected, and 66 (20.4%) of them were positive for influenza. Fifty-six (85%) were infected by influenza A whereas ten (15%) were by influenza B virus. Higher temperature (aOR 2.03, 95% CI 1.296–3.181), less activity (aOR 2.07, 95% CI 1.158–3.693), and seizure (aOR 4.2, 95% CI 1.614–10.978) on admission were significant risk factors associated with influenza in children. Meteorology parameters such as humidity and rainfall amount were statistically significant at 95% CI [1.133 (1.024–1.255)] and 95% CI [0.946 (0.907–0.986)]. Conclusion The prevalence of influenza was high among children with upper respiratory symptoms, and they were infected predominantly with the influenza A virus. Children presented with seizures, less activity, and fever were the significant risk factors for influenza. Influenza vaccination should be prioritized as preventive measures for children.
Collapse
|
22
|
Naserrudin NA, Culleton R, Pau Lin PY, Baumann SE, Hod R, Jeffree MS, Ahmed K, Hassan MR. Generating Trust in Participatory Research on Plasmodium knowlesi Malaria: A Study with Rural Community Gatekeepers during the COVID-19 Pandemic. Int J Environ Res Public Health 2022; 19:ijerph192315764. [PMID: 36497837 PMCID: PMC9737837 DOI: 10.3390/ijerph192315764] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/15/2022] [Accepted: 11/23/2022] [Indexed: 06/01/2023]
Abstract
BACKGROUND Plasmodium knowlesi malaria is a zoonotic infection that affects rural communities in South East Asia. Although the epidemiology of the disease has been extensively researched, the voices of individuals within affected communities often go unheard. Here, we describe a study that explores the importance of gatekeepers in conducting research among rural communities, their perspectives on the challenges encountered when attempting to avoid malaria infection, and their views on participatory research. METHODS Between 1 November 2021 and 28 February 2022, we conducted a study in Kudat district, Sabah, using a multi-method design. All participants consented to the study, which included health care workers (HCWs) (n = 5), community leaders (n = 8), and faith leaders (n = 1). We conducted interviews, transect walks, and observations with gatekeepers to ensure data trustworthiness. All interviews were conducted in the Sabah Malay dialect. The sessions were audio- and video-recorded, transcribed into English and analyzed using thematic analysis. RESULTS Between 2017 and 2021, the number of cases of P. knowlesi malaria detected in humans ranged from 35 to 87 in villages under the care of the Lotong primary health care clinic. The challenges in controlling malaria include social norms, lifestyles, socioeconomic factors, environmental factors, and limitations of basic resources. Critical discussions regarding participation with the gatekeepers identified that face-to-face interviews were preferable to online discussions, and influenced willingness to participate in future research. CONCLUSION This study was conducted among village gatekeepers during the COVID-19 pandemic and generated information to drive methodological changes, opening up new ideas by sharing perspectives on challenges in P. knowlesi malaria control among vulnerable communities. The study generated trust in the community and expanded knowledge regarding participation that is critical for future community-based studies.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Sabah State Health Department, Ministry of Health, Kota Kinabalu 88590, Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Ehime, Matsuyama 791-0295, Japan
| | - Pauline Yong Pau Lin
- Faculty of Social Sciences and Humanities, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Sara Elizabeth Baumann
- Department of Behavioral and Community Health Sciences, School of Public Health, University of Pittsburgh, Pittsburgh, PA 15261, USA
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Department of Public Health Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| |
Collapse
|
23
|
Tambat N, Mulani SK, Ahmad A, Shaikh SB, Ahmed K. Pyrazine Derivatives—Versatile Scaffold. Russ J Bioorg Chem 2022. [DOI: 10.1134/s1068162022050259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
24
|
Bin Said I, Kouakou YI, Omorou R, Bienvenu AL, Ahmed K, Culleton R, Picot S. Systematic review of Plasmodium knowlesi in Indonesia: a risk of emergence in the context of capital relocation to Borneo? Parasit Vectors 2022; 15:258. [PMID: 35850777 PMCID: PMC9290274 DOI: 10.1186/s13071-022-05375-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 06/23/2022] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The Indonesian Republic plans to relocate its capital from Jakarta to East Kalimantan, Borneo Island, in the next few years. This relocation may be associated with deforestation, decreased biodiversity, and an increased risk of emerging zoonotic infections, including Plasmodium knowlesi malaria. The Malaysian part of Borneo Island is one of the main hotspots of P. knowlesi malaria. METHODS Considering this risk, we evaluated the transmission dynamics of P. knowlesi in the Indonesian Archipelago based on a literature search and extensive review of data from the Indonesian Ministry of Health. RESULTS We report that 545 P. knowlesi cases were documented in Indonesia, mainly in the Aceh and North Sumatra provinces, with 95% of these occurring in the last 4 years. CONCLUSIONS The main P. knowlesi vectors are present in the area of the future capital, requiring strengthened surveillance to reduce the risk of emerging cases in a rapidly growing population.
Collapse
Affiliation(s)
- Ibrahim Bin Said
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, University Lyon, 69100 Villeurbanne, France
- Institut Agama Islam Negeri (IAIN) Kediri, Jawa Timur, 64127 Kota Kediri, Indonesia
| | - Yobouet Ines Kouakou
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, University Lyon, 69100 Villeurbanne, France
| | - Roukayatou Omorou
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, University Lyon, 69100 Villeurbanne, France
| | - Anne-Lise Bienvenu
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, University Lyon, 69100 Villeurbanne, France
- Service Pharmacie, Groupement Hospitalier Nord, Hospices Civils de Lyon, 69004 Lyon, France
| | - Kamruddin Ahmed
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah Malaysia
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Sabah Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Matsuyama, Japan
| | - Stephane Picot
- Malaria Research Unit, UMR 5246 CNRS-INSA-CPE-University Lyon1, University Lyon, 69100 Villeurbanne, France
- Institute of Parasitology and Medical Mycology, Hôpital de La Croix-Rousse, Hospices Civils de Lyon, 69004 Lyon, France
| |
Collapse
|
25
|
Naserrudin NA, Culleton R, Hod R, Saffree Jeffree M, Ahmed K, Hassan MR. Exploring the key anthropological drivers of and barriers to zoonotic malaria preventative behaviour in a community exposed to Plasmodium knowlesi infection in Malaysia: protocol for a qualitative study with a participatory research design. BMJ Open 2022; 12:e060866. [PMID: 35772825 PMCID: PMC9247694 DOI: 10.1136/bmjopen-2022-060866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Plasmodium knowlesi malaria is a zoonotic mosquito-borne disease with complex epidemiology. According to the WHO, the prevention and control of vector-borne diseases require community participation to increase coherence between malaria interventions and sustainable public health programmes. We describe a participatory research (PR) design for a study aimed at exploring the key anthropological drivers of and barriers to zoonotic malaria preventive behaviour among communities exposed to P. knowlesi infection in Malaysia. Participatory approaches can facilitate policymakers in designing future zoonotic malaria control programmes by investigating community perspectives and concerns about zoonotic malaria in a local context. METHODS AND ANALYSIS The PR will be conducted over a period of 12 months, from March 2022 to March 2023, among adults (>18 years old) who are permanent residents in a rural village exposed to P. knowlesi malaria in Sabah, Malaysia. We will select patients who were diagnosed with P. knowlesi infection from January to December 2021 for focus group discussions (FGDs), as they can provide perspectives on the disease from the point of view of those previously diagnosed with infection. In-depth interviews (IDIs) with people of importance in the community, such as village heads, will also be conducted. Both FGDs and IDIs will be conducted from March 2022 until June 2022. Concurrently, a photovoice with adults over 18 years old who reside in the community will be conducted. The target sample sizes for FGDs, IDIs and photovoice are 6-8, 12 and 10-15 participants, respectively. We will use a study framework as a theoretical lens to guide the exploration of the beliefs, social contexts, barriers and drivers surrounding zoonotic malaria preventive behaviour. ETHICS AND DISSEMINATION This study has been approved by the Medical Research and Ethics Committee Ministry of Health Malaysia (NMRR ID-21-01980-JEH) and the Research and Innovation Secretariat, Faculty of Medicine, Universiti Kebangsaan Malaysia (FF-2021-462). All participants will provide consent prior to participation. The results will be reported in international peer-reviewed journals and presented at conferences and on other platforms.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Matsuyama, Ehime, Japan
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| | - Mohammad Saffree Jeffree
- Public Health Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Bangi, Kuala Lumpur, Malaysia
| |
Collapse
|
26
|
Ahmed K, Breuer J, Huynh K, Abi-Jaoudeh N. Abstract No. 277 Racial disparity in acute pulmonary embolism treatment. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
|
27
|
Naserrudin NA, Monroe A, Culleton R, Hod R, Jeffree MS, Ahmed K, Hassan MR. Reimagining zoonotic malaria control in communities exposed to Plasmodium knowlesi infection. J Physiol Anthropol 2022; 41:14. [PMID: 35413881 PMCID: PMC9004057 DOI: 10.1186/s40101-022-00288-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 03/31/2022] [Indexed: 12/21/2022] Open
Abstract
Plasmodium knowlesi malaria infection in humans has been reported throughout southeast Asia. The communities at risk are those living in areas where Macaque monkeys and Anopheles mosquito are present. Zoonotic malaria control is challenging due to the presence of the reservoir host and the possibility of human-vector-human transmission. Current control measures, including insecticide-treated nets (ITNs) and indoor residual spraying (IRS), are insufficient to address this threat due to gaps in protection associated with outdoor and early evening vector biting and social and economic activities, such as agricultural and forest work. Understanding the challenges faced by affected communities in preventing mosquito bites is important for reducing disease transmission. This opinion paper discusses opportunities to improve P. knowlesi malaria control through understanding the challenges faced by communities at risk and increasing community engagement and ownership of control measures. The paper highlights this issue by describing how the concept of reimagining malaria can be adapted to zoonotic malaria control measures including identifying current gaps in vector control, understanding interactions between environmental, economic, and human behavioral factors, and increasing community participation in and ownership of control measures.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.,Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Sabah State Health Department, Ministry of Health, Kota Kinabalu, Malaysia
| | - April Monroe
- Johns Hopkins Center for Communication Programs, Johns Hopkins Bloomberg School of Public Health, Baltimore, USA
| | - Richard Culleton
- Department of Molecular Parasitology, Proteo-Science Centre, Ehime University, Matsuyama, Japan
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia
| | - Muhammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia, Kota Kinabalu, Sabah, Malaysia.,Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Kuala Lumpur, Malaysia.
| |
Collapse
|
28
|
Naserrudin NA, Hod R, Jeffree MS, Ahmed K, Hassan MR. The Emerging Threat of Plasmodium knowlesi Malaria Infection: A Concept Paper on the Vulnerable Factors in Human. Int J Environ Res Public Health 2022; 19:ijerph19074419. [PMID: 35410098 PMCID: PMC8998343 DOI: 10.3390/ijerph19074419] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Revised: 03/28/2022] [Accepted: 04/03/2022] [Indexed: 02/01/2023]
Abstract
In South-East Asia (SEA), there has been an increase in the trend of detected and reported cases of Plasmodium knowlesi malaria in the last few decades. This higher transmission rate within SEA countries is attributed to the distribution of the Macaque, banded leaf monkeys, and Anopheles mosquito in this region. This study aims to propose a concept that highlights the integration of vulnerability factors to P. knowlesi malaria infection. The relevant literature on the vulnerability factors of P. knowlesi was reviewed. Any theories and models that could be integrated to support the factors were also explored throughout this study. Exposure to P. knowlesi malaria was found to be influenced by sociodemographic, socioeconomic, environmental, social context, belief, and human behaviour factors. However, these factors were commonly discussed separately in existing studies. For better disease prevention and control, all these factors should be explored collectively, to facilitate research aimed at generating a deeper understanding of the vulnerability factors to P. knowlesi malaria from various perspectives, including the genetic, sociodemographic, socioeconomic, environmental, sociocultural beliefs, and human behaviour of the population.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Sabah State Health Department, Ministry of Health, Putrajaya 62590, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Department of Public Health, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
- Correspondence:
| |
Collapse
|
29
|
Naserrudin NA, Hod R, Jeffree MS, Ahmed K, Hassan MR. Expert Consensus on a Proposed Study Framework to Explore Factors Influencing Plasmodium knowlesi Malaria Preventive Behavior: A Modified Delphi Method Protocol. Int J Environ Res Public Health 2022; 19:ijerph19074141. [PMID: 35409824 PMCID: PMC8998657 DOI: 10.3390/ijerph19074141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 03/25/2022] [Accepted: 03/29/2022] [Indexed: 12/10/2022]
Abstract
The increasing incidence of P. knowlesi malaria infection among humans is a public health threat. This zoonotic disease is challenging to eliminate owing to the presence of animal reservoirs. Understanding the factors such as the community’s belief, social context, drivers, and barriers can provide insights into malaria preventive behavior. It is crucial to improve the current preventive measures. This study aims to achieve consensus among malaria experts based on evidence from literature reviews and experts’ opinions on possible factors influencing malaria preventive behavior among communities exposed to P. knowlesi malaria infection. A modified Delphi study protocol was developed to gather experts’ consensus on the study framework to explore the factors influencing preventive behavior among communities exposed to P. knowlesi malaria infection. The framework is adapted from the ideation model, and it is integrated with other relevant theories and extensive literature reviews. We will use the modified Delphi protocol to reach a consensus. The experts will respond to each questionnaire item and a related open-ended questionnaire. Consensus is predetermined at more than 70% agreement on the items. We will use descriptive statistics and thematic analysis to analyze the data. All experts will remain anonymous to maintain the characteristics of a traditional Delphi study.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Sabah State Health Department, Ministry of Health, Kota Kinabalu 88590, Malaysia
| | - Rozita Hod
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia; (M.S.J.); (K.A.)
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu 88400, Malaysia
| | - Mohd Rohaizat Hassan
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.A.N.); (R.H.)
- Correspondence:
| |
Collapse
|
30
|
Fong SY, Mori D, John JL, Giloi N, Jeffree MS, Ahmed K. Mumps outbreak in university students: first detection of mumps virus genotype F in Borneo. Trop Med Health 2022; 50:20. [PMID: 35236426 PMCID: PMC8889699 DOI: 10.1186/s41182-022-00411-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/22/2022] [Indexed: 11/10/2022] Open
Abstract
Background In October 2016, a mumps outbreak occurred among the students living in the on-campus dormitory of a public university located in Kota Kinabalu, Sabah, Malaysia. This study aimed to investigate the outbreak and identify the genotype of the mumps virus (MuV) strain that was involved in the outbreak. Main body During the outbreak, one 21-year-old and four 20-year-old males staying in the same dormitory building were reported to have developed symptoms of mumps. Of these, two students were available during the investigation for sample collection to detect MuV by reverse transcription polymerase chain reaction (RT-PCR) of the 639-bp fragment encompassing the entire small hydrophobic (SH) gene. Nucleotide sequencing of the amplicon and phylogenetic analysis using the neighbor-joining method was performed to determine the MuV genotype. Of the two buccal swab samples, one was positive for MuV. The MuV strain in this sample belonged to genotype F and it was clustered together with genotype F strains from China with 96.84–99.68% nucleotide identity. Conclusions Genotype F has limited circulation and is endemic in mainland China. Genotype F strains occasionally reported from other countries were epidemiologically linked to China. This study is the first to report a case of genotype F MuV in Malaysia and no epidemiological link could be established with mainland China. The results provide important information that can assist in strategic planning to improve the prevention and control of mumps infection in Malaysia.
Collapse
Affiliation(s)
- Siat Yee Fong
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Daisuke Mori
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.,Department of Health Sciences, School of Medicine, Kyushu University, Fukuoka, Japan
| | - Jecelyn Leaslie John
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Nelbon Giloi
- Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohammad Saffree Jeffree
- Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia. .,Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.
| |
Collapse
|
31
|
Mori D, John JL, Sabri SIB, Shaharom SMB, Iha H, Yamaoka Y, Matsumoto T, Ahmed K. Seroepidemiological survey of the prevalence of Helicobacter pylori infection in Sabah, Malaysia. IJID Regions 2022; 2:126-129. [PMID: 35757073 PMCID: PMC9216690 DOI: 10.1016/j.ijregi.2021.12.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 12/23/2021] [Accepted: 12/26/2021] [Indexed: 12/24/2022]
|
32
|
Fornace K, Manin BO, Matthiopoulos J, Ferguson HM, Drakeley C, Ahmed K, Khoon KT, Ewers RM, Daim S, Chua TH. A protocol for a longitudinal, observational cohort study of infection and exposure to zoonotic and vector-borne diseases across a land-use gradient in Sabah, Malaysian Borneo: a socio-ecological systems approach. Wellcome Open Res 2022; 7:63. [PMID: 35284640 PMCID: PMC8886174 DOI: 10.12688/wellcomeopenres.17678.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2022] [Indexed: 11/20/2022] Open
Abstract
Introduction. Landscape changes disrupt environmental, social and biological systems, altering pathogen spillover and transmission risks. This study aims to quantify the impact of specific land management practices on spillover and transmission rates of zoonotic and vector-borne diseases within Malaysian Borneo. This protocol describes a cohort study with integrated ecological sampling to assess how deforestation and agricultural practices impact pathogen flow from wildlife and vector populations to human infection and detection by health facilities. This will focus on malaria, dengue and emerging arboviruses (Chikungunya and Zika), vector-borne diseases with varying contributions of simian reservoirs within this setting. Methods. A prospective longitudinal observational cohort study will be established in communities residing or working within the vicinity of the Stability of Altered Forest Ecosystems (SAFE) Project, a landscape gradient within Malaysian Borneo encompassing different plantation and forest types. The primary outcome of this study will be transmission intensity of selected zoonotic and vector-borne diseases, as quantified by changes in pathogen-specific antibody levels. Exposure will be measured using paired population-based serological surveys conducted at the beginning and end of the two-year cohort study. Secondary outcomes will include the distribution and infection rates of Aedes and Anopheles mosquito vectors, human risk behaviours and clinical cases reported to health facilities. Longitudinal data on human behaviour, contact with wildlife and GPS tracking of mobility patterns will be collected throughout the study period. This will be integrated with entomological surveillance to monitor densities and pathogen infection rates of Aedes and Anopheles mosquitoes relative to land cover. Within surrounding health clinics, continuous health facility surveillance will be used to monitor reported infections and febrile illnesses. Models will be developed to assess spillover and transmission rates relative to specific land management practices and evaluate abilities of surveillance systems to capture these risks.
Collapse
Affiliation(s)
- Kimberly Fornace
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Benny Obrain Manin
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Jason Matthiopoulos
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Heather M. Ferguson
- Institute of Biodiversity, Animal Health and Comparative Medicine, University of Glasgow, Glasgow, UK
| | - Chris Drakeley
- Faculty of Infectious and Tropical Diseases, London School of Hygiene & Tropical Medicine, London, UK
| | - Kamruddin Ahmed
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Koay Teng Khoon
- Sabah State Health Department, Ministry of Health, Malaysia, Kota Kinabalu, Malaysia
| | | | - Sylvia Daim
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- East Malaysia Zoonotic and Infectious Diseases Society, Kota Kinabalu, Malaysia
| | - Tock Hing Chua
- Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- East Malaysia Zoonotic and Infectious Diseases Society, Kota Kinabalu, Malaysia
| |
Collapse
|
33
|
James C, Brunckhorst O, Fanshawe J, Hammadeh M, Sheriff M, Thomas R, Williams M, Khan S, Ahmed H, Van Hemelrijck M, Stewart R, Dasgupta P, Ahmed K. Evaluating the baseline mental wellbeing of newly diagnosed prostate cancer patients. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00355-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
34
|
Ngwe Tun MM, Mori D, Sabri SB, Kugan O, Shaharom SB, John J, Soe AM, Nwe KM, Dony JF, Inoue S, Morita K, Ahmed K. Serological Evidence of Zika Virus Infection in Febrile Patients and Healthy Blood Donors in Sabah, Malaysian Borneo, 2017-2018. Am J Trop Med Hyg 2022; 106:601-606. [PMID: 34814105 PMCID: PMC8832921 DOI: 10.4269/ajtmh.21-0802] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 09/29/2021] [Indexed: 02/03/2023] Open
Abstract
Several Zika virus (ZIKV) seroprevalence studies have been conducted in Africa, Asia, Oceania, the Americas, and the Caribbean. However, studies on ZIKV seroprevalence are limited in Malaysia though several studies have shown that the disease is endemic in the Malaysian state of Sabah. To evaluate the seroprevalence of ZIKV infection, 818 serum samples were collected from febrile patients and healthy blood donors from the Kudat and Kota Kinabalu districts in Sabah from 2017 to 2018. They were screened for ZIKV infection by IgM and IgG ELISA, and positive ZIKV IgM samples were subjected to a 90% neutralization test for confirmation. Twenty-four (6% [95% CI 4 to 8]) confirmed and two (0.5% [95% CI 0.13 to 1.8]) probable ZIKV infections were detected among 400 febrile illness patients. Of 418 healthy blood donor samples, six (1.4% [95% CI 0.65 to 3]) were determined as confirmed ZIKV infections and six (1.4% [95% CI 0.65 to 3]) indicated probable ZIKV infection. This is the first study on the seroprevalence of ZIKV infections among patients and healthy blood donors in Sabah. Compared with previous studies in Malaysia, this study shows that the incidence of ZIKV infection has increased. It also suggests that a sero-surveillance system is essential to determine the circulation of ZIKV in Sabah, Malaysia.
Collapse
Affiliation(s)
- Mya Myat Ngwe Tun
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan
| | - Daisuke Mori
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Shahnaz Binti Sabri
- Department of Transfusion Medicine, Queen Elizabeth Hospital II, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Omar Kugan
- Putatan District Health Office, Ministry of Health Malaysia, Putatan, Sabah, Malaysia
| | - Saliz Binti Shaharom
- Department of Transfusion Medicine, Queen Elizabeth Hospital II, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Jecelyn John
- Borneo Medical and Health Research Center, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Aung Min Soe
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan
| | - Khine Mya Nwe
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan
| | - Jiloris Frederick Dony
- Kota Kinabalu Public Health Laboratory, Sabah State Health Department, Ministry of Health Malaysia, Kota Kinabalu, Sabah, Malaysia
| | - Shingo Inoue
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan
| | - Kouichi Morita
- Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, Nagasaki, Japan;,Address correspondence to Kouichi Morita, Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan, E-mail: or Kamruddin Ahmed, Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia, E-mail:
| | - Kamruddin Ahmed
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia;,Borneo Medical and Health Research Center, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia;,Address correspondence to Kouichi Morita, Department of Virology, Institute of Tropical Medicine and Leading Program, Nagasaki University, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan, E-mail: or Kamruddin Ahmed, Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, 88400 Kota Kinabalu, Sabah, Malaysia, E-mail:
| |
Collapse
|
35
|
Li Y, Li M, Ahmed K, Yang J, Song L, Cui ZG, Hiraku Y. Mechanistic Study of Macranthoside B Effects on Apoptotic Cell Death in Human Cervical Adenocarcinoma Cells. Folia Biol (Praha) 2022; 68:189-200. [PMID: 37256553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Macranthoside B (MB) is a triterpenoid saponin extracted from Lonicera macranthoides, a traditional Chinese medicine. In the current study, we investigated the anticancer potential of MB in various cancer cells and elucidated its underlying mechanisms. MB exposure inhibited cell proliferation, induced mitochondrial membrane potential (MMP) loss, increased sub-G1 accumulation, and resulted in cleavage of caspase-3 and PARP, which are reflective of apoptosis. In HeLa cells, MB induced down-regulation of SOD2 and GPx1, phosphorylation of Akt and PDK1, and thus promoted ROS-mediated apoptosis. This was further supported by the protection of sub-G1 accumulation, MMP loss, cleavage of caspase-3 and PARP in the presence of N-acetylcysteine (NAC). Additionally, MB induced cell death via down-regulation of ubiquitin-like with PHD and ringfinger domains 1 (UHRF1) and Bcl-xL. Taken together, this study provides a new insight into the apoptosis- inducing potential of MB, and its molecular mechanisms are associated with an increase in oxidative stress and inhibition of the PDK1/Akt pathway.
Collapse
Affiliation(s)
- Y Li
- School of Life Science and Technology, Henan Institute of Science and Technology, Xinxiang, China
| | - M Li
- School of Medicine, Xizang Minzu University, Weicheng District, Xianyang, Shaanxi, China
- Department of Environmental Health, University of Fukui School of Medical Sciences, Fukui, Japan
| | - K Ahmed
- Faculty of Eastern Medicine, Hamdard University, Islamabad, Pakistan
| | - J Yang
- School of Life Science and Technology, Henan Institute of Science and Technology, Xinxiang, China
| | - L Song
- School of Life Science and Technology, Henan Institute of Science and Technology, Xinxiang, China
| | - Z G Cui
- Department of Environmental Health, University of Fukui School of Medical Sciences, Fukui, Japan
| | - Y Hiraku
- Department of Environmental Health, University of Fukui School of Medical Sciences, Fukui, Japan
| |
Collapse
|
36
|
Kahraman H, Altay Koçak A, Albakkour K, Muftah H, Dalgıç B, Çağlar K, Ahmed K, Bozdayı G. [Investigation of Group A Rotavirus G10, G12 Genotypes Emerging in Patients with Acute Gastroenteritis in a Tertiary Care Hospital]. MIKROBIYOL BUL 2021; 55:553-567. [PMID: 34666655 DOI: 10.5578/mb.20219707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Rotaviruses are the most common cause of viral gastroenteritis with the highest mortality and morbidity rates in children aged 0-5 years. The aim of this study was to determine the frequency of rotavirus infection in patients whose stool samples were sent to microbiology laboratory to investigate the etiology of diarrhea, to investigate the rotavirus genotypes that are common in our region and G10, G12 genotypes that have recently become common in the world. Fecal samples of 476 patients aged between 0-92 years who applied between November 2016 and February 2018 were studied via immunochromatographic rapid test and enzyme-linked immunosorbent assay (ELISA) methods. ELISA positive samples were studied by nested reverse transcriptase chain reaction (RT-PCR) and genotyped by agarose gel electrophoresis. Rotavirus was found positive in 18.3% and 17% of stool samples by immunochromatographic test and ELISA, respectively. All ELISA positive samples were also detected as positive by RT-PCR. 18.5% of female patients and 15.7% of male patients were found to be positive and rotavirus positivity was not statistically significant between genders. The frequency of rotavirus in different age groups was 23.5% (6-12 years), 17.3% (13-24 months) and 16% (25-36 months). It was determined that rotavirus cases were most common in the spring. G1, G2, G3, G4, G9, G10, and G12 were detected in 37%, 7.4%, 16.1%, 6.2%, 9.9%, 2.5%, 26% of the samples, respectively. G12 was the most common genotype after G1. The most common G and P genotype combination was G1P[8] (17.2%). This was followed by G12P[8] (11.11%) and G3P[8] (11.11%). P[8] (53%) was found to be the dominant P genotype. In this study, it was observed that rotavirus, which is the cause of childhood diarrhea, can also be encountered in advanced ages and even new genotypes that infect humans worldwide may also be the causative agents. Therefore, we concluded that it is important to investigate new genotypes such as G10 and G12 in molecular epidemiological studies.
Collapse
Affiliation(s)
- Hande Kahraman
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Division of Medical Virology, Ankara, Turkey
| | - Aylin Altay Koçak
- Baskent University Faculty of Medicine, Department of Medical Microbiology, Ankara, Turkey
| | - Katren Albakkour
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Division of Medical Virology, Ankara, Turkey
| | - Hager Muftah
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Division of Medical Virology, Ankara, Turkey
| | - Buket Dalgıç
- Gazi University Faculty of Medicine, Division of Pediatric Gastroenterology, Ankara, Turkey
| | - Kayhan Çağlar
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Division of Medical Virology, Ankara, Turkey
| | - Kamruddin Ahmed
- Universiti Malaysia Sabah Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Kota Kinabalu, Sabah, Malaysia
| | - Gülendam Bozdayı
- Gazi University Faculty of Medicine, Department of Medical Microbiology, Division of Medical Virology, Ankara, Turkey
| |
Collapse
|
37
|
Hoepli A, Ahmed K, Rickli H, Eberli F, Kobza R, Pedrazzini G, Radovanovic D. Achievement of guideline recommended LDL-C goals in patients with acute myocardial infarction (AMI) in Switzerland. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
In 2016 and subsequently again in 2019 the ESC/EAS Guidelines for the Management of Dyslipidaemia established a more intensive reduction of LDL cholesterol (LDL-C) treatment recommendations. We aim to characterize patients with acute myocardial infarction (AMI) with regards to achievement of recommended LDL-C goals and their current lipid lowering therapy.
Methods
We retrospectively analysed patients with AMI admitted to Swiss hospitals between 2016 and 2020. Patients were classified as “very high risk” due to prior atherosclerotic cardiovascular disease (ACSVD) events including at least one of the following: Myocardial infarction (MI), stroke, peripheral arterial disease (PAD) and type 2 diabetes mellitus with target organ damage. The remaining patients were classified as “other risk”. LDL-C treatment recommendation goals for the “very high risk” population were set to 1.8mmol/L (2016 ESC/EAS Guidelines) or 1.4mmol/L (2019 ESC/EAS Guidelines) and for the “other risk” population to 2.6mmol/L or 1.8mmol/L. To identify differences between the two groups the Mann-Whitney test was used and for differences within a group the Kruskal-Wallis test. In-hospital outcomes were summarised as major adverse cardiac and cerebrovascular events (MACCE).
Results
Among 7114 patients included, 18.4% were categorized as “very high risk” and 81.6% as “other risk” (p<0.001). In general, the “very high risk” patients were older (69.2y vs. 63.6y, p<0.001), more likely to be men (78.8% vs. 75.3%, p=0.007), had poorer in-hospital outcomes (6.0% vs. 3.4%, p<0.001) and were more often on lipid lowering treatment (statin/ezetimibe/combination) (LLT) prior to admission (64.8% vs 14.0%, p<0.001). The overall LDL-C median for the “very high risk” population was significantly lower than for the “other risk” population (2.4mmol/L vs. 3.5mmol/L, p<0.001). In addition, median (IQR) LDL-C increased in the “other risk” group over the years from 3.5mmol/L (2.7; 4.2) in 2016 to 3.7mmol/L (3.1; 4.4) in 2020. In contrast, no change in LDL-C was observed in the patients at higher risk (Fig. 1).
Patients in the “other risk” group were more likely to miss the recommended LDL-C goals (2016 Guidelines: 80.0% vs. 75.4%, 2019 Guidelines: 94.2% vs. 89.1%). Patients without LLT prior to admission had a higher chance of not reaching the recommendations compared to patients with LLT prior to admission (without LLT: 2016: 85.3% vs. 91.0%, 2019: 96.1% vs. 96.6%), (with LLT: 2016: 50.8% vs. 66.8%, 2019: 83.2% vs.85.2%) (Fig. 2).
Conclusion
Median LDL-C levels have tended to increase in recent years in patients with very high CV risk and AMI admitted to Swiss hospitals. Despite existing lipid lowering therapies only few patients met guideline recommended LDL-C goals. Our results indicate that clinical implementation of guidelines remains to be optimised with regards to achievement of LDL-C goals to reduce CV risk and improve outcomes.
Funding Acknowledgement
Type of funding sources: None. Figure 1. LDL-C developmentFigure 2. Recommended LDL-C goal achievement
Collapse
Affiliation(s)
- A Hoepli
- University of Zurich, AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | - K Ahmed
- Novartis Pharma Switzerland AG, Rotkreuz, Switzerland
| | - H Rickli
- Cantonal Hospital St. Gallen, Klinik für Kardiologie, St. Gallen, Switzerland
| | - F Eberli
- Triemli Hospital, Zurich, Switzerland
| | - R Kobza
- Kantonsspital Lucerne, Herzzentrum, Lucerne, Switzerland
| | - G Pedrazzini
- Cardiocentro Ticino, Department of Cardiology, Lugano, Switzerland
| | - D Radovanovic
- University of Zurich, AMIS Plus Data Center, Epidemiology, Biostatistics and Prevention Institute, Zurich, Switzerland
| | | |
Collapse
|
38
|
John JL, Mori D, Amit LN, Mosiun AK, Chin AZ, Ahmed K. High proportion of norovirus infection and predominance of GII.3 [P12] genotype among the children younger than 5 in Sabah, Malaysian Borneo. J Clin Virol 2021; 143:104968. [PMID: 34509928 DOI: 10.1016/j.jcv.2021.104968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022]
Abstract
Globally, norovirus (NoV) has become one of the important causes of acute gastroenteritis (AGE) in children. It is responsible for death of children younger than 5 years in developing countries. Although there is limited information and the rate of child mortality caused by diarrhea is low in Malaysia, the burden of diarrhea is high, especially in Sabah. NoV GI, GII and GIV genogroups are known to infect humans, and GII.4 is the predominant genotype distributed worldwide. Better understanding of the etiology of NoV will help to inform policies for prevention and control. The aim of this study was to determine the burden and genotype distribution of NoV in children younger than 5 years with AGE who attended health-care facilities in Sabah, Malaysia. Diarrhea stool samples were collected from 299 children with AGE and NoV was detected by amplifying the capsid and RNA-dependent RNA polymerase gene and reverse transcription-polymerase chain reaction (RT-PCR) analysis. Nucleotide sequencing of the amplicons was used for genotypes and phylogenetic analyses . NoV-positive stool samples were found in 17.7% (53/299) among which 13/53 (24.5%), 38/53 (71.7%), and 2/53 (3.8%) identified as NoV GI, GII and combination of GI and GII, respectively. The most common genotypes were GII.3 [P12] (80%) followed by GII.6 [P7] (13.3%), and GII.17 [P17] (6.7%). In the phylogenetic tree, all Sabahan NoV samples were shown to share ancestry with their respective genotype from predominantly East Asian countries and to some extent Australia and Europe. However, the Sabahan strains formed independent clusters with significant bootstrap values, indicating a clonal spread after the strains had entered Sabah.
Collapse
Affiliation(s)
- Jecelyn Leaslie John
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Daisuke Mori
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Lia Natasha Amit
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | | | - Abraham Zefong Chin
- Department of Community and Family Medicine, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia; Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Malaysia.
| |
Collapse
|
39
|
Chin AZ, Avoi R, Atil A, Awang Lukman K, Syed Abdul Rahim SS, Ibrahim MY, Ahmed K, Jeffree MS. Risk factor of plasmodium knowlesi infection in Sabah Borneo Malaysia, 2020: A population-based case-control study. PLoS One 2021; 16:e0257104. [PMID: 34506556 PMCID: PMC8432820 DOI: 10.1371/journal.pone.0257104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In the Malaysian state of Sabah, P. knowlesi notifications increased from 2% (59/2,741) of total malaria notifications in 2004 to 98% (2030/2,078) in 2017. There was a gap regarding P. knowlesi acquisition risk factors related to practice specifically in working age group. The main objective of this study was to identify the risk factors for acquiring P. knowlesi infection in Sabah among the working age group. METHODS AND METHODS This retrospective population-based case-control study was conducted in Ranau district to assess sociodemographic, behavioural and medical history risk factors using a pretested questionnaire. The data were entered and analyzed using IBM SPSS version 23. Bivariate analysis was conducted using binary logistic regression whereas multivariate analysis was conducted using multivariable logistic regression. We set a statistical significance at p-value less than or equal to 0.05. RESULTS A total of 266 cases and 532 controls were included in the study. Male gender (AOR = 2.71; 95% CI: 1.63-4.50), spending overnight in forest (AOR = 1.92; 95% CI: 1.20-3.06), not using mosquito repellent (AOR = 2.49; 95% CI: 1.36-4.56) and history of previous malaria infection (AOR = 49.34; 95% CI: 39.09-78.32) were found to be independent predictors of P. knowlesi infection. CONCLUSIONS This study showed the need to strengthen the strategies in preventing and controlling P. knowlesi infection specifically in changing the practice of spending overnight in forest and increasing the usage of personal mosquito repellent.
Collapse
Affiliation(s)
- Abraham Zefong Chin
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Richard Avoi
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Azman Atil
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Faculty of Medicine, Department of Community Health, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Khamisah Awang Lukman
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Syed Sharizman Syed Abdul Rahim
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohd Yusof Ibrahim
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Faculty of Medicine and Health Sciences, Department of Pathology and Microbiology, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Department of Public Health Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| |
Collapse
|
40
|
Fong SY, Mori D, Rundi C, Yap JF, Jikal M, Latip ALLBA, Johnny V, Ahmed K. A five-year retrospective study on the epidemiology of hand, foot and mouth disease in Sabah, Malaysia. Sci Rep 2021; 11:17814. [PMID: 34497287 PMCID: PMC8426372 DOI: 10.1038/s41598-021-96083-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 07/27/2021] [Indexed: 11/19/2022] Open
Abstract
Hand, foot, and mouth disease (HFMD) is endemic in Malaysia, with the number of cases increasing. Sabah has experienced several HFMD outbreaks, but information on the epidemiology and molecular characteristics of responsible viruses is scarce. In this study, data of 17,574 reports of HFMD cases in Sabah from 2015 to 2019 were extracted from a public health disease surveillance system and analyzed. Twenty-one swab samples from 13 children were collected from Beaufort, Sabah, during an outbreak in August 2018 for detection and serotyping of causative viruses by semi-nested reverse transcription-polymerase chain reaction (snRT-PCR) of the VP4–VP2 region and consensus degenerate hybrid oligonucleotide primer PCR of the VP1 region, respectively. Nucleotide sequencing and phylogenetic analysis were conducted by the neighbor-joining method. The average annual incidence of HFMD was 94.3 per 100,000 people, with the greatest yearly increase between 2017 and 2018. Swabs from six children were tested positive for enterovirus, of which five were positive for CVA16 and one for EV71. All CVA16 strains belonged to sub-genotype B1a, and the EV71 strain belonged to sub-genotype B5. Phylogenetic analyses indicate that enterovirus genotype shift might be responsible for the increasing trend of HFMD in Sabah, however, further study is needed.
Collapse
Affiliation(s)
- Siat Yee Fong
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia.,Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Daisuke Mori
- Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia
| | - Christina Rundi
- Sabah State Health Department, Ministry of Health Malaysia, Jalan Mat Salleh, 88590, Kota Kinabalu, Sabah, Malaysia
| | - Jun Fai Yap
- Sabah State Health Department, Ministry of Health Malaysia, Jalan Mat Salleh, 88590, Kota Kinabalu, Sabah, Malaysia
| | - Muhammad Jikal
- Sabah State Health Department, Ministry of Health Malaysia, Jalan Mat Salleh, 88590, Kota Kinabalu, Sabah, Malaysia
| | - A L Liza Binti Abd Latip
- Beaufort Health Office, Ministry of Health Malaysia, Pekan Beaufort, 89800, Beaufort, Sabah, Malaysia
| | - Victor Johnny
- Sabah State Health Department, Ministry of Health Malaysia, Jalan Mat Salleh, 88590, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia. .,Department of Pathology and Microbiology, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Jalan UMS, 88400, Kota Kinabalu, Sabah, Malaysia.
| |
Collapse
|
41
|
Amit LN, Mori D, John JL, Chin AZ, Mosiun AK, Jeffree MS, Ahmed K. Emergence of equine-like G3 strains as the dominant rotavirus among children under five with diarrhea in Sabah, Malaysia during 2018-2019. PLoS One 2021; 16:e0254784. [PMID: 34320003 PMCID: PMC8318246 DOI: 10.1371/journal.pone.0254784] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 07/03/2021] [Indexed: 12/12/2022] Open
Abstract
Rotavirus infection is a dilemma for developing countries, including Malaysia. Although commercial rotavirus vaccines are available, these are not included in Malaysia's national immunization program. A scarcity of data about rotavirus genotype distribution could be partially to blame for this policy decision, because there are no data for rotavirus genotype distribution in Malaysia over the past 20 years. From January 2018 to March 2019, we conducted a study to elucidate the rotavirus burden and genotype distribution in the Kota Kinabalu and Kunak districts of the state of Sabah. Stool specimens were collected from children under 5 years of age, and rotavirus antigen in these samples was detected using commercially available kit. Electropherotypes were determined by polyacrylamide gel electrophoresis of genomic RNA. G and P genotypes were determined by RT-PCR using type specific primers. The nucleotide sequence of the amplicons was determined by Sanger sequencing and phylogenetic analysis was performed by neighbor-joining method. Rotavirus was identified in 43 (15.1%) children with watery diarrhea. The male:female ratio (1.9:1) of the rotavirus-infected children clearly showed that it affected predominantly boys, and children 12-23 months of age. The genotypes identified were G3P[8] (74% n = 31), followed by G1P[8] (14% n = 6), G12P[6](7% n = 3), G8P[8](3% n = 1), and GxP[8] (3% n = 1). The predominant rotavirus circulating among the children was the equine-like G3P[8] (59.5% n = 25) with a short electropherotype. Eleven electropherotypes were identified among 34 strains, indicating substantial diversity among the circulating strains. The circulating genotypes were also phylogenetically diverse and related to strains from several different countries. The antigenic epitopes present on VP7 and VP4 of Sabahan G3 and equine-like G3 differed considerably from that of the RotaTeq vaccine strain. Our results also indicate that considerable genetic exchange is occurring in Sabahan strains. Sabah is home to a number of different ethnic groups, some of which culturally are in close contact with animals, which might contribute to the evolution of diverse rotavirus strains. Sabah is also a popular tourist destination, and a large number of tourists from different countries possibly contributes to the diversity of circulating rotavirus genotypes. Considering all these factors which are contributing rotavirus genotype diversity, continuous surveillance of rotavirus strains is of utmost importance to monitor the pre- and post-vaccination efficacy of rotavirus vaccines in Sabah.
Collapse
Affiliation(s)
- Lia Natasha Amit
- Faculty of Medicine and Health Sciences, Department of Pathobiology and Medical Diagnostics, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Daisuke Mori
- Faculty of Medicine and Health Sciences, Department of Pathobiology and Medical Diagnostics, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Jecelyn Leaslie John
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Abraham Zefong Chin
- Faculty of Medicine and Health Sciences, Department of Community and Family Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Andau Konodan Mosiun
- Kunak District Health Office, Ministry of Health Malaysia, Kunak, Sabah, Malaysia
| | - Mohammad Saffree Jeffree
- Faculty of Medicine and Health Sciences, Department of Community and Family Medicine, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Kamruddin Ahmed
- Faculty of Medicine and Health Sciences, Department of Pathobiology and Medical Diagnostics, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- Faculty of Medicine and Health Sciences, Borneo Medical and Health Research Centre, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
- * E-mail:
| |
Collapse
|
42
|
Jikal M, Mori D, Yusoff AFH, Rai SB, Mukhsam MH, Ali I, Latif LA, Perianayagam AAS, Bernad E, Bailon CCE, Lee LG, Fredolin V, Ahmed K. Probable Nipa Palm Wine-Associated Hepatitis A Outbreak after Attending a Funeral Ceremony in Sabah. Am J Trop Med Hyg 2021; 105:777-782. [PMID: 34255740 DOI: 10.4269/ajtmh.21-0036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 05/06/2021] [Indexed: 11/07/2022] Open
Abstract
Foodborne outbreaks of hepatitis A virus (HAV) are most commonly associated with fresh and frozen produce and with various types of shellfish. Alcoholic beverage-borne outbreaks of hepatitis A are extremely rare. Here, we report an outbreak of hepatitis A associated with the consumption of a traditional wine at a funeral ceremony in the Sabah state of Malaysian Borneo. Confirmed cases were determined by serum anti-HAV immunoglobulin M and/or for fecal HAV by reverse transcription polymerase chain reaction (RT-PCR). The amplicons of RT-PCR were subjected to nucleotide sequencing followed by phylogenetic analysis. We conducted a 1:2 case-control study to identify the possible exposure that led to the outbreak. Sixteen patients met the case definition, they were 18 to 58 years old and 90% of them were males. The case-control study showed that the consumption of nipa palm wine during the ceremony was significantly associated (P = 0.0017) with hepatitis A infection (odds ratio, 5.44; 95% CI, 1.80-16.43). Untreated river water was used to dilute the traditional wine, which was assumed to be the source of the infection. Phylogenetically, these viruses belonged to genotype IA and formed an independent cluster with strains from Taiwan, Japan, and the Philippines. This strain might be an emerging HAV in Asian countries. Environmental assessments were performed and environmental samples were negative for HAV. The incidence of hepatitis A in Sabah was also determined and it was 0.795/100,000 population. Strict monitoring of traditional wine production should be implemented by the local authority to prevent future outbreaks.
Collapse
Affiliation(s)
- Muhammad Jikal
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Daisuke Mori
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| | - Ahmad Faudzi Hj Yusoff
- Institute of Medical Research, Ministry of Health, Jalan Pahang, Kuala Lumpur, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | | | - M Hafiz Mukhsam
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Ismail Ali
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Liza Abd Latif
- Beaufort Health Office, Ministry of Health, Pekan Beaufort, Beaufort, Sabah, Malaysia
| | | | - Esther Bernad
- Sabah State Health Department, Ministry of Health, Kota Kinabalu, Sabah, Malaysia
| | - Cynthia C E Bailon
- Beaufort Health Office, Ministry of Health, Pekan Beaufort, Beaufort, Sabah, Malaysia
| | - Lim Guan Lee
- Beaufort Health Office, Ministry of Health, Pekan Beaufort, Beaufort, Sabah, Malaysia
| | - Vielerian Fredolin
- Papar Health Office, Ministry of Health, Bandar Papar, Papar, Sabah, Malaysia
| | - Kamruddin Ahmed
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia.,Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Sabah, Malaysia
| |
Collapse
|
43
|
Naserrudin NA, Abdul Aziz EI, Aljet E, Mangunji G, Tojo B, Jeffree MS, Culleton R, Ahmed K. High incidence of asymptomatic cases during an outbreak of Plasmodium malariae in a remote village of Malaysian Borneo. PLoS Negl Trop Dis 2021; 15:e0009450. [PMID: 34081725 PMCID: PMC8205135 DOI: 10.1371/journal.pntd.0009450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 06/15/2021] [Accepted: 05/05/2021] [Indexed: 11/19/2022] Open
Abstract
An outbreak of Plasmodium malariae occurred in Sonsogon Paliu village in the remote area of Ulu Bengkoka sub-district of Kota Marudu, Northern Sabah, Malaysian Borneo from July through August 2019. This was the first outbreak of malaria in this village since 2014. On 11th July 2019 the Kota Kinabalu Public Health Laboratory notified the Kota Marudu District Health Office of a Polymerase Chain Reaction (PCR) positive case of P. malariae. This index case was a male from Sulawesi, Indonesia working for a logging company operating in Sonsogon Paliu. During the resulting outbreak, a total of 14 symptomatic cases were detected. All of these cases were positive by thick and thin blood smear examination, and also by PCR. During the outbreak, a mass blood survey screening was performed by light-microscopy and PCR. A total of 94 asymptomatic villagers 31 (33.0%) were PCR positive but thick and thin blood smear negative for P. malariae. Both symptomatic and asymptomatic cases received treatment at the district hospital. When symptomatic and asymptomatic cases were considered together, males (29/45. 64.5%) were infected more than females (16/45, 35.6%), the male:female ratio being 1.8:1. Adults were the predominant age group infected (22/45, 48.9%) followed by adolescents (19/45, 42.2%) and children under five years of age (4/45, 8.9%). This report illustrates that symptomatic and submicroscopic cases pose a challenge during P. malariae outbreaks and that PCR is a valuable tool for their identification. The rapid identification and control of imported malaria is crucial for the continued control of malaria in Malaysia. In Malaysia, malaria caused by the human-only malaria parasites has been all but eliminated, and the major obstacles to a malaria-free status are now emerging malaria caused by zoonotic transmission of Plasmodium knowlesi parasites and outbreaks caused by imported parasites. One such outbreak occurred in 2019 in a village in northern Sabah. This outbreak was unusual, as it was found to be caused by P. malariae, an often-benign human malaria parasite rarely seen in Malaysia. We investigated this outbreak and found that the index case could be traced to an Indonesian migrant worker employed in the logging industry. An additional 13 people in the village developed malaria symptoms and were subsequently found to be positive for P. malariae. A further 94 inhabitants of the village without symptoms were then tested by a sensitive PCR technique, and 31 of them were also found to be positive for the parasite. These results illustrate the threat posed by asymptomatic carriage of malaria parasites, and the importance of PCR testing for outbreaks of residual malaria in elimination settings.
Collapse
Affiliation(s)
- Nurul Athirah Naserrudin
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
- Kota Marudu District Health Office, Ministry of Health Malaysia, Kota Marudu, Malaysia
| | | | - Erdie Aljet
- Kota Marudu District Health Office, Ministry of Health Malaysia, Kota Marudu, Malaysia
| | - George Mangunji
- Kota Marudu District Health Office, Ministry of Health Malaysia, Kota Marudu, Malaysia
| | - Bumpei Tojo
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
| | - Mohammad Saffree Jeffree
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Community and Family Medicine Department, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
| | - Richard Culleton
- Division of Molecular Parasitology, Proteo-Science Center, Ehime University, Toon, Japan
| | - Kamruddin Ahmed
- Borneo Medical and Health Research Centre, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- Department of Pathobiology and Medical Diagnostics, Faculty of Medicine and Health Sciences, Universiti Malaysia Sabah, Kota Kinabalu, Malaysia
- * E-mail:
| |
Collapse
|
44
|
Chong SMY, Hung RKY, Gwozdz A, Irwin S, Eastbury J, Cross T, Ahmed K, Taylor C, Goldenberg SD, Sanderson J, Olsburgh J. 30-Day postoperative COVID-19 outcomes in 398 patients from regional hospitals utilising a designated COVID-19 minimal surgical site pathway. Ann R Coll Surg Engl 2021; 103:395-403. [PMID: 33956529 PMCID: PMC10335038 DOI: 10.1308/rcsann.2020.7072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2020] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Postoperative pulmonary complications and mortality rates during the COVID-19 pandemic have been higher than expected, leading to mass cancellation of elective operating in the UK. To minimise this, the Guy's and St Thomas' Hospital NHS Foundation Trust elective surgery hub and the executive team at London Bridge Hospital (LBH) created an elective operating framework at LBH, a COVID-19 minimal site, in which patients self-isolated for two weeks and proceeded with surgery only following a negative preoperative SARS-CoV-2 polymerase chain reaction swab. The aim was to determine the rates of rates of postoperative COVID-19 infection. METHODS The collaboration involved three large hospital trusts, covering the geographic area of south-east London. All patients were referred to LBH for elective surgery. Patients were followed up by telephone interview at four weeks postoperatively. RESULTS Three hundred and ninety-eight patients from 13 surgical specialties were included in the analysis. The median age was 60 (IQR 29-71) years. Sixty-three per cent (252/398) were female. In total, 78.4% of patients had an American Society of Anesthesiologists grade of 1-2 and the average BMI was 27.2 (IQR 23.7-31.8) kg/m2. Some 83.6% (336/402) were 'major' operations. The rate of COVID-19-related death in our cohort was 0.25% (1/398). Overall, there was a 1.26% (5/398) 30-day postoperative all-cause mortality rate. Seven patients (1.76%) reported COVID-19 symptoms, but none attended the emergency department or were readmitted to hospital as a result. CONCLUSION The risk of contracting COVID-19 in our elective operating framework was very low. We demonstrate that high-volume major surgery is safe, even at the peak of the pandemic, if patients are screened appropriately preoperatively.
Collapse
Affiliation(s)
| | | | | | - S Irwin
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | | | | | | | - C Taylor
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - SD Goldenberg
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - J Sanderson
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| | - J Olsburgh
- Guy’s and St Thomas’ Hospital NHS Foundation Trust, UK
| |
Collapse
|
45
|
Ahmed Narikkoottungal S, Siddiqui A, Constantin A, Farrow S, Ahmed K. POS1177 REVAMPING BIOLOGIC THERAPY DURING COVID-19. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.1008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background:The COVID-19 pandemic has caught us all by surprise – from governments to individuals; the medical fraternity being no exception. It has affected all walks of life; with its immense contagiosity, diverse and intriguing pathogenesis and manifestations differing from other viruses. It has indeed left humanity in dark, unchartered waters; particularly in the early months of the pandemic.Objectives:This article shares the experience, in a Rheumatology department in a District General Hospital (DGH) in the United Kingdom, of managing patients on Biologic (b) and Targeted Synthetic (ts) DMARDs, in the midst of the COVID-19 Pandemic.Methods:All Rheumatology patients at the Princess Alexandra Hospital (PAH) in Harlow newly started on a biologic or targeted synthetic DMARD between 3rd July and 3rd Oct 2020 were identified. These patients had active inflammatory arthritis. Each patient was discussed in a dedicated Multi-Disciplinary Team (MDT) meeting and a consensus on treatment reached in-line with local and National guidelines.Figure 1.A slide presented at the Essex Rheumatology Association (ERA) meeting explaining the process adopted at the Rheumatology Department at Harlow during the peak of COVID-19 pandemic with new b/ts DMARD patients.Results:Of the 50 patients identified; 39 had Rheumatoid Arthritis, 6 had Ankylosing Spondylitis and 5 had Psoriatic Arthritis. Of these 50 patients, 5 patients decided against treatment during the stage of ‘Enhanced Verbal Consent’. These patients were flaring recurrently and were in regular contact with the department. However, they were afraid to start new Biologic treatment because of the risks of Covid-19. The breakdown of the biologic agents used in the remaining 45 patients were as follows: Adalimumab:11, Rituximab: 10, Etanercept: 9, Tofacitinib: 11, Tocilizumab SC: 3, Tocilizumab IV: 1, Sarilumab: 2, Secukinumab: 1, Infliximab: 1, Baricitinib: 1, Apremilast: 1Figure 2.Breakdown of the various b/ts DMARD agents newly started in the 45 patients between 3/7/20 - 3/10/20 at PA Hospital, Harlow, UKConclusion:The over-riding principle that guided the Department during the COVID crisis was: primum non nocere (first, do no harm). The adherence to the Case Based Discussions (CBDs) positively impacted on decision making, ensuring safe initiation of Biologic DMARDs even during the height of the pandemic. This is vital to achieve early disease remission. The MDT meetings comprising Doctors, Specialist Pharmacist and Nurse Specialists ensured prompt risk stratification of individual patients. It gave patients the opportunity to be part of the decision-making - evident in the five of the fifty patients, who opted to defer the start date of their treatments. The choice of the new Biologic agent was based on the latest National COVID-19 guidelines. The agents with the shortest half-life were selected. Moreover, patients for Rituximab were given one pulsed infusion, as opposed to two infusions. Only one of the 45 patients started on a Biologic agent over this period, either was tested positive or had symptoms suggestive of COVID-19.References:[1]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7261974[2]https://rmdopen.bmj.com/content/6/2/e001314[3]https://www.nejm.org/doi/full/10.1056/nejmc2009567[4]https://www.jrheum.org/content/early/2020/05/13/jrheum.200527[5]https://www.uptodate.com/contents/coronavirus-disease-2019-covid-19-care-of-adult-patients-with-systemic-rheumatic-disease[6]www.england.nhs.uk/clinical-guide-rheumatology-patients-v1-19-march-2020.pdf[7]https://www.rheumatology.org.uk/practice-quality/covid-19-guidance[8]https://www.nice.org.uk/guidance/ng167/chapter/4-Treatment-considerations[9]https://www.gmc-uk.org/ethical-guidance/ethical-guidance-for-doctors/decision-making-and-consentAcknowledgements:We acknowledge the whole Rheumatology Dept at Harlow for their sincere team work during the COVID-19 pandemic – Sabaa Naz (Rheumatology Pharmacist), Mona Kamal Zou (Biologics Nurse Specialist), Lily Robinson (DMARD Nurse Specialist), Mary Surendran (Osteoporosis Nurse Specialist), Janet Bell (Secretary to Dr Ahmed) and Claire Stroud (Secretary to Dr Farrow).Disclosure of Interests:None declared.
Collapse
|
46
|
Aydin A, Ahmed K, Abe T, Raison N, Van Hemelrijck M, Ahmed H, Al-Jabir A, Brunckhorst O, Shinohara N, Zhu W, Zeng G, Sfakianos J, Tewari A, Gözen A, Rassweiler J, Skolarikos A, Kunit T, Knoll T, Moltzahn F, Thalmann G, Lantz Powers A, Chew B, Sarica K, Khan M, Dasgupta P. Simulation in urological training and Education (SIMULATE): A randomised controlled clinical and educational trial to determine the effect of simulation-based surgical training. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01334-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
47
|
Jasionowska S, Bochinski A, Shiatis V, Singh S, Brunckhorst O, Rees R, Ahmed K. Anterior urethroplasty for the management of urethral strictures in males: A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)00780-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
48
|
Dincer A, Brunckhorst O, Genel O, Ahmed K. Anxiety and depressive symptom prevalence in testicular cancer patients: A systematic review. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01030-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
|
49
|
Khaleeq T, Hanif U, Maqsood Y, Ahmed K, Patel A. 23 Reaudit and Completing the Audit Cycle of Quality of Informed Consent for Surgery on Neck of Femur Fracture in Royal Stoke University Hospital. Br J Surg 2021. [DOI: 10.1093/bjs/znab134.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Using guidelines highlighted by the British Orthopaedic Association an reaudit was performed within our department to assess the adequacy of informed consent for NOF fractures to complete the audit cycle. 50 patients were included in the Audit and reaudit. Risk was classified as common, less common, rare and ‘other’. The adequacy of informed consent was evaluated by assessing the quality and accuracy of documentation. Infection, bleeding risks, clots and anaesthetic risks were documented in all patients (100%). Areas of improvement were seen in the documentation of neurovascular injuries (98%), pain (90%) and altered wound healing (87%). There was no significant change in the documentation of failure of surgery (83%) and neurovascular injuries (98%). The Poorly documented risk factors from the initial audit were seen to improve which included mortality (70%), prosthetic dislocation (90%) and limb length discrepancy (50%). There has been a significant improvement in the quality of Informed consent in the department and this could be attributed to the installation of ward posters and verbal dissemination of information to junior doctors. Recommendation for interventions would be to present in the next clinical governance meeting and presenting at the new junior doctors’ induction at August.
Collapse
Affiliation(s)
- T Khaleeq
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - U Hanif
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - Y Maqsood
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - K Ahmed
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| | - A Patel
- Royal Stoke University Hospital, Stoke on Trent, United Kingdom
| |
Collapse
|
50
|
Hay D, Ahmed K, Dasgupta P, Challacombe B. O53: SO YOU WANT TO BE A ROBOTIC SURGEON? THE EFFECT OF BASELINE PSYCHOMOTOR ABILITY AND VIDEO-GAME EXPERIENCE ON ROBOTIC SURGICAL SKILL: A RANDOMISED CONTROL TRIAL. Br J Surg 2021. [DOI: 10.1093/bjs/znab117.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
We assessed whether expert mentoring improved the rate of uptake of robotic surgical skill and whether general advanced psychomotor ability (PMA), and specific video-game experience (VGE) had any impact on robotic surgical skill.
Method
Twenty robotically naive medical students were blinded and randomised to two cohorts; control (CC) and intervention (IC). Each student's initial performance on a variety of da Vinci Skills Simulator (dVSSim) exercises was measured and then reassessed following an independent practice (CC) or mentor guided practice session (IC). Outcome metrics were overall score, time to completion, economy of motion and master workspace range. Quantitative, questionnaire data was collected to evaluate the relationship between robotic surgical skill, PMA and VGE. Statistical analysis was performed with SPSS software utilising the independent t-test.
Result
On average, overall score for CC improved by 16.8% compared to 43.3% for the IC (p=0.04). Time to completion improved by 26.2% (CC) vs. 40% (IC), economy of motion by 16.5% vs. 25% and master workspace range by 8% vs. 11%. PMA correlated with better initial performances for all metrics, especially for overall score (p=0.003) and economy of motion (p=0.03). Students with more VGE had overall scores that were on average 20% better than those with little or no experience and this relationship was also seen for economy of motion and master workspace range.
Conclusion
Expert mentoring leads to a greater improvement in performance than independent practice alone. Advanced PMA correlates with greater innate robotic skill, as does VGE, but to a lesser extent.
Take-home message
1) Expert mentoring leads to a greater improvement in performance than independent practice alone. 2) Advanced PMA correlates with greater innate robotic skill, as does VGE, but to a lesser extent.
Collapse
|