Epidemiology of malaria in Rohingya refugee camps in Bangladesh within 2017–2020

Background: Malaria causes significant morbidity and mortality in tropical and sub-tropical regions, particularly in humanitarian emergencies including refugee camps in malaria endemic areas. An epidemiological investigation was conducted on malaria disease distribution and risk factors in the world’s largest refugee settlement, the Rohingya refugee camps on the south-eastern border area of Bangladesh, within 2017–2020. Methods: From February 2017 to March 2020, 30,460 febrile patients were tested for malaria using light microscopy and rapid diagnostic tests. Most were self-presenting symptomatic patients and a minority were from door-to-door malaria screening. Diagnostic tests were done by trained medical technologists upon the advice of the concerned physicians in the camps. Test positivity rate (%) and annual parasite incidence were calculated and compared using chi-squared (χ 2) test or odds ratios. Results: The overall average annual test positivity rate (TPR) was 0.05%. TPR was highest in people who had travelled to the forest in the previous 2 months, at 13.60%. Cases were clustered among male adults aged 15–60 years. There were no cases among children under five years or pregnant women and no deaths from malaria. Conclusion: This study found very few malaria cases among Rohingya refugees with the majority of cases being imported from hilly forested areas, which were thus assumed to act as the reservoir for transmission

Real-time PCR assay and rapid diagnostic tests for the diagnosis of clinically suspected malaria patients in Bangladesh

<p>Abstract</p> <p>Background</p> <p>More than 95% of total malaria cases in Bangladesh are reported from the 13 high endemic districts. <it>Plasmodium falciparum </it>and <it>Plasmodium vivax </it>are the two most abundant malaria parasites in the country. To improve the detection and management of malaria patients, the National Malaria Control Programme (NMCP) has been using rapid diagnostic test (RDT) in the endemic areas. A study was conducted to establish a SYBR Green-based modified real-time PCR assay as a gold standard to evaluate the performance of four commercially-available malaria RDTs, along with the classical gold standard- microscopy.</p> <p>Methods</p> <p>Blood samples were collected from 338 febrile patients referred for the diagnosis of malaria by the attending physician at Matiranga</p> <p>Upazila Health Complex (UHC) from May 2009 to August 2010. Paracheck RDT and microscopy were performed at the UHC. The blood samples were preserved in EDTA tubes. A SYBR Green-based real-time PCR assay was performed and evaluated. The performances of the remaining three RDTs (Falcivax, Onsite Pf and Onsite Pf/Pv) were also evaluated against microscopy and real-time PCR using the stored blood samples.</p> <p>Result</p> <p>In total, 338 febrile patients were enrolled in the study. Malaria parasites were detected in 189 (55.9%) and 188 (55.6%) patients by microscopy and real-time PCR respectively. Among the RDTs, the highest sensitivity for the detection of <it>P. falciparum </it>(including mixed infection) was obtained by Paracheck [98.8%, 95% confidence interval (CI) 95.8-99.9] and Falcivax (97.6%, 95% CI 94.1-99.4) compared to microscopy and real-time PCR respectively. Paracheck and Onsite Pf/Pv gave the highest specificity (98.8%, 95% CI 95.7-99.9) compared to microscopy and Onsite Pf/Pv (98.8, 95% CI 95.8-99.9) compared to real-time PCR respectively for the detection of <it>P. falciparum</it>. On the other hand Falcivax and Onsite Pf/Pv had equal sensitivity (90.5%, 95% CI 69.6-98.8) and almost 100% specificity compared to microscopy for the detection of <it>P. vivax</it>. However, compared to real-time PCR assay RDTs and microscopy gave low sensitivity (76.9%, 95% CI 56.4-91) in detecting of <it>P. vivax </it>although a very high specificity was obtained (99- 100%).</p> <p>Conclusion</p> <p>The results of this study suggest that the SYBR Green-based real-time PCR assay could be used as an alternative gold standard method in a reference setting. Commercially-available RDTs used in the study are quite sensitive and specific in detecting <it>P. falciparum</it>, although their sensitivity in detecting <it>P. vivax </it>was not satisfactory compared to the real-time PCR assay.</p

-Short Communication COMMUNITY OF HELMINTH PARASITES IN RITA RITA (HAMILTON BUCHANUN)

Key words: Rita rita, helminthes, prevalence and intensity of parasites. A majority of fishes carry heavy infection of parasites, which cause deterioration in the food value of fish and may even result in their mortality. Besides, there are a number of ‘helminth parasites ’ which are transmitted to men only through fish. The activities of parasite damage the tissues lining the wall of intestine, stomach, bile duct, liver, etc and cause microscopic lesions in the host’s tissue which become the site for secondary infection by bacteria. Wisneiwski (1958) stated that the character of a water body influences and determines the parasite fauna of its community. The physiological and biological features of the host affect the community of parasites even more seriously (Bibby 1972), and these factors determine the final composition of parasite fauna of the fish. Little is known about the distribution, pathogenic effects and control of most of the diseases in natural population of fresh water fish. The helminth parasite fauna of fresh water fishes, its frequency and distribution have been studied in many parts of the world (Kennedy and Hine 1969). The helminth parasites of fishes may herm their hosts in variety of ways e.g. a) by causing mechanical injury and atrophy of blood vessels or other ducts, b) by introducing toxic metabolic by products able to produce changes in the blood, enzyme, vitamin and hormone activity of the host, c) by depriving the fish from its nutrition, d) by acting as carrier or vectors of other pathogens and e) by providing a point of category for other pathogens through mechanical damage (Mehra 1991). The fauna of trematodes, nematodes and cestodes, mainly caryophyllides are found both in marine and freshwater fishes of Bangladesh, as the temperature never falls below 4°C, which is a suitable temperature for excellent survival and distribution of these parasites. Bashirullah (1973), Ahmed (1981), Zaman et al

-Short Communication INCIDENCE OF NEMATODE INFECTIONS AMONG THE CHILDREN BROUGHT TO

Helminthic infection due to nematodes is a major public health problem in the developing and underdeveloped countries including Bangladesh. This is due to poor hygienic habits and living condition of the majority of the population. The common nematodes found in Bangladesh are Ascaris lumbricoides, Trichuris trichiura, Ancylostoma duodenale etc. Ascariasis, Trichuriasis and Ancylostomiasis appear to flourish in the communities where the socio-economic status is dominated by poverty, poor housing, insufficient sanitation and a need of health education (Crompton 1988). Children are more exposed to these soil transmitted worms which are also associated with stunted growth ( Cooper and Bundy 1987, Adams et al. 1994) and impaired cognitive functions ( Nokes et al. 1998). Helminths infection causes decreased body resistance, retardation of physical and mental development of children, indigestion, diarrhoea, anorexia and lack of memory, increased morbidity rate, greater incidence of abortion, sterility, stillbirth and impaired lactation, anaemia, pneumonia, bronchitis, appendicitis, increased susceptibility to various non-helminthic diseases (Stephenson 1987; Adams et al. 1994). The high prevalence rate of the parasite was correlated with poverty, poor sanitation and impoverished health services ( WHO 1987). A number of studies have been conducted throughout Bangladesh during the past half century regarding to the infestation of intestinal nematodes. Among them Kuntz (1960), Muazzem and Ali (1961,1968), Muttalib e

Eczema among the Outdoor Diabetic Patients of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital, Dhaka

Background: Eczema is one of the important causes of public health problem. So, we conducted a study to assess the socio-demographic characteristics (age, sex, occupation, socio-economic condition, site of lesion, diabetes status etc) and to find out their relationship with the complicated eczema. Objective: The objective of the study was to find out the eczema cases attending in Department of Dermatology of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) Hospital and to identify the surface complications of eczema and the occurrence of eczema among the diabetic patients of BIRDEM Hospital. Materials and Methods: This cross-sectional study was carried out among the outdoor diabetic patients attending the Department of Dermatology of BIRDEM Hospital, Dhaka, Bangladesh during the period of 1st September to 31st November, 2014. Results: A total of 600 patients were interviewed. Of them, 60% were female and 40% were male. Among them, majority (29.17%) were in the age group of 40–49 years. Most of the subjects (66.67%) were service holders. Majority of the subjects (61.67%) were from low socio-economic status. In majority cases (41.67%) lesions were in hand and in 33.33% in legs. Diabetes was uncontrolled in 76.67% cases and only 15% controlled it and 8.33% controlled strictly. Conclusion: Factors like occupation, diabetes status etc. were found associated with high occurrence of eczema