A survey on malaria in mobile Cambodians in Aranyaprathet, Sa Kaeo Province, Thailand.

A cross-sectional survey of the malaria prevalence among mobile Cambodians in Aranyaprathet, at the Thai-Cambodia border, was conducted in November 2000. A total of 666 asymptomatic, mobile Cambodians who worked as traders and laborers were studied. The overall prevalence rate was 2.4%, with 93.75% of the infections being due to Plasmodium vivax and 6.25% due to Plasmodium falciparum. Almost all cases had low level of parasitemia (1+) and no sexual stages were found. Factors associated with malaria infection included being male, being in the 10-59 year age group, having a lower level of education and frequent trans-border crossing. Both groups of migrant workers (traders and laborers) had an equal chance of infection.

Septic shock secondary to scrub typhus: characteristics and complications.

Scrub typhus is an acute febrile illness caused by infection with Orientia tsutsugamushi transmitted by the bite of larval trombiculid mites (chiggers). A prospective study was conducted in septic shock patients in Maharat Hospital, Nakhon Ratchasima Province, Thailand, from 12 November 2001 to 5 January 2002. Of the 51 septic shock patients studied during the 7 week period, 18 (35.3%) were found to have evidence of scrub typhus infection; 3 patients (16.7%) died. In this study, septic shock caused by Orientia tsutsugamushi is the most prominent (35.3%) in endemic area of scrub typhus. Scrub typhus with septic shock patients results in organ failure: respiratory failure, DIC were predominant, followed by renal and hepatic involvement. Two deaths were due to respiratory failure and one death was as a result of combined respiratory and renal failure. Fever was the most common symptom, followed by headache, myalgia and dyspnea; lymphadenophathy and eschar are common signs. Laboratory findings revealed that almost all of the patients had a mild leukocytosis, reduced hematocrit and thrombocytopenia; SGOT, ALP, direct bilirubin (DB), total billirubin (TB), BUN, Cr were elevated; hypoalbuminemia was noted. Urinalysis showed that 88.9% of the patients had albuminuria. 77.8% of patients had abnormal chest X-rays.