Soil-transmitted helminth infections among malaria patients determined by microscopy and real-time PCR methods at two district hospitals in Sarawak, Malaysia.

Malaria is still endemic in Sarawak and Sabah. Numerous studies have indicated that patients with malaria are commonly co-infected with helminthes particularly in endemic regions. The aim of this study was to investigate the incidence of soil-transmitted helminth (STH) infection among malaria patients using microscopy and multiplex real-time PCR at two district hospitals in Sarawak. A total of 94 patients who were clinically-suspected to have malaria were confirmed to be infected by both microscopy and multiplex real-time PCR. By the molecular method, 23.4%, 74.5% and 2.1% of the samples were positive for Plasmodium falciparum, P. vivax and mixed P. falciparum and P. vivax, respectively. Among the malaria patients, 48.9% were found to be co-infected with STHs. In comparison, microscopic examinations showed that 6.4% of the malaria patients were infected with STHs. From the real-time PCR positive samples, 31.9% had single helminth infections while 17% had mixed infections. In conclusion, this study showed that almost half of the malaria patients at the two Sarawak hospitals were co-infected with helminth. Future studies should be specifically designed to determine if there is any correlation between the two infections in terms of incidence and intensity.

Duration of detection of anti-BmR1 IgG4 antibodies after mass-drug administration (MDA) in Sarawak, Malaysia.

The detection rates of brugian filariasis in three regions of Sarawak namely Central, North and South after three courses of mass drug administration (MDA) from year 2004 to 2006 was investigated. A recombinant BmR1 antigen-based IgG4 detection test, named Brugia Rapid and night blood smear for microfilaria (mf) detection were used. All three regions recorded a sharp fall in mf positive rates after a year post-MDA. Meanwhile Brugia Rapid positive rates declined more gradually to 3.8% and 5.6% of the pre-MDA levels in the Central and North regions, respectively. This study showed that in filariasis endemic areas in Sarawak, anti-filarial IgG4 antibodies to BmR1, as detected by the Brugia Rapid test, were positive for one to two years after mf disappearance.