Relationship between serogroups and enterotoxin production of Escherichia coli from children with diarrhoea

It has been reported that the enterotoxigenic Escherichia coli could be serotyped in various countries and some serotypes were restricted to each area. Thus a study was conducted on 2522 Escherichia coli isolates from 501 diarrhoeal cases and 374 control cases from the Intakaw survey. Enterotoxigenic strains were isolated from 91 cases of diarrhoea and from 29 control cases. It was found that the serogroups 0126 and 0114 were associated with heat-stable (ST) and heat-labile (LT) toxin producing isolates respectively. 027 and 06 serogroups showed a correlation with ST alone and STLT producers respectively. Though the other serogroups sought were 01, 026, 0119, 0159, 0127, 0128, 0148 and 0159, it was notedthat only 60 percent of the enterotoxigenic E. clli could be serogrouped. The serotyping of flagella was also done and different patterns including H8, H12, H19, H21, H32, H38, H49 and H51 were observed.

Decontamination of vegetables by washing with natural water

In Myanmar raw vegetables are usually consumed after washing with water. The purpose of this is to determine the degree of decontamination of these vegetables after washing with different types of natural water. The samples of the vegetalbes from a local market in Yangon were collected and faecal coliforms (FC) were isolated from them using standard methods. FC counts ranged from 2.1 x 10 to 1.1 x 10(5)/gm of vegetables. The FC isolation rate was reduced by 1 log only after they were washed once with uncontaminated tap water (FCC = 0 MPN/100 ml). But, FC isolation rate of the coriander increased after washing with the contaminated pond and rever water. However, a significant reduction could be achieved after washing 3 times with uncontaminated tap water without washing hands and utensils with soap and reapective water. But after hands and utensils were washed properly, the isolation rate from vegetables was significantly reduced after washing twice. The use of contaminated water was not effective in decontaminating them.

Non-01 Vibrio cholerae isolation from flies, cooked children foods drinking water, currency notes and vegetables in Yangon

Non-01 V. cholerae isolation was done from flies, cooked children's food, drinking water, currency notes and vegetables in Yangon during 1984 to 1989. They were found in 45.7

of flies samples, 3.5

of cooked children's foods, 4.4

of drinking water samples, 5

of currency notes and 0.6

of vegetables samples. The strains of non-01 V. cholerae isolated from these sources shared identical biochemical reactions. They all were grown at both 37C and 42C and they were resistant to polymyxin B sulphate.

Thalassemia in the outpatient department of the Yangon Children's Hospital in Myanmar: knowledge, attitudes and practice in relation to thalassemia.

A maternal knowledge, attitudes and practice (KAP) study concerning the nature and prevention of thalassemia was carried out at the Yangon Children's Hospital in Myanmar. The KAP information was collected using a pretested schedule. Only 18 to 28% of the mothers knew at least one of the statements: thalassemia is a genetic disorder; both parents of thalassemic children carry abnormal genes; there is a 25% chance of recurrence in each subsequent pregnancy. Eighty-two per cent of the respondents decided not to have a further pregnancy for fear of recurrence and of these 62% were currently practising contraception. Oral contraception was the most commonly used method (56%). The median scores as well as the percent responses in favor of the three attitude scales relating to limiting thalassemic children, prenatal diagnosis and termination of pregnancy were high. Although there is a need to increase the community awareness of thalassemia in Myanmar, there is a possibility that prenatal diagnosis and pregnancy termination will be accepted for the prevention of thalassemia.

Thalassemia in the outpatient department of the Yangon Children's Hospital in Myanmar: basic hematological values of thalassemia traits.

The present study was conducted in the Outpatient Department (OPD) of Yangon Children's Hospital (YCH) during June to November 1990 to determine the hematological data of 133 Myanmar patients with thalassemia trait who were the parents of patients with known beta-thalassemia major or hemoglobin E (Hb E)/beta-thalassemia. The mean values of hemoglobin (Hb) concentration, packed cell volume (PCV), mean cell hemoglobin (MCH) and mean cell volume (MCV) were significantly lower than normal controls but the mean cell hemoglobin concentration (MCHC) was the same as controls. Increased osmotic resistance tested in 0.36% buffered saline was detected in 81-97% of cases depending on the cut-off point. High levels of Hb A2 (> 3.5%) were found in 93% of cases whereas Hb F was increased (> 0.8%) only in 23% of cases. Although the mean red cell count (RBC) was significantly higher than normal, only 79% of thalassemia traits were detected if the RBC count of > 5.0 x 10(12)/1 was taken as the discrimination limit. Other discrimination functions such as MCH/RBC, MCV/RBC, (MCV)2 x MCH x 0.01 and MCV-(RBC/10(12)/1)-(5 x Hb) - 3.4 or - 8.4 were tested for their utility in diagnosing thalassemia traits. All of them were found not to be superior to each of the simple tests (MCV, MCH, Hb A2 or osmotic fragility) in diagnosing thalassemia traits. The one tube osmotic fragility test is a the suitable test to be used in future thalassemia screening programs in Myanmar.

Thalassemia in the outpatient department of the Yangon Children's Hospital in Myanmar: cost analysis of the day-care-room services for thalassemia.

A cost analysis study for the fiscal year 1989-1990 was conducted in the day care room (DCR) for thalassemia patients at the Yangon Children's Hospital in Myanmar to provide a basis for future cost-effectiveness, cost-benefit and efficiency analyses. Two types of costs, hospital costs and costs borne by the patients' families were studied by reviewing hospital records and by interviewing family members of patients. Of the total cost of DCR services for thalassemia 74 to 75% was contributed by material costs most of which were for imported items. The cost of each transfusion visit and the annual cost per patient were Kyats 166.5 to 173.3 and Kyats 1,108.6 to 1,208.7, respectively. The median cost (range) per treatment visit and the averaged annual median cost (range) borne by the patients' families were Kyats 21 (0-302) and Kyats 107 (0-1,509), respectively.

The effect of sunlight on contaminated water

To determine the effect of sunlight on contaminated water a study was conducted in Yangoon between February to May 1990. The natural water samples were collected and faecal coliform count (FCC) was determined after 0,1,2,3,4 and 10 hours of exposure to sunlight. Sunlight has bactericidal effect on the faecal coliforms in contaminated water. FCC was zero after 2nd day of exposure by using these 3 commonly used kitchen containers: glass bottles, plastic jars and aluminum pots. Sunlight may be used to decontaminate drinking water if boiling is not possible.

The effect of cloth filters on contaminated drinking water

The effect of cloth filters on removing faecal coliforms from contaminated water was determined in Yangon by isolating faecal coliform using the multiple tube method. Three different sources of drinking water (tap, shallow well and pound) sample were subjected to filtration using one layer, two layers and asoap and water wasned single layer cloth filters. The commonly used cloth filters for filtering drinking water in Myanmar homes were not effective in removing faecal coliforms from contaminated drinking water.

Effect of alum on bacteria in water

A disinfecting property of alum on bacteria in different water types was studied. Alum concentrations of 0.025 per cent, 0.15 per cent and 0.1 per cent were added to natural waters (shallow well, pond and tube well) with and without seeded pathogens (Vibrio cholerae 01, Shigella dyseneriae type 1, enterotoxigenic Escherichia coli and Salmonella typhi). Total bacterial and faecal coliformcounts as well as counts foe the 4 specific pathogens were made at 0, 1, 2 and 4 hours after adding alum. The effects of different concentrations of alum on bacteri were compared. Because of the effect of alum (0.1 per cent) was not so effective on S.typhi, we found that the best decontamination powder of alum which is suitable for human was at 0.05 per cent. It is most effective against V.cholerae and S. dysenteria 1, removing them within 1-2 hours. Potash alum is probably a potentially useful cost-effectuve intervention measure for decontaminating household water in future community interventions.

The effect of chemical agents on contaminated water

The study was done to determine the effect of bleaching powder, alum and potassium permanganage on contaminated water. The natural water samples were collected in Yangon from February 1989 to January 1990. They were treated with these 3 chemical agents and faecal coliform (FC) count was determined by multipletube method. Bleaching powder and alum could reduce FC by 3 logs and 2 logs within 0.5 and 1 hour respectively. However, potassium permanganate could reduce only 1 log within 1 hour. As expected, the data showed that water treatment with chlorination was the most effective means of providing good microbiological quality of drinking water. After bleaching powder, potash alum was also found to be quite effective in cleaning the pathogens and turbidity from the water.

Enteric bacterial contamination of some Myanmar fruit sweets

Myanmar fruit sweets are widely eaten by our people. In the process of making these sweets, there are many ways by which they can get contaminated. The purpose of the study is to determine the degree of contamination. The percentage isolation of enteric bacteriae was the highest in the sweet-damp types and during the hot-wet season. The enteric bacteriaea were isolated more in tamarinds and the plums and the least in marian group. The Myanmar fruit sweets may be one of the potentially important vehicle to transmit diarrhoeal pathogens during the hot-wet season in Myanmar. Improvements in the personal and environmental hygiene are needed to prevent contamination during their production.

Seasonal variation in acute diarrhoea in children in two village communities in Burma

639 under-five children at Htaukkyant villages in 1979-80, and over 700 under five children at Intakaw villages in 1982-83, were followed up by daily diarrhoea surveillance and monthly anthropometry for a duration of one year. There was a definite seasonality for acute diarrhoea, the incidence rates during the monsoon months being significantly higher than those during the winter months. Bacterial agents, especially enterotoxigenic Escherichia coli, were the most common pathogens for acute diarrhoea during monsoon, and rotavirus was the most common pathogen detected during winter. Presumably, because of the cytopathic effect of rotavirus, children who developed diarrhoea during winter had smaller gain in body weights per month than those who developed diarrhoea during monsoon (being most commonly associated with enterotoxigenic Escherichia coli).

Comparative analysis between mortality of insures workers in industrial establishments and of working age population in Rangoon

Registered mortality data for 5 years ,from the Social Security Scheme Dispensaries and the Vital Statistc Section of the Central Statistical organization were studied. Proportionate mortality ratios, truncated, age-specific and age-.adjusted mortality rates and standardized mortality ratios, by sex and cause between 20-59 years of age were estimated.In both the insured and working age populations in Rangoon, infective and parasitic diseases (among which pulmonary tuberculosis formed the main portion), still remained the principal case of death, followed closely, by cardio-vascular and malignant disease. Age-specific mortality rates were higher in males than females within each population, resembling those of industrial countries. When same sex comparison between the populations was made, risk of dying was equal at (30-34) years of age, below which insured males and females, and above which working age men and women had higher risk than their counterparts. However, male industrial workers not only had the highest risk of death in accidents-violence under 35 years within its group but also had a higher chance of dying than other sub-populations from this cause in all age groups to the maximum of 13 times On the whole, workers under Social security scheme were observed to have 'healthy worker effect' as found by others. The possible causes of differences in mortality within and between in insured and general populations were underscored. The importance of proper registration of each worker including entry of age, type of occupation and duration of employment was stressed. The reliability of the data was also discussed.