First detection of Babesia sp. in Bornean sun bear (Helarctos malayanus euryspilus Horsfield) in Sabah, Malaysia

@#The Bornean sun bear, a subspecies of the endangered Malayan sun bear, resides only on Borneo Island and little is known about diseases or parasites that may impact their health. In 2019, blood and ticks were collected from 46 captive bears held at the Bornean Sun Bear Conservation Centre in Sabah, Malaysia during annual health examinations in response to previous blood smear analysis that revealed presumptive haemoparasites in more than half the resident bears. Polymerase chain reaction detected a unique Babesia sp. in one of the bears. Disease surveillance of mosquitoes trapped along the outer perimeter of the bears’ outdoor enclosure did not reveal any malaria parasites. This research marks the first documented case in Bornean sun bears of both a Babesia sp. and the Ixodes tick Haemaphysalis nr koningsbergeri. More research on incriminating the vector and the effects of Babesia infection on the health of Bornean sun bears is needed. Due to the zoonotic nature of babesiosis, mitigative actions should be taken to protect any humans that work with or come into close contact with these captive bears or their enclosures.

Molecular characterisation of hemagglutinin and neuraminidase genes of the first highly pathogenic Avian Influenza H5N1 2.3.2.1c virus isolated from Sabah, Malaysia

@#Highly Pathogenic Avian Influenza (HPAI) is a highly contagious disease in poultry. The outbreaks can lead to flock mortality up to 100% in two to three days. In July 2018, high mortality in a commercial layer farm in Kauluan village, Sabah was reported. Samples were sent to Veterinary Research Institute Ipoh for diagnosis. Virus isolation and molecular detection is carried out simultaneously. The causative agent was then identified as AI H5N1 virus by real time reverse transcription-polymerase chain reaction (RT-PCR). The virus was then subjected for further nucleotide sequencing of full length hemagglutinin (HA) and neuraminidase (NA) gene. The PQRERRRKR/GLF motif at the HA cleavage site indicated that the isolate was of HPAI virus. Phylogenetic analysis of the HA gene showed that the isolate was belonged to the clade 2.3.2.1c virus. In the HA gene, besides the S133A substitution, the virus possesses conserved amino acid at most of the avian receptor binding sites including the glutamine (Q) and glycine (G) at position 222 and 224 respectively, indicating that the virus retains the avian-type receptor binding preference. As such, the zoonotic potential of the virus was relatively low. On the other hand, though the N154D and T156A substitution were detected in the same gene, the pandemic potential of this Sabah 2.3.2.1c virus is low in the absence of the Q222L, G224S, H103Y, N220K and T315I. A typical 20 amino acid deletion with loss of four corresponding glycosylation sites in the NA stalk region was visible. Though three NA resistance markers were detected, the virus was predicted to be sensitive to NA inhibitor. This is the first HPAI H5N1 outbreak in Sabah. The introduction of this virus into East Malaysia for the first time raised an alert alarm of the future epidemic potential. Strict farm biosecurity, continuous surveillance programme in poultry, wild birds, migratory birds; molecular epidemiology as well as risk assessment for the virus with pandemic potential are needed in dealing with emergence of new influenza virus in the country.

Identification of Newcastle Disease Virus sub-genotype VII 1.1 isolated from chickens in Sabah, Malaysia

@#Newcastle disease (ND) is an extremely contagious and fatal viral disease causing huge economic losses to the poultry industry. Following recent ND outbreaks in Sabah in commercial poultry and backyard farms, it was speculated that this could be due to a new introduction of Newcastle Disease Virus (NDV) genotype/sub-genotype. Here we report the genetic characterization of NDVs isolated from Sabah during early 2021. All isolates were amplified and sequenced with primers specific to the viral fusion (F) gene using reverse transcription-polymerase chain reaction (RT-PCR). Nucleotide sequence analysis of the F gene showed that all isolates shared similar homology of 99.4% with NDV strain from Iran isolated in 2018. Amino acid sequences of the F protein cleavage site revealed the motif of 112RRQKRF117 indicating all isolates were of virulent strain. Phylogenetic analysis demonstrated that all isolates were clustered under sub-genotype VII 1.1 and clustered together with isolates from Iran (previously known as subgenotype VIIl). The present findings suggested that there is an emerging of a new sub-genotype into the poultry population in Sabah and this sub-genotype has never been reported before in Malaysia. Therefore, transboundary monitoring and continuous surveillance should be implemented for proper control and prevention of the disease. A further molecular epidemiological analysis of NDV is needed to well understand the circulatory patterns of virulent strains of NDV in the country to prevent future outbreaks.

Assessment of the susceptibility status of Aedes albopictus (Diptera: Culicidae) from Interior, Sandakan and Tawau divisions of Sabah, Malaysia based on WHO diagnostic doses of larvicides

@# Susceptibility status of Aedes albopictus (Skuse) sampled from residential areas in Interior, Sandakan and Tawau divisions of Sabah, Malaysia, was evaluated based on the WHOrecommended doses of organochlorine and organophosphate larvicides. To determine susceptibility status, larval bioassays were carried out and post 24-hour mortalities based on WHO resistance classifications were adopted. The results demonstrated that Ae. albopictus larvae were resistant toward 5 out of the 8 larvicides tested. Larvae from all populations were resistant against bromophos, fenitrothion, malathion, temephos and dichlorodiphenyltrichloroethane (DDT), with mortalities ranging from 0.00 to 89.33%. Dieldrin, on the other hand, could induce 100.00% mortalities in all populations, followed by fenthion and chlorpyrifos, with mortalities ranging from 97.33 to 100.00% and 81.33 to 100.00% respectively. Despite most populations exhibiting similitude in their resistance status, larvae from Sandakan exhibited the highest resistance level whereas the lowest level was observed in Keningau. In view of the inadequacy of some larvicides in controlling Ae. albopictus in this study, integrated management such as insecticide rotation or combination of interventions is warranted.

Ecological Analysis of Five Years Dengue Cases and Outbreaks in Keningau, Sabah, Malaysia

@#Introduction: Dengue fever is caused by the dengue virus that is transmitted via Aedes mosquitoes. The lifecycle of Aedes mosquitoes is affected by the local climate (rainfall) which influences dengue transmission. Sabah is one of the states that is laden with a high incidence rate of dengue in Malaysia and the condition seems to have worsened with sudden, multiple outbreaks occurring in the year 2016. Methods: An ecological analysis was conducted in Keningau, Sabah to analyse dengue case patterns and distribution over a 5-year period and to exhibit the correlation between rainfall, larval indices, dengue incidences, and outbreaks. Results: Significant cross-correlation analysis (CCF) was discovered between rainfall and Aedes index at lag number 5 with a correlation coefficient of 0.151 (±0.063) as well as between rainfall and Breteau Index at lag number 5 with a correlation coefficient of 0.143 (±0.063). However, no significant cross-correlation analysis was found between Aedes index and dengue incidences. Associations were also seen between larval indices and outbreak cases. Conclusion: This study showed an increase of Aedes and Breteau Indices to susceptibility level five weeks after rainfall which increases the risk of dengue transmission.

The Importance Of High Index Of Suspicion And Immediate Containment Of Suspected Covid-19 Cases In Institute Of Higher Education Sabah, Malaysia Borneo

@#Higher education institutions face major challenges in managing the impact of the COVID-19 pandemic. The risk of exposure from the community poses a threat to campus staff and students. This study describes epidemiological characteristics of suspected COVID-19 cases among a public university’s students and staff. This is a retrospective review on data collected from the institute’s COVID-19 Preparedness and Respond Centre, located at the main campus in Kota Kinabalu, the capital city of Sabah from mid-January to April 2020. Incidence rate was calculated, and epidemiological information retrieved from interviews and relevant documents. The majority of suspected COVID-19 cases were staff (57.1%) with incidence rates higher among males (IR=40.2/1,000 population) and those working in the frontline (IR=39.6/1,000 population). Suspected COVID-19 cases were mostly related to occupation (37.3%) and social contacts (27.3%). Student cases were largely related to household (38.1%) and during travel (33.3%). One positive COVID-19 case was reported of out of the 161 suspected cases (0.6%) in the institution. An operational team must be set up to conduct situational analysis and integrate management with other departments. Suspected COVID-19 cases must be quarantined and monitored on a daily basis. A high index of suspicion and effective containment of suspected cases will prevent spread of the virus among students and staff.

Demographic and Socioeconomic Profile of Transfusion Dependent Beta-Thalassemia Major Patients in Sabah

@# Thalassemia prevalence in Malaysia is highest in Sabah. This study was conducted to characterize the demographic and socioeconomic profile of transfusion-dependent β-thalassemia major patients in Sabah, to explore their parents’ background, and to identify factors associated with having more than one thalassemia major children in the family. Methods: This was a cross-sectional study conducted in Hospital Wanita dan Kanak-Kanak Sabah and Hospital Kota Belud Sabah between February 2018 and Jun 2019. A total of 108 patients attending Thalassemia Treatment Clinic at both centers were selected randomly for interview. Results: β-thalassemia major patients in this study were majority from the indigenous ethnic groups (Kadazan, Dusun, Murut, Rungus, Sungai). Parents of the thalassemia patients mostly had low education level and socioeconomic status. Thirty-seven percent of parents have more than one children with thalassemia major and a high proportion (41.7%) have intermarriages. Parents with a higher number of children in the family are associated with having more than one thalassemia major children (OR: 2.1, 95% CI: 1.5, 2.9, P-value = 1.3 x 10-5). Conclusions: A considerably high proportion of parents have more than one children with thalassemia major in this study. Knowledge and counselling are important to parents with low educational level and socioeconomic status to ensure their understanding of thalassemia risk and prevention

Cell proliferation assessment of human gingival fibroblasts treated with Clinacanthus nutans using alamarBlue assay

@#Clinacanthus nutans (C. nutans), a well-known ethnopharmacological plant consumed for its medicinal purposes by Southeast Asian communities. C. nutans is said to possess antipyretic, inflammatory, antiedemic as well as analgesic properties and used traditionally in treating various skin ailments, Herpes infection, cancer and diabetes. The young leaves of this C. nutans are consumed in Malaysia for maintaining health. In this study, the proliferative activity of human gingival fibroblast cells (HGF-1, ATCC®CRL-2014™, USA) treated with the ethanol extract obtained from C. nutans leaves at three different concentrations (250, 125 and 62.5 µg/ml) was compared with the untreated cells using alamarBlue assay. The proliferative activity of HGF-1 using alamarBlue assay showed that the cells treated with 62.5 μg/ml of ethanolic extract of C. nutans leaves exhibited increased proliferation compared to the other groups and hence does not exhibit any cytotoxicity on HGF-1.

Newly diagnosed end stage kidney disease in a single centre in Sabah

Aim: To study the epidemiology, clinical characteristics, vascular access, and the short term survival of ESRD patients initiated on dialysis from Hospital Queen Elizabeth (HQE). Background: The number of patients with ESRD is increasing in Sabah, Malaysia. Most patients present late and some live in remote areas with difficult access to healthcare services. Many therefore present with potentially fatal complications. Methods: All the newly confirmed ESRD patients who were initiated on renal replacement therapy (RRT) from 1 January to 31 December 2014 were included. The basic epidemiological and clinical data were collected. They were divided into three groups: Group 1 - those known to the medical service and had been prepared properly for the initiation of RRT; Group 2 - those known to the medical service, but were not prepared for the RRT; Group 3 - those with undiagnosed CKD. Outcome is mainly survival at 3rd, 6th, 9th and 12th month. Results: There were 249 ESRD patients. 153 (61.4%) were male. The average age was 53.3 (range 12 - 83). The main cause of ESRD was diabetic nephropathy (128 patients, 51.4%). Most patients were started on RRT with a catheter (74.3%), 47 patients (18.9%) with a fistula, and 17 patients (6.8%) with a Tenckhoff catheter. 185 (74.3%) patients were not prepared properly (Group 2 – 66.3%, and Group 3 – 8.0%). The survival for 249 patients were 86.3% at 6 months, 77.9% at 12 months. Group 2 has the worst survival (81.9% at 6 months, 71.1% at 12 months). Conclusions: Our data showed that most patients (74.3%) were started on dialysis in an unplanned manner with poor survival. A comprehensive and well-supported predialysis programme is needed.

Antenatal Care (Anc) Services Utilization In Maternal And Child Health (Mch) Clinics Of Kinabatangan (Rural) And Sandakan (Urban) Of Sabah, Malaysia

This paper investigates the antenatal care (ANC) services utilization in currently pregnant women during their visits to maternal and child health (MCH) clinics of rural (Kinabatangan) and urban (Sandakan), Sabah. A community clinic based, cross-sectional descriptive study was performed. In total, 800 currently pregnant women attending two MCH clinics, from April to September 2012, were participated using tested set questionnaires. Descriptive analysis was used for background characteristics and chi-square analysis was applied to identify the rural-urban differences among the variables.In both study areas, previous births delivered by skilled birth personnel were same. In pregnant women from rural, less income, more grand-multiparity, earlier antenatal care booking, more frequent post-natal care, more use of contraception compared to those in urban. In comparison, urban pregnant women had more anti-tetanus toxoid injection in their previous pregnancies, past history of antenatal care for at least four times, increase in household members. As this study found the differences in ANC services utilization at Rural and Urban, further study is needed to explore concrete reasons for above findings. By delivering services according to the needs of all clients, irrespective of their place of residence, it will improve ANC services utilization in both areas of Sabah and hence will improve more on existing health status of the Nation.

First report of Erwinia psidii associated with papaya dieback disease in Malaysia

Aims: The outbreak of papaya dieback disease in Malaysia has been reported since 2003. Several reports previously confirmed Erwinia papayae and E. mallotivora to be the causal pathogen of the disease. The present study aimed to identify the causal pathogen of papaya dieback disease in Sabah. Methodology and results: Infected tissues of papaya dieback disease were collected from Kota Belud, Sabah and the bacterium responsible for the infection was isolated on Luria Bertani (LB) agar and nutrient agar (NA). Seven isolates with similar characteristics to Erwinia were isolated, subjected to the Koch’s Postulates test and then identified using 16S rRNA sequencing technique. The bacterium was identified to be E. psidii, a common pathogen to guava but not to papaya. Conclusion, significance and Impact of study: This report serves as the first confirmation of the E. psidii in causing papaya dieback disease, suggesting the possibility of this bacterium undergoing host shifting to papaya plants and the possibility of becoming another major threat to the papaya industry in the future.

The Interpretation Of Depressive Symptoms In Urban And Rural Areas In Sabah, Malaysia

Objective: The treatment gap for mental health disorders in Sabah, Malaysia is estimated to be over 90%. Probable reasons include how the depressive symptoms are interpreted. The aim of this study was to explore the interpretation of depressive symptoms in Sabah in rural and urban areas in order to find ways of reducing the treatment gap. Methods: Subjects were given an instrument which consisted of a vignette identification exercise and a set of statements about causes and treatment of depression, which the subjects were asked to rate. Results: One hundred and ninety eight subjects from an urban area and 180 subjects from a rural area were sampled. The most common cause given for the vignette identification was “Stress”, with “Counseling” the preferred treatment option. Principal component analysis (PCA) of the causes of depression revealed five factors: “Lifestyle” (11 items), “Stress and Pressure” (10 items), “Supernatural” (9 items), “Environmental” (6 items) and “Biological” (5 items), with the “Environmental” and “Stress and Pressure” items the most heavily endorsed. PCA of the treatment options showed seven factors, of which five were retained for further analysis: “Psychological treatment and lifestyle,” “Traditional” and “Lifestyle”, “Religion”, “Psychology” with “Religion” and “Psychological treatment and lifestyle” the most heavily endorsed and “Supernatural” the least heavily endorsed. Conclusion: Improving the treatment gap in mental health in Sabah will require educating people on the differences between stress and depression, making services more acceptable by increasing the provision for psychological therapies and working with religious leaders

Antihyperlipidemic activity of the medicinal plants among Kadazan and Dusun communities in Sabah, Malaysia: A review

Sabah is one of the 13 states within the Federation of Malaysia and is located in the northernmost part of Borneo. It is the second largest state in Malaysia with a landmass of approximately 7.4 million hectares. The total forested area is 4.7 million hectares. Sabah, being part of Borneo, is rich in plant biodiversity. There is also an abundance of medicinal plants and other plants for everyday use. There is a great awarness regarding association between low density lipoprotein reduction and decreased cardiovascular disease mortality. The antihyperlipidaemic activity of herbs plays an important role in the reduction of cardiovascular diseases, which is the top disease that causes mortality all over the world. Lipid-lowering activity of medicinal plant for phytomedicine research and drug development for such a disease are now focused all over the world. A plant-based diet rich in fruit, vegetables, and legumes and low in saturated fat is an effective prescription for anyone with more severe atherosclerosis. Howerver, there are few herbs available that provide some protection for persons with the above disease. The antihyperlipidaemia property in plant plays a vital role to reduce atherosclerosis. Thus, there is an increasing search for the lipid lowering agents from natural origin. In this review an attempt has been made to give an overview of the antihyperlipidemic activity in traditional medicinal plants found widely in Kadazan and Dusun communities in Sabah, Malaysia. The antihyperlipidemic activity of the traditional medicinal plants in these communities is more helpful for the development of new drugs used in the protection against dyslipidemia or atherosclerosis.

Rapid Rural Appraisal of a Rural Village in Sabah

Rapid Rural Appraisal (RRA) is a systematic, semi-structured activity carried out in the field by a multidisciplinary team that is designed to obtain new information and hypotheses about rural life. This article reports the results of an RRA conducted in Kampung Paris 1 (KGP1), Kinabatangan, Sabah under the Annual Health Promotion Program of the School of Medicine, Universiti Malaysia Sabah. A systematic random sampling was used to recruit the villagers and data was obtained through compilation of pre-existing data, field observation, structured interviews with key informants and villagers. Cardiorespiratory diseases were prevalent in KGP1. Common water sources such as rain water collected in dug wells in KGP1 were unhygienic. Dangerous toxic fumes were produced by the burning of municipal wastes nearby village houses. The villagers of KGP1 were exposed to various farm animals, which may harbor zoonoses. Health care services are limited in KGP1. Villagers who were not poor (>RM897) represented 48% of the population, followed by the poor (RM503-897), 20% and the hardcore poor (1.00 person per bedroom. Poor water hygiene, polluted air from open burning, exposure to farm animals, poverty, poor education, overcrowding and inadequate health care services were among the few possible factors affecting the health of villagers in KGP1. Formal rigorous research should be conducted in the future to facilitate specific health interventions in areas of need such as KGP1.