Effective High-Throughput Blood Pooling Strategy before DNA Extraction for Detection of Malaria in Low-Transmission Settings

In the era of (pre) elimination setting, the prevalence of malaria has been decreasing in most of the previously endemic areas. Therefore, effective cost- and time-saving validated pooling strategy is needed for detection of malaria in low transmission settings. In this study, optimal pooling numbers and lowest detection limit were assessed using known density samples prepared systematically, followed by genomic DNA extraction and nested PCR. Pooling strategy that composed of 10 samples in 1 pool, 20 µl in 1 sample, was optimal, and the parasite density as low as 2 p/µl for both falciparum and vivax infection was enough for detection of malaria. This pooling method showed effectiveness for handling of a huge number of samples in low transmission settings (<9% positive rate). The results indicated that pooling of the blood samples before DNA extraction followed by usual nested PCR is useful and effective for detection of malaria in screening of hidden cases in low-transmission settings.

ABO blood groups and susceptibility to Malaria

A total of 425 villagers from four malaria endemie villages in Kanbaunk village tract, Yephyu Township. Taninthayee Division were examined for the presence of malaria parasites in blood and ABO blood groups with the aim to find out if there are any differences in the parasite positive rate among the ABO bolld groups. The distribution of blood groups was 22 per cent, 35 per cent, 38 per cent and 5 per cent for A,B,O and AB blood groups respectively. their allotment are similar to other parts of the country. the parasite positive rate in all persons irrespective of blood group was 23 per cent P. falciparum and P. vivax accounting for 81 per cent and 19 per cent respectively. when the parasite positive rates were compared among the 4 blood groups, they were 20 per cent, 14 per cent, 16 per cent and 14 per cent respectively but there was no significant difference among different blood groups. The ratio of P. falciparum and P. vivax did not differ significantly among the four blood groups. Thus, according to our results ABO blood groups have no relation with malaria susceptibility.

Rheumatology in Pathein practice

It is a prospective descriptive study on patients with rheumatological diseases who attended Shin Pa Ku private specialist clinic (SPK) and Patein General Hospital (PGH) from Dec 1998 to July 1999. Spectrum of rheumatological diseases was recorded by using proforma. Among 162 rheumatological cases, there were 6 cases of SLE and 3 cases of Systemic scleros is, and all were females. Among the seronegative diseases, 3 patients were suffering from ankylosing spondylitis, and all were suffering from ankylosing spondylitis, and all were males. In 15 cases of reactive arthritis 47

were males and 53

females. But in 9 cases ofgout, there was male preponderance (78

).Osteoarthritis accounts for 53 cases, with male 36

and 23 cases of rheumatic fever, has also female dominance(79

). Filbromyalgia affected 14 patients and all were females. Among a total of 28 casesof Rheumatoid arthritis (RA) mean age was 48.18yr (SD=15.57), Male: Female=1:4. Average duration for morning stiffness was 72.81 min (SD=2.72) and visual anologue pain score (VAPS) was 61.29 (SD=21.13). Grip power of left hand was found to be 88.57mmHg (SD=77.92) and that of right hand was 99.64mmHg (SD=6.50).Only 5.6

had renal involvement. RA occurred in patients irrespective of any educational status and occupation. Most of them had no concomitant diseases at the time of enrollment. RA is the 2nd commonest rhematological disease in this study. Moreover, it especially occurs in working age group and also greatly affects the qualtiyof life.

Well-breeding Anopheles dirus and their role in malaria transmission in Myanmar.

Mosquitos were collected with human and animal baits from March 1996 to January 1998 in four villages located along the Yadana gas pipe line in Yepyu township, Dawae district, Tanintharyi Division, southern Myanmar. A total of 23 anopheline species were collected. Anopheles dirus were abundant in pre-monsoon (May/June) an post-monsoon (October) months. All An. dirus caught both humans and cattle were assayed with specific, sporozoite enzyme-linked immunosorbent assays (ELISAs). A total of 5/250 (2%) caught with human bait was found positive with Plasmodium vivax from Eindayaza, Ohnbinkwin and Thaechaung during rainy and cool-dry months. Larval surveys also showed An. dirus larvae/pupae were caught from domestic wells (6 to 46% found positive). Clinical surveys indicated that transmission is hyperendemic and occur all year round in all four villages.

Correlation between immunofluorescence assay (IFA) positivity and malaria endemicity in Myanmar

Immunofluorescence assay (IFA) for intra-erythrocytic Plasmodium falciparum parasite was determined in all ages and both sexes of permanent inhabitants of 3 villages in Myanmar with differing malaria endemicity. According to the WHO criteria, malaria endemicity depends on the parasite positive rate and spleen rate and the 3 villages could be characterized as one village each of hypoendemicity, mesoendemicity and hyperendemicity. The prevalence of IFA positivity were 30 per cent , 71 per cent and 97 per cent and the mean IFA titers were 800, 13,800 and 174,000 in the hypo, meso and hyperendemic villages respectively.. Thus, there is a good correlation between malaria endemicity and the IFA positivity and mean IFA titers. These data indicate that IFA assay can be used to assess malaria endemicity and applicable where proper epidemiological surveys especially in low and medium endemic areas are not possible.

The level of knowledge, attitude and practice in relation to malaria in Oo-do village, Myanmar.

A knowledge, attitude and practice (KAP) study concerning the nature and prevention of malaria was carried out in a rural area of Myanmar. According to the findings, many (over 40%) people do not have a clear cut knowledge on the transmission of malaria. Only one fourth of them had chemoprophylaxis before going to the forest, but they do not have the proper knowledge of the chemoprophylaxis regarding the type and dosage. Although there is acceptable knowledge (about 80% of the subject knew that mosquito bite causes malaria) and positive attitude towards malaria (100% of respondents agreed that malaria was a serious health problem in this area and 97% of respondents agreed that they would like to participate in malaria control activities), it is necessary to increase the community awareness of the transmission of the disease, its consequences and ways and means to control the disease to a minimum, especially in endemic areas.

Effects of beta-thalassaemia trait on pregnancy and foetal outcomes

Ten cases of pregnant mothers with confirmed beta-thalassaemia trait were studied for any complications occurred during pregnancy and labour and after birth. All cases were found to have no complications during pregnancy and labour giving normal full-term vaginal delivery. All the newborns were also found to have normal birth weight and have no complications. These findings indicate that beta- thalassaemia trait has no deleterious effects on pregnancy and foetal outcomes. No active interventions are required during antenatal care throughout pregnancy in beta-thalassaemia trait.

The use of Moringa oleifera (dan-da-lun) seed for the sedimentation and decontamination of household water Part II: Community-based study

The seeds of Moringa oleifera were tested as clearing and sedimentation agents in household water in Thaung Gyi Lay village with 110 households. Questionnaires were completed for each household and follow-up visits were carried out to ascertain the hypothetical acceptability (attitude), initial acceptability (behaviour) and experimental acceptability. It was observed that 78.9 per cent of the people accepted to use Moringa oleifera seeds if these were easily available. For continuous use of Moringa oleifera seeds, 47.3 per cent wanted to use, 44.7 per cent could not decide and only three households (2.7 per cent) did not want to use these. It was observed that the taste and pH of water did not change after treatment with Moringa oleifera seeds. There was no complaint about the treated water. This study will highlight the acceptance to use Moringa oleifera seeds for the sedimentation of turbid water.

Post-mortem histological and dissecting microscopic appearance of the proximal jejunum of Myanmar children

A comparative morphological study of jejunal villi under the dissecting microscope and their histological changes under the light microscope was performed on 100 childhood necropsies from Yangon Children Hospital. they were from a-day-old meonate to twelve-year-old children. Four patterns of villi morphology were observed under the dissecting microscope: finger-like, tongue-like, leave-like and ridge villi. Histologically, inflammatory cells infiltration in the lamina propria and submucosa with vascular congestion of graded severity were observed. There is no correlation between villi morphology and histological changes. Tongue-like and leave-like villi could be regarded as normal for our children. Although histological examination of the post-mortem jejunal materials yields limited value, it could be of supportive or additive value if studied simultaneously with the dissecting microscopy.

The usefulness of Moringa oleifera (dan-da-lun) seed for the sedimentation and decontamination of turbid water from ponds and revers Part I: Laboratory investigations

The seeds of Moringa oleifera were tested as the clearing and sedimentation agents in tubid water from various sources (1) DMR pond (2) Yangon river (3) Bago River (4) Hline River (5) Hlinethaya Pond (6) artesian well from laydaunkkan and (7) Thanlyin River. the turbidity reduction of 80.00 to 99.5 percent paralled by a primary bacterial reduction of 90.00 to 99.99 per cent were obtained within the first one to two hours of treatment, the bacteria being concentrated in the coagulated sediment. It was observed that 100 mg (one ywe) of the seed powder served as a clearing agent in one litre of turbid water. However, the difference of clearing activity was not significant with different amounts of powder, lwhen 50 mg, 100 mg and 200 mg respectively were used with constant water quantity (one litre) within 24 hours. Moreover, the effect of the seeds could not alter the original pH of the tested water samples. The powder of M. oleifera leaves, bark and roots had no power to clear the turbidity of tested water samples.

The phytohemagglutinin (PHA)-induced peripheral lymphocyte blastogenic response in cancer patients

The in vitro blastogenic response of peripheral bolld lymphocytes was determined in 50 patients with various types of malignancies by quantitation of phytohaemagglutinin PHA-induced tritiated thymidine uptake. PHA-induced blastogenic response was impaired in patients with malignancy more so in patients with squamous cell carcinoma in whom there was an inverse correlation with the stage of the tumor and the reduction. No correlation was seen in patients with adenocarcinoma, lymphoma or sarcoma. these data indicate that PHA-induced blastogenic respoonse is a potentially useful assay for the detection of immunocompromized persons especially in patients suffering from squamous cell carcinoma.

Seasonal variation of flea population and its relationship with small mammal hosts in sub-urban Yangon

Monthly flea and small mammal surveys covering three seasons (cool dry, hot dry and monsoon) were carried out at three townships in Yangon. From more than 400 small ammmals captured, two species of fleas totalling about 700 were collected and identified as Xenopsylla astia and Xenopsylla cheopis. General flea inded was found to be highest in May (dry hot) with 6.7 and lowest in November (cool dry) with 0.09. Total ratio of collected X. astia and X. cheopis was foung to be about 2:1. However, host-vector specificity was pronounced between these two species especially on B. bengalensis. The great majority of X. astia were infested on B. bengalensis (p < 0.05) and the majority of X. cheopis were infested on other above ground species namely Rattus exulans, R. rattus and Suncus murinus mainly in dry hot seasons. Several factors which might govern the host-vector specificity are outlined. Dur to the host-vector specificity, the limitations and the use of various flea indices are discussed and suggestions are made for a proper surveillance system. The prospect of the timely flela control program as a preventive plague control measure is also discussed.

The peripheral lymphocyte mitogenic responses of apparently healthy Myanmar blood donors

The responses of peripheral lymphocytes to mitogens namely, phytohemagglutinin (PHA) and lipopolysaccharide (LPS) were determined in 50 apparently healthy blood donors. The stimulation indexes of PHA and LPS of male and female donos were calculated. Though there was a singificant difference (p < 0.001) between the sexes to PHA response, no significant difference was found in LPS response. Also the mitogen responses had no correlation with the age and the number of T and B lymphocytes in the peripheral blood.