ABSTRACT
Routine diagnosis of intestinal microsporidiosis in clinical diagnostic laboratories relies mostly on detection of microsporidial spores via special staining and microscopic techniques. This paper describes the comparative evaluation of Calcofl uor White M2R method, with modifi ed Gram-chromotrope Kinyoun method as the reference standard. One hundred and six stool samples were examined for the presence of microsporidial spores. Sensitivity, specifi city, positive and negative predictive values of the Calcofl uor White M2R method compared to the reference technique were 95.2%, 4.3%, 78.2% and 20.0%, respectively. The positive predictive value (PPV) was 78.2% and the negative predictive value (NPV) was 20.0%. Despite low specifi city of the CFW method due to its ability to stain chitinous wall of microorganisms, the presence of distinct deep-blue horizontal or equitorial stripes in microsporidial spores in modifi ed Gram-chromotrope Kinyoun would likely reduce the false positive results obtained in the Calcofl uor White M2R. Hence, the simultaneous use of these two methods would give better performance and accuracy for the detection of microsporidial spores in patients with intestinal microsporidiosis.
ABSTRACT
Introduction: Little is known about the sero-prevalence of diphtheria anti-toxoid antibody levels among medical students in Malaysia. They too, just like other health care workers (HCWs) are at risk of contracting and transmitting diphtheria. Fortunately, this can be prevented by giving a specific vaccine: the diphtheria, tetanus and pertussis (DTP) vaccine. Nonetheless, data from local or regional surveys are needed before any decision is made by the respective authorities. General objective: We studied the epidemiology of diphtheria anti-toxoid antibody levels and vaccination history amongst medical students and staff in Faculty of Medicine and Health Sciences, Universiti Putra Malaysia. Specific objectives: We determined the level of diphtheria anti-toxoid antibodies amongst pre-clinical students and staff. Methodology: A total of 152 sera were collected from subjects aged 19 to 63, and diphtheria anti-toxoid levels were measured by an enzyme-linked immunosorbent assay. Results: One hundred and fifty-two (94.4%) blood samples out of 161 participants were successfully withdrawn, which comprised 105 (69.1%) and 47 (30.9%) medical students and staff, respectively. A total of 77.6% and the other 22.4% of the subjects had full and basic protection, respectively. Higher levels were predominant amongst males and they were 1.3 times more protected than females in 20-29 year-old group (85.1% vs 66.2%; odd ratios 1.25 [95% CI 1.03-1.50]; P=0.03). No significant difference in the levels of immunity among subjects for ethnicity and academic position (P>0.05). Recommendations: Level of full protection against diphtheria toxin should be clearly defined by broad population based studies using several comparable detection methods. Medical students and staff with basic protection should be closely monitored or should be given a booster dose for those who are at high risk of acquiring the disease. Thus, a standard degree of coverage should be clearly determined for health workers to prevent a potential outbreak. Conclusion: Students and staff possess immunity towards diptheria toxin however the level of full protective antibody is yet to be determined in future.
ABSTRACT
Introduction: Preventive fogging is defined as space spraying of insecticide against mosquitoes in order to prevent outbreak of mosquito borne infection. Despite provision of various preventive and control activities against dengue and chikungunya infection by Ministry of Health Guideline, the detail on preventive fogging has not yet specified. However, this has been adopted by certain institutions as part of the routine strategies against dengue outbreak. A study on preventive fogging was conducted in one of the hostels in Universiti Putra Malaysia. The research was done for 16 weeks in which one routine fogging activity was done at the mid period of study. The main objectives of this study were to determine the effectiveness of preventive fogging activities against Aedes mosquitoes and to identify the distribution and abundance of Aedes mosquitoes in the area. Method: The fogging activity was carried out by the management staff as part of their preventive measures in the student hostels. Ovitrap was used as an indicator to monitor the impact of fogging activity and its continuous surveillance was monitored weekly. The ovitraps were placed indoors and outdoors. Species identification was carried out in the laboratory. The SPSS program was used to analyse the statistical data on the effectiveness of fogging activity. Larval count (indoors and outdoors) and ovitrap index (OI) readings were identified as ovitrap surveillance data for statistical analysis. Results: The results showed that Aedes albopictus was the only species of the genus Aedes found in this hostel. The area had been highly infested by Ae. Albopictus as indicated by high Ovitrap Index ranging between 48.33% to 90.00%. The mean (SD) of Ovitrap Index was reduced from 71.67% (12.73%) (before the preventive fogging), to 69.42% (14.40%) (after the fogging). Overall reduction in mosquito and larval density was also observed between pre and post fogging activity in this study. Conclusion: The implementation of preventive fogging has favourably reduced the dengue vector population up to 5 weeks after the introduction of preventive fogging. However, sole dependency on preventive fogging may lead to insecticide resistance. Revisiting the policy on preventive fogging; and identifying it as an additional tool for preventing dengue infection in higher learning institutions are recommended.
ABSTRACT
Intestinal microsporidia is an emerging human disease caused by microsporidia. A study was conducted to determine the prevalence of microsporidia in patients with gastro-intestinal symptoms and to examine the clinical manifestations associated with intestinal microsporidiosis. A descriptive cross-sectional study using a well-structured questionnaire; a review of medical records was also undertaken. Positive stool samples were defined as presence of one or more pinkish-violet ovoid structures with a belt-like stripe under high power field (100x) using modified gram-chromotrope stain (MGC). A total of 353 faecal specimens of patients was examined and 100 patients were found to have positive stool samples for microsporidia. The overall prevalence of microsporidia was 28.3%. Acute and chronic diarrhoea were seen in 49.0% and 36.0% patients, respectively. The commonest clinical presentations were diarrhoea (85.0%) with 83.0% of patients having loose or watery stools, vomiting (75.0%), foul-smelling stools (60.0%), nausea (59.0%) and cramping abdominal pain (39.0%). The least common symptoms were fever (15.0%), mucous in stool (5.0%) and blood in stool (4.0%). This study concludes that the prevalence of microsporidia is still high (28.3%) and the majority of patients (93.0%) are symptomatic; the most common gastro-intestinal symptom is diarrhoea with loose or watery stools. Hence, it is recommended that a stool screening for microsporidia be done in selected patients presented with gastrointestinal symptoms.