Is there a risk of suburban transmission of malaria in Selangor, Malaysia?

Background The suburban transmission of malaria in Selangor, Malaysia’s most developed and populous state still remains a concern for public health in this region. Despite much successful control efforts directed at its reduction, sporadic cases, mostly brought in by foreigners have continued to occur. In addition, cases of simian malaria caused by Plasmodium knowlesi, some with fatal outcome have caused grave concern to health workers. The aim of this study was to investigate the possibility of local malaria transmission in suburban regions of Selangor, which are adjacent to secondary rainforests. Findings A malaria survey spanning 7 years (2006 - 2012) was conducted in Selangor. A total of 1623 laboratory confirmed malaria cases were reported from Selangor’s nine districts. While 72.6% of these cases (1178/1623) were attributed to imported malaria (cases originating from other countries), 25.5% (414/1623) were local cases and 1.9% (31/1623) were considered as relapse and unclassified cases combined. In this study, the most prevalent infection was P. vivax (1239 cases, prevalence 76.3%) followed by P. falciparum (211, 13.0%), P. knowlesi (75, 4.6%), P. malariae (71, 4.4%) and P. ovale (1, 0.06%). Mixed infections comprising of P. vivax and P. falciparum were confirmed (26, 1.6%). Entomological surveys targeting the residences of malaria patients’ showed that the most commonly trapped Anopheles species was An. maculatus. No oocysts or sporozoites were found in the An. maculatus collected. Nevertheless, the possibility of An. maculatus being the malaria vector in the investigated locations was high due to its persistent occurrence in these areas. Conclusions Malaria cases reported in this study were mostly imported cases. However the co-existence of local cases and potential Plasmodium spp. vectors should be cause for concern. The results of this survey reflect the need of maintaining closely monitored malaria control programs and continuous extensive malaria surveillance in Peninsula Malaysia

Effect of In-situ Water Harvesting and Contour Bunding on Yield of Sorghum in Marginal Lands.

Page(s): 4 (1), 14- 31, 10 Ref.As a result of in-situ testing of rain water harvesting, for four seasons at on-station research level, chisel ploughing together with contour bunding technique have been chosen as appropriate means of water harvesting and conservation measures. The technique was tested on marginally cultivated, hard compacted soil of relatively low infiltration rates, locally known as "gardud" (sandy clay). This type of soil is of good farming potential if appropriate soil and water management techniques are undertaken. The aim of using this technique is to improve the ability of "gardud" soil to absorb and conserve water, to alleviate the effect of long dry spells by harvesting surface runoff to increase soil water storage for earlier and better plant establishment and hence to increase yield. The chisel and contour bunding every 10 metres were better than the control flat technique in improving soil physical properties and increasing soil water storage. The effect was reflected in highly significant sorghum plant establishment and growth. Both grain and dry matter yields were significantly increased by chisel and contour bunding. The technique increased grain yield by 152% over the control. Also, contour and non-contour treatments produced 1277 kg/ha and 1016 kg/ha, respectively, for the mean of chisel and flat treatments with 25.7% increase.The economic analysis indicated a 204% marginal rate of return for chisel polugh with contour over chisel alone. Even contour bunding with flat cultivation has doubled the economic return compared to the traditional flat alone. Therefore, this improved technology is economically superior to the traditional cultivation. Furthermore, it can be adopted to utilize- "gardud" soil as an alternative to, and to relief pressure from, exhausted and continuously cultivated poor "goz" sandy soil.Khartoum University Pres

Uncommon clinical presentations of cutaneous leishmaniasis in Sudan

International audienceCutaneous leishmaniasis in Sudan is caused by Leishmania major zymodeme LON1. Self-healing usually occurs within 1 year but occasionally its duration is prolonged and treatment is required. The clinical forms are ulcers, nodules and noduloulcerative lesions. Here we describe seven patients with uncommon lesions that were difficult to recognize as Leishmania infections. These included mycetoma-like lesions, lesions that resembled L. tropica infection and others. One HIV/AIDS patient had Kaposi's sarcoma with Leishmania parasites in the Kaposi lesions. Most of these uncommon clinical forms were difficult to treat. The diagnosis depended on a high degree of suspicion and the demonstration of parasites in smears or culture. PCR was used to characterize parasites from the patients described here. Leishmania major was found by kDNA PCR in all patients, except one, who had a leishmanioma due to L. donovani. In three patients, including one with a L. tropica like-lesion, the parasites were confirmed as L. major by gp63 PCR-RFLP

A review on the diagnosis infection in cattle of Schistosoma bovis: current status and future prospects Revisão sobre diagnóstico de infecção por Schistosoma bovis em bovinos: estado atual e perspectivas para o futuro

Bovine schistosomiasis, caused by Schistosoma bovis, is a serious veterinary problem in many parts of the worid. The current methods used for the diagnosis of the disease include clinical signs, pathological lesions, parasitological and serological techniques. As clinical signs and parasitological lesions caused by S. bovis are indistinguishable from those induced by other trematode parasites, confirmation of diagnosis by these methods is unreliable. Parasitological techniques used to demonstrate eggs of the parasite in fecal or tissue samples represent the most accurate method for detection of an active S. bovis infection. The tissue of choice for detection of S. bovis infection is the liver because of the visible macroscopic lesion that can be seen in that organ and the rapid detection of the parasite eggs under the microscope using crush smears. The serological techniques used for diagnosis of the disease do not necessarily identify an active infection. In addition, some of the positive reactions are non specific. However, serology is useful to identify previous infection in epidemiologic study. The ELISA has been recentiy validated for the diagnosis of bovine schistosomiasis and will probably replace the other serological tests. The immunoblotting technique has been proven satisfactory to detect antibodies to defined and recombinant schistosome antigen vaccines. Nucleic acid hybridization techniques have been described for the study of schistosome species-specific identification. However, these molecular techniques have not yet revolutionarized diagnosis of schistosomiasis. These techniques will probably serve as the basis for future diagnostic tests.<br>Esquistossomose bovina, causada pelo parasita Schistosoma bovis, é um problema muito sério para a Veterinária em muitas partes do mundo. Os métodos atuais utilizados para o diagnóstico da doença incluem sinais clínicos, lesões patológicas, e técnicas de parasitologia e sorologia. Como os sinais clínicos e as lesões parasitológicas causadas pelo S. bovis são distingüíveis em relação às lesões induzidas por outros trematódeos, a confirmação do diagnóstico por estes métodos é questionável. Técnicas de parasitologia utilizadas para demonstrar ovos do parasita em amostras fecais ou teciduais representam os métodos mais acurados para detecção de uma infecção ativa pelo S. bovis. O tecido de preferência para detecção da infecção causada pelo S. bovis é o fígado devido à visível lesão macroscópica que pode ser vista neste órgão e da rápida detecção dos ovos do parasita usando "crush smears" e visualização microscópica. As técnicas de sorologia utilizadas para o diagnóstico desta doença não identificam necessariamente uma infecção ativa. Adicionalmente, algumas reações positivas não são específicas. Entretanto, sorologia é válida para identificar infecções prévias em um estudo epidemiológico. O teste de ELISA tem sido desenvolvido recentemente para o diagnóstico de equistossomose bovina e provavelmente substituirá os outros testes sorológicos. A técnica de "immunoblotting" tem sido satisfatoriamente aprovada para a detecção de anticorpos e vacinas recombinantes do antígeno do esquistossoma. Técnicas de hibridização do ácido nucleico tem sido descritas para o estudo de identificação de especificidade do schistossoma. Entretanto, estas técnicas moleculares ainda não revolucionaram o diagnóstico da esquistossomose. Provavelmente, estas técnicas ainda serão base para os testes de diagnóstico do futuro

Global perspective of familial hypercholesterolaemia: a cross-sectional study from the EAS Familial Hypercholesterolaemia Studies Collaboration (FHSC)

Background The European Atherosclerosis Society Familial Hypercholesterolaemia Studies Collaboration (FHSC) global registry provides a platform for the global surveillance of familial hypercholesterolaemia through harmonisation and pooling of multinational data. In this study, we aimed to characterise the adult population with heterozygous familial hypercholesterolaemia and described how it is detected and managed globally. Methods Using FHSC global registry data, we did a cross-sectional assessment of adults (aged 18 years or older) with a clinical or genetic diagnosis of probable or definite heterozygous familial hypercholesterolaemia at the time they were entered into the registries. Data were assessed overall and by WHO regions, sex, and index versus non-index cases. Findings Of the 61 612 individuals in the registry, 42 167 adults (21 999 [53·6%] women) from 56 countries were included in the study. Of these, 31 798 (75·4%) were diagnosed with the Dutch Lipid Clinic Network criteria, and 35 490 (84·2%) were from the WHO region of Europe. Median age of participants at entry in the registry was 46·2 years (IQR 34·3–58·0); median age at diagnosis of familial hypercholesterolaemia was 44·4 years (32·5–56·5), with 40·2% of participants younger than 40 years when diagnosed. Prevalence of cardiovascular risk factors increased progressively with age and varied by WHO region. Prevalence of coronary disease was 17·4% (2·1% for stroke and 5·2% for peripheral artery disease), increasing with concentrations of untreated LDL cholesterol, and was about two times lower in women than in men. Among patients receiving lipid-lowering medications, 16 803 (81·1%) were receiving statins and 3691 (21·2%) were on combination therapy, with greater use of more potent lipid-lowering medication in men than in women. Median LDL cholesterol was 5·43 mmol/L (IQR 4·32–6·72) among patients not taking lipid-lowering medications and 4·23 mmol/L (3·20–5·66) among those taking them. Among patients taking lipid-lowering medications, 2·7% had LDL cholesterol lower than 1·8 mmol/L; the use of combination therapy, particularly with three drugs and with proprotein convertase subtilisin–kexin type 9 inhibitors, was associated with a higher proportion and greater odds of having LDL cholesterol lower than 1·8 mmol/L. Compared with index cases, patients who were non-index cases were younger, with lower LDL cholesterol and lower prevalence of cardiovascular risk factors and cardiovascular diseases (all p<0·001). Interpretation Familial hypercholesterolaemia is diagnosed late. Guideline-recommended LDL cholesterol concentrations are infrequently achieved with single-drug therapy. Cardiovascular risk factors and presence of coronary disease were lower among non-index cases, who were diagnosed earlier. Earlier detection and greater use of combination therapies are required to reduce the global burden of familial hypercholesterolaemia. Funding Pfizer, Amgen, Merck Sharp & Dohme, Sanofi–Aventis, Daiichi Sankyo, and Regeneron