137 research outputs found

    The epidemiology and molecular characterization of Burkholderia pseudomallei in Malaysian Borneo

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    Melioidosis is a potentially fatal disease caused by Burkholderia pseudomallei which is endemic in Malaysian Borneo. The general aim of this study is to elucidate the molecular epidemiology of B. pseudomallei in Malaysian Borneo. Consistent with the Wallace line theory of separation, genotyping showed Malaysian Borneo clinical B. pseudomallei isolates were more related to Southeast Asian strains than to Australian strains. Whole genome sequencing demonstrated that B. pseudomallei from Sarawak were very closely related to each other. Biochemical testing using VITEK 2 revealed that 25% of B. pseudomallei from Malaysian Borneo were misidentified as B. cepacia, suggesting that specificity of that identification system is regionally dependent. A major and unexpected finding was that 88% of Sarawak B. pseudomallei were gentamicin susceptible, with these B. pseudomallei being restricted to multilocus sequence type ST881 and its single locus variant ST997. A novel nonsynonymous mutation was identified within amrB, an essential component of the AmrAB-OprA multi-drug efflux pump. Reversion of the mutation to the wild-type sequence confirmed the role of this mutation in conferring aminoglycoside and macrolide sensitivity. No environmental B. pseudomallei were isolated from Sarawak but other Burkholderia species were isolated, prompting the formulation of hypotheses to explain the lack of environmental B. pseudomallei. Although inconclusive, experiments showed antagonistic activities by other environmental Burkholderia spp. recovered from environmental sampling studies towards B. pseudomallei and also that gentamicin susceptible B. pseudomallei were slightly xiv less robust than gentamicin resistant strains in competing with other soil microorganisms. This thesis contributed to the understanding of the population structure of B. pseudomallei in Malaysian Borneo, Southeast Asia and globally. The discovery of gentamicin susceptibility in Sarawak B. pseudomallei has significant implications for laboratory diagnosis and environmental sampling of B. pseudomallei in Malaysian Borneo and potentially in other melioidosis endemic regions. Although the exact distributions, quantification and potential environmental hazards and implications of B. pseudomallei in Malaysian Borneo remain uncertain, these studies have led to important research questions now to be explored. Most immediate is further searching for the proposed existence of an as yet unidentified localized niche of B. pseudomallei in Malaysian Borneo

    Incorrect identification of recent Asian strains of Coxsackievirus A16 as human enterovirus 71: Improved primers for the specific detection of human enterovirus 71 by RT PCR

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    BACKGROUND: Human enterovirus 71 has emerged as an important pathogen in the Asia Pacific region and it is important to be able to make a rapid and specific diagnosis for outbreak control. Recent Asian strains of Coxsackievirus A16 have changes in the VP1 gene which causes mispriming of widely used primers for human enterovirus 71 specific identification. METHODS: Local strains of Coxsackievirus A16 were sequenced in the VP4 and VP1 genes and using sequence alignment tools, an improved set of primers were designed for specific identification of human enterovirus 71. These primers were evaluated against virus isolates as well as primary clinical specimens. RESULTS: A total of 218 virus strains were tested. All 39 human enterovirus 71 isolates were positive and none of the 38 Coxsackievirus A16, 127 other enteroviruses and 14 prototype flaviviruses and adenoviruses were positive when tested with the new primers. When aliquots of primary specimens known to have yielded human enterovirus 71 were retrospectively tested, we found that within 2 months of collection of the specimens, greater than 90% were positive but that the success rate diminished rapidly to 18% after 2 years storage. CONCLUSIONS: Our new primers will be useful in rapid diagnosis of human enterovirus 71 infection, and can also be used as a screening tool in surveillance programmes for early warning of human enterovirus 71 transmission

    Knowledge and Information-Seeking Behaviour on Nasopharyngeal Cancer in Urban and Rural Sarawak, Malaysia

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    The study examined knowledge and information-seeking behaviour on nasopharyngeal cancer (NPC) in urban and rural Sarawak. A survey was conducted in Kuching and Kampung Bengoh involving 121 respondents (44 Kuching; 77 Kampung Bengoh). The results showed that most respondents do not have family and friends who had NPC, and their work are not related to NPC. A majority of them had not looked for information on NPC and only four of them have had screening for NPC. As for intention to obtain more information on NPC in the next six months, only 46.3% reported likelihood to do so but 20.7% were unlikely to do so because they felt uncomfortable with the subject of cancer and they did not feel a need to find out more about it. There were no significant differences between the Kuching and Bengoh respondents on their attitudes towards information-seeking on cancer and intention to seek information on NPC. However, the common sources of information on NPC differ for the urban and rural respondents: the urban respondents relied on the Internet, their doctors and leaflets for NPC information but the rural respondents depended on the television, radio and newspaper are the main sources of health information. These results suggest that different channels of information need to be used to address the low level of awareness on NPC and ambivalent attitudes towards seeking information on NPC in rural and urban areas in Sarawak

    Getting the Message Across: Examining Malaysia’s Covid-19 Public Service Announcement (PSA) Infographics

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    The current COVID-19 pandemic has become an unprecedented public health crisis and there is much ongoing research investigating its wide-ranging impacts on all areas of society and people's everyday lives. This article presents preliminary findings of an ongoing study that inquires into Malaysia's COVID-19 public service announcement (PSA) infographics and how they convey much-needed information to the general public during the pandemic period. Drawing upon research on infographics in healthcare and health risk communication, the article examines COVID-19 PSA infographics that have been produced in Malaysia and the ways they achieve what they are designed to do. The findings show that the infographics 1) are numerous and mostly presented in the informational and process-based types, 2) cover various topics related to the information on the novel virus, its risks, and recommended preventive and control measures, 3) possess key components of infographic and (4) adopt a three-way process of engaging the target audience. The findings also reveal several key points worth considering in thinking about the infographics, including whether they communicate the right message to the right audience at the right time and whether they are designed according to the principles of message design in health risk communication

    Molecular phylogeny of modern coxsackievirus A16

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    A phylogenetic analysis of VP1 and VP4 nucleotide sequences of 52 recent CVA16 strains demonstrated two distinct CVA16 genogroups, A and B, with the prototype strain being the only member of genogroup A. CVA16 G-10, the prototype strain, showed a nucleotide difference of 27.7–30.2% and 19.9–25.2% in VP1 and VP4, respectively, in relation to other CVA16 strains, which formed two separate lineages in genogroup B with nucleotide variation of less than 13.4% and less than 16.3% in VP1 and VP4, respectively. Lineage 1 strains circulating before 2000 were later displaced by lineage 2 strains

    COMMUNICATING PERCEIVED BARRIERS TO ADOPTING NASOPHARYNGEAL CANCER PREVENTIVE BEHAVIOUR

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    The study investigated how the public communicate their perceived barriers to adopting the preventive behaviour to minimise risk of Nasopharyngeal cancer (NPC), also known as nose and throat cancer. The study involved 65 participants living in Kuching and Samarahan divisions of Sarawak, Malaysia. Semi-structured interviews were conducted to explore their perceived barriers after reading an NPC pamphlet produced by the Ministry of Health, Malaysia. The participants reported that living a healthy lifestyle is more difficult than consulting a doctor. A total of 19% participants reported that living a healthy lifestyle is hard, 29% remained indifferent and 52% found it easy. They knew NPC risk could be minimised by reducing smoking, following a healthy diet and exercising. However, the main perceived barrier was a lack of discipline. For 69% of the participants, seeing a doctor about NPC was not a barrier, but the remaining participants fear of facing the truth and the pain of the cancer screening. The findings suggest that in the context of NPC, recommendations to consult doctors should be more visibly worded to attract the public’s attention and to motivate action to seek medical treatment
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