Genetic diversity of toxigenic Vibrio cholerae O1 from Sabah, Malaysia 2015.

BACKGROUND: Cholera is an important health problem in Sabah, a Malaysian state in northern Borneo; however, Vibrio cholerae in Sabah have never been characterized. Since 2002, serogroup O1 strains having the traits of both classical and El Tor biotype, designated as atypical El Tor biotype, have been increasingly reported as the cause of cholera worldwide. These variants are believed to produce clinically more severe disease like classical strains. PURPOSE: The purpose of this study is to investigate the genetic diversity of V.cholerae in Sabah and whether V.cholerae in Sabah belong to atypical El Tor biotype. METHODS: ERIC-PCR, a DNA fingerprinting method for bacterial pathogens based on the enterobacterial repetitive intergenic consensus sequence, was used to study the genetic diversity of 65 clinical V.cholerae O1 isolates from 3 districts (Kudat, Beluran, Sandakan) in Sabah and one environmental isolate from coastal sea water in Kudat district. In addition, we studied the biotype-specific genetic traits in these isolates to establish their biotype. RESULTS: Different fingerprint patterns were seen in isolates from these three districts but one of the patterns was seen in more than one district. Clinical isolates and environmental isolate have different patterns. In addition, Sabah isolates harbor genetic traits specific to both classical biotype (ctxB-1, rstRCla) and El Tor biotype (rstRET, rstC, tcpAET, rtxC, VC2346). CONCLUSION: This study revealed that V.cholerae in Sabah were genetically diverse and were atypical El Tor strains. Fingerprint patterns of these isolates will be useful in tracing the origin of this pathogen in the future.

Political transition and emergent forest-conservation issues in Myanmar.

Political and economic transitions have had substantial impacts on forest conservation. Where transitions are underway or anticipated, historical precedent and methods for systematically assessing future trends should be used to anticipate likely threats to forest conservation and design appropriate and prescient policy measures to counteract them. Myanmar is transitioning from an authoritarian, centralized state with a highly regulated economy to a more decentralized and economically liberal democracy and is working to end a long-running civil war. With these transitions in mind, we used a horizon-scanning approach to assess the 40 emerging issues most affecting Myanmar's forests, including internal conflict, land-tenure insecurity, large-scale agricultural development, demise of state timber enterprises, shortfalls in government revenue and capacity, and opening of new deforestation frontiers with new roads, mines, and hydroelectric dams. Averting these threats will require, for example, overhauling governance models, building capacity, improving infrastructure- and energy-project planning, and reforming land-tenure and environmental-protection laws. Although challenges to conservation in Myanmar are daunting, the political transition offers an opportunity for conservationists and researchers to help shape a future that enhances Myanmar's social, economic, and environmental potential while learning and applying lessons from other countries. Our approach and results are relevant to other countries undergoing similar transitions.

Surveillance Evaluation of the National Cancer Registry in Sabah, Malaysia.

BACKGROUND: Cancer is the fourth leading cause of death in Sabah Malaysia with a reported agestandardized incidence rate was 104.9 per 100,000 in 2007. The incidence rate depends on nonmandatory notification in the registry. Underreporting will provide the false picture of cancer control program effectiveness. The present study was to evaluate the performance of the cancer registry system in terms of representativeness, data quality, simplicity, acceptability and timeliness and provision of recommendations for improvement. MATERIALS AND METHODS: The evaluation was conducted among key informants in the National Cancer Registry (NCR) and reporting facilities from FebMay 2012 and was based on US CDC guidelines. Representativeness was assessed by matching cancer case in the Health Information System (HIS) and state pathology records with those in NCR. Data quality was measured through case finding and reabstracting of medical records by independent auditors. The reabstracting portion comprised 15 data items. Selfadministered questionnaires were used to assess simplicity and acceptability. Timeliness was measured from date of diagnosis to date of notification received and data dissemination. RESULTS: Of 4613 cancer cases reported in HIS, 83.3% were matched with cancer registry. In the state pathology centre, 99.8% was notified to registry. Duplication of notification was 3%. Data completeness calculated for 104 samples was 63.4%. Registrars perceived simplicity in coding diagnosis as moderate. Notification process was moderately acceptable. Median duration of interval 1 was 5.7 months. CONCLUSIONS: The performances of registry's attributes are fairly positive in terms of simplicity, case reporting sensitivity, and predictive value positive. It is moderately acceptable, data completeness and inflexible. The usefulness of registry is the area of concern to achieve registry objectives. Timeliness of reporting is within international standard, whereas timeliness to data dissemination was longer up to 4 years. Integration between existing HIS and national registration department will improve data quality.

Influencing factors for household water quality improvement in reducing diarrhoea in resource-limited areas.

BACKGROUND AND OBJECTIVES: Water and sanitation are major public health issues exacerbated by rapid population growth, limited resources, disasters and environmental depletion. This study was undertaken to study the influencing factors for household water quality improvement for reducing diarrhoea in resource-limited areas. MATERIALS AND METHODS: Data were collected from articles and reviews from relevant randomized controlled trials, new articles, systematic reviews and meta-analyses from PubMed, World Health Organization (WHO), United Nations Children's Fund (UNICEF) and WELL Resource Centre For Water, Sanitation And Environmental Health. DISCUSSION: Water quality on diarrhoea prevention could be affected by contamination during storage, collection and even at point-of-use. Point-of-use water treatment (household-based) is the most cost-effective method for prevention of diarrhoea. Chemical disinfection, filtration, thermal disinfection, solar disinfection and flocculation and disinfection are five most promising household water treatment methodologies for resource-limited areas. CONCLUSION: Promoting household water treatment is most essential for preventing diarrhoeal disease. In addition, the water should be of acceptable taste, appropriate for emergency and non-emergency use.

Hunting for a living: wildlife trade, rural livelihoods and declining wildlife in the Hkakaborazi National Park, north Myanmar.

Hunting is a threat to wildlife within the Hkakaborazi National Park in north Myanmar. We used questionnaire surveys to obtain data on variables such as commonly targeted species, prices of traded wildlife, reasons for hunting and the relative importance of livelihood sources. We examine (a) the significance of hunting and trade for livelihoods and explore (b) the impacts of hunting on targeted species. Ninety per cent of trade records (n = 803) was constituted by seven species commonly targeted by hunters (serow, red goral, muntjac, bear, Assamese macaque, black musk deer and takin). Commercially valuable species previously targeted by hunters (tiger, otter, pangolin) appear to be completely absent from current harvest records and potentially in decline. Although farming is the predominant occupation, hunting (driven by trade) represents a significantly higher source of income than other livelihood activities. Management recommendations include increased investment in enforcement, education and outreach, small livestock development, improved crop productivity, demarcation of no-take areas for wildlife and biological monitoring of targeted species.

Hunting, livelihoods and declining wildlife in the Hponkanrazi Wildlife Sanctuary, North Myanmar.

The Hponkanrazi Wildlife Sanctuary, North Myanmar and three contiguous protected areas, comprise some of the largest expanses of natural forest remaining in the region. Demand for wildlife products has resulted in unsustainable exploitation of commercially valuable species resulting in local extirpation of vulnerable species. Camera trap, track and sign, and questionnaire-based surveys were used to examine (a) wildlife species targeted by hunters, (b) the importance of wild meat for household consumption, and (c) the significance of hunting as a livelihood activity for resident villages. Certain commercially valuable species highly preferred by hunters were either completely absent from hunt records (tiger, musk deer and otter) or infrequently obtained during actual hunts (bear, pangolin). Species obtained by hunters were commonly occurring species such as muntjacs with low commercial value and not highly preferred by hunters. Fifty eight percent of respondents (n = 84) indicated trade, 27% listed subsistence use and 14% listed human-wildlife conflict as the main reason for hunting (n = 84). Average amount of wild meat consumed per month is not significantly higher during the hunting season compared to the planting season (paired t-test, P > 0.05). Throughout the year, the average amount of fish consumed per month was higher than livestock or wild meat (Friedman test, P < 0.0001). Hunting is driven largely by trade and wild meat, while not a critical source of food for a large number of families could potentially be an important, indirect source of access to food for hunting families. Findings and trends from this study are potentially useful in helping design effective conservation strategies to address globally prevalent problems of declining wildlife populations and dependent human communities. The study provides recommendations to reduce illegal hunting and protect vulnerable species by strengthening park management through enforcement, increasing the opportunity costs of poaching, establishing no-take zones and research to determine the economic significance of hunting for livelihoods.

The efficacy of compression immobilization technique in retarding spread of radio-labeled Russell's viper venom in rhesus monkeys and 'mock venom' NaI131 in human volunteers.

The efficacy of the modified compression immobilization technique in retarding spread of radio-labeled Russell's viper venom in 3 rhesus monkeys (Macaca mulata) and "mock venom" NaI131 in 14 human volunteers was studied. 0.1 microgram of Russell's viper venom having 10 microCi radioactivity in 0.2 ml normal saline containing 0.5% bovine serum albumin was injected subcutaneously at the lateral aspect of the right hind limb of a rhesus monkey. A hand-tight bandaging of a rubber pad measuring 55 x 28 x 16 mm over the injection site and splinting effectively retard spread of radio-labeled venom for the entire length of time applied, although complete immobilization was not achieved. In human volunteers, application of a pad measuring 60 x 50 x 17 mm over the subcutaneous injection site of 20 microCi or 12 microCi/0.2 ml NaI131 with a hand-tight bandaging (60 +/- 10 mmHg) and immobilization of limb was found to be effective in retarding the movement of radioactive NaI131. These results suggested that the compression pads tried in this study effectively retard the spread of radio-labeled Russell's viper venom (MW ranging from 20,000-90,000) and radioactive NaI131 (MW 150) from the site of injection. Thus, it is highly likely that the present compression pad will be useful as a first-aid measure in Russell's viper bite victims.