ABSTRACT
The district of Kudat has one of the highest and most persistent malaria transmission levels in Sabah, Malaysia, with annual parasite incidence of 102 per 1,000 inhabitants per year. Due to this situation and the failure of DDT spraying to control malaria, a community participation health program (Sukarelawan Penjagaan Kesihatan Primer or SPKP) was developed as an adjunct to current anti-malarial measures during 1987-1991. SPKP is made up of unpaid community workers known as village health volunteers (VHVs). VHVs are selected by a village development and security committees training and supervision a member of the Vector-Borne Diseases Control Program (VBDCP). The beneficiaries of SPKP consisted primarily of Runggus people and other remote, and mobile populations who visit the home of a VHV for diagnosis and treatment. This group of febrile patients and their children who attend a participating school submit finger prick blood and personal details to the VHV. and receive a presumptive treatment for malaria. Thick and thin blood smears are examined by a VBDCP microscopist who then prepare and forward a radical or curative treatment to the VHV so that it can be administered to the microscopically-positive patient free of charge. Between June 1987 to June 1991, VHVs from 32 kampungs (villages) and 22 schools collected 56,245 slides representing 24.7% of total slide collection compared to 74.9% collected by passive case detection (PCD) posts in health centers and district hospital. The average volunteer treated 11.8 (range 10.4-13.4) and 31.4 (range 26-49) patients per month in kampungs and schools respectively. In contrast, non-SPKP posts in a district hospital, health centers and flying doctor service treated an average of 616.3 patients per month (range 134.8-1032.8). The slide positivity rate of blood smears taken by VHVs was 8.43% compared with 7.37% for non-SPKP posts. Average slide collection and slide positivity rates varied considerably from one community to another, despite their close geographic proximity. The monthly number of VHV-diagnosed patients from the school and kampungs communities and the monthly number of true malaria patients in the two groups were significantly correlated. Sustainability of SPKP was linked to an ongoing process of social change which involved co-operative networking between the government health sector and the community. This in turn provided a stimulus for malaria abatement efforts. When Runggus people themselves control and maintain ownership of community-based malaria programs, the function of SPKP as a malaria surveillance system and an antimalarial drug distribution network is vastly improved.
Subject(s)
Animals , Antimalarials/administration & dosage , Child , Communicable Disease Control/methods , Community Health Workers , Community Networks/organization & administration , Health Education , Humans , Malaria/epidemiology , Malaysia/epidemiology , Mosquito Control , Pilot Projects , Plasmodium falciparum/isolation & purification , Population Surveillance/methods , Program Evaluation , School Health Services , Seasons , Statistics, Nonparametric , VolunteersSubject(s)
Adolescent , Adult , Anti-Bacterial Agents/pharmacology , Child , Child, Preschool , Cholera/microbiology , Drug Resistance , Female , Humans , Infant , Malaysia , Male , Microbial Sensitivity Tests , Middle Aged , Pteridines/pharmacology , Vibrio cholerae/metabolismABSTRACT
Using seven methods of surveillance, 58 species of mosquitoes from nine genera were in Pantai and the two neighbouring villages during two visits in 1982. Ma. bonneae was the most prevalent species attracted to man. In the forest shade Ma. bonneae and Ma. dives showed activity throughout the 24 hours with peak biting during 1900-2100 hours. An. balabacensis exhibited peak activity shortly after midnight. Inside and outside house, Ma. bonneae showed similar activity except that it ceased during the day. Mansonia was only mildly zoophilic. CDC light traps gave poor yields of mosquitoes. Pyrethrum spray catch inside houses early morning did not include any Mansonia. Outdoor day resting catch included Ma. bonneae fed on man. Transmission of Brugia, probably human filariasis, by Ma. bonneae occurred in Pantai and in the two neighbouring villages. One infection in Ma. dives was found in Pantai. The monthly infective biting rate and monthly transmission potential for Ma. bonneae were estimated at the forest shade and outside the house in Pantai.
Subject(s)
Animals , Behavior, Animal , Buffaloes , Culicidae/physiology , Feeding Behavior , Filariasis/transmission , Humans , Insect Vectors , Malaysia , Mosquito Control/methods , Seasons , Species SpecificityABSTRACT
A total of 37 species of mosquitoes from seven genera were collected in six villages in the Bengkoka Peninsula, Sabah State, during two visits in 1981 in connection with studies on malaria and filariasis. Fifty-five per cent of the total mosquitoes collected were Mansonia. An. collessi constituted a new record of the species from Sabah. An. balabacensis was found to be naturally infected with sporozoites. Ma. bonneae was found to be naturally infected with Brugia, probably B. malayi. Parous rates of An. balabacensis and Ma. bonneae were very high with consequent high probability of survival ideally suiting transmission of malaria and filariasis.
Subject(s)
Aedes/microbiology , Animals , Anopheles/microbiology , Culex/microbiology , Culicidae/microbiology , Filariasis/transmission , Humans , Insect Vectors , Malaria/transmission , Malaysia , Rural PopulationABSTRACT
Three cases of schistosomiasis in 2 Filipinos and one Chinese in Sabah are reported. Diagnosis was based on incidental histological findings of Schistosoma japonicum-like ova in the liver and rectal biopsies. As these 3 patients are immigrants to Sabah, it is assumed that they are imported cases, and that Sabah has been free of the disease from 1970 to 1977.