The Southeast Asian Journal of Tropical Medicine and Public Health
EVALUATION OF ASSOCIATIONS BETWEEN DIET AND GASTROINTESTINAL DISORDERS IN SAUDI ARABIA
Gastrointestinal (GI) disorders are a public health problem in Saudi Arabia and diet may influence these conditions. In this study we aimed to evaluate associations between diet and GI disorders among Saudi adults in order to inform efforts to control and prevent these conditions. Study subjects were recruited from the Aseer Region, Saudi Arabi using online surveys distributed via social media platforms and institutional mailing lists of King Khalid University. Inclusion criteria for study subjects were: being aged ≥18 years, living in the Aseer Region, being willing and giving consent to participate in the study. Exclusion criteria for study subjects were: being unwilling to participate in the study, not completing the required questionnaire and having a serious health condition that could confound the dietary assessment. The minimum number of study subjects calculated to be needed for the study was 423. Each subject was asked to complete a self-administered questionnaire that was previously validated, adapted and pilot tested among 20 residents from the study area who met inclusion and exclusion criteria for study subjects. This cross-sectional study was conducted during January-June 2025. The questionnaire asked about consumption of fruits, vegetables, grains, dairy products, proteins/meats, sugary foods, fats and fast food. It also asked about physical activity level, smoking status, weight and height. A body mass index (BMI) was calculated from the weight and height. Dietary intake of each of the recorded items was classified as never, low (1-2 times/week), moderate (3-6 times/week) and high (≥7 times/week) following Food and Agricultural Organization (FAO), World Health Organization (WHO) guidelines. Consumption of sugary items, fats and fast food were categorized into low/healthy, moderate and high/unhealthy consumption. Physical activity was categorized as low, moderate, or high following WHO recommendations, with thresholds based on weekly minutes of moderate and vigorous activity. BMI was categorized as underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), overweight (25.0-29.9 kg/m²), and obese (≥30.0 kg/m²). Subjects were asked if they had been diagnosed with any of the following gastrointestinal (GI) disorders: constipation, functional dyspepsia, gastritis, gastroesophageal reflux disease (GERD), inflammatory bowel disease (IBD Crohn’s or ulcerative colitis), irritable bowel syndrome (IBS), and peptic ulcer disease (PUD). Associations between diet and these specific GI disorders were assessed using multivariable logistic regression analysis and reported as adjusted odds ratios (aOR) with 95% confidence intervals (CI). A total of 430 subjects were included in the study, 256 (59.5%) females. The mean (±standard deviation) age of study subjects was 36.9 (±10.8) (range: 18-65) years. Twenty-seven subjects (6.3%) never consumed fruit. 328 (76.3%), 58 (13.5%) and 17 (3.9%) had low, moderate and high fruit intake, respectively. 15 (3.5%) never consumed vegetables. 272 (63.3%), 99 (23.0%) and 44 (10.2%) had low, moderate and high vegetable intake, respectively. Three subjects (0.7%) never consumed grains. Eighty (18.6%), 191 (44.4%) and 156 (36.3%) had low, moderate and high grain intake, respectively. Nine subjects (2.1%) never consumed protein/meat. 132 (30.7%), 188 (43.7%) and 101 (23.5%) had low, moderate and high protein/meat intake, respectively. Nine subjects (2.1%) never consumed dairy products. 262 (60.9%), 121 (28.2%) and 38 (8.8%) had low, moderate and high dairy intake, respectively. Fifteen subjects (3.5%) never consumed sugary foods. 222 (51.7%), 127 (29.5%) and 66 (15.3%) had low, moderate and high sugary food intake, respectively. Eight subjects (1.9%) never consumed fat. 234 (54.4%), 138 (32.1%) and 50 (11.6%) consumed low, moderate and high fat intake; thirty-two subjects (7.4%) never consumed fast-food. 309 (71.9%), 81 (18.8%) and 8 (1.9%) had low, moderate and high fast-food intake, respectively. 117 subjects (27.2%) reported having been diagnosed with a GI disorder: 12 (2.8%) had constipation, 9 (2.1%) had functional dyspepsia, 55 (12.8%) had gastritis, 17 (4.0%) had GERD, 1 (0.2%) had IBD, 18 (4.2%) had IBS and 5 (1.2%) had PUD. Subjects with low fruit intake were significantly more likely to have a GI disorder than those on a moderate to high fruit diet (aOR = 0.685, 95%CI: 0.497-0.945, p-value = 0.021). Females were significantly less likely than males to have a GI disorder (aOR = 0.490; 95%CI: 0.273-0.878, p-value = 0.017). Insummary, subjects with a low fruit diet were significantly more likely to have a GI disorder and females were significantly less likely to have a GI disorder. We conclude, subjects with a low fruit diet and males in the study population should be encouraged to consume more fruit. Further studies are needed to determine if people with a low fruit diet and males consume more fruit if this will reduce the chance of developing a GI disorder.
Copyright (c) 2025 The Southeast Asian Journal of Tropical Medicine and Public Health
PREVALENCE AND DETERMINANTS OF INTERNET GAME ADDICTION AND PSYCHOLOGICAL EFFECTS AMONG MALE STUDENTS IN HEALTH SCIENCE PROGRAMS AT JAZAN UNIVERSITY, SAUDI ARABIA
The internet has become a common means of communication, education, research, business, entertainment, and games. An excessive use of the latter has led to a disorder termed Internet Gaming Addiction (IGA). A cross-sectional study assessed the prevalence of IGA based on the Internet Gaming Disorder-20 test among male health science students (n = 486), 18-35 years of age, enrolled at Jazan University, Saudi Arabia, in 2023. Data were collected via a Google Form of a validated Arabic version of a close-ended self-answered questionnaire on the students’ sociodemographic background, academic discipline and performance, mental health, lifestyle, and recreational activity. Using univariate statistics followed by multiple logistic regression modeling, two independent risk factors were identified associated with IGA, namely, prior psychological diagnosis and internet gaming as a recreational activity. The study findings should prompt educators, health providers and administrators at colleges and universities in Saudi Arabia to implement educational programs promoting responsible gaming behavior.
ASSESSING THE HEALTH AND NUTRITION OF CHILDREN FROM LOW-INCOME HOUSEHOLDS IN RURAL PANDEGELANG, BANTEN, INDONESIA
Undernutrition is linked to food insecurity, which is brought on by low income, restricted access to wholesome food, low educational attainment, and poor hygiene habits, all of which contribute to the development of disease. To address undernourishment among children under five, this study aimed to evaluate the prevalence of undernutrition in children from low-income households and provide appropriate handling. Pandeglang District was selected as the study area due to its high rate of province undernourished children. Information was gathered on the children’s anthropometry, general characteristics, household socioeconomics, and 24-hour recall of food consumption. The results revealed that among the 105 children assessed, 40% were stunted, 23.8% were underweight, and 4.8% were experiencing wasting, indicating a notably high level of undernutrition. These figures place Pandeglang as the district with the highest undernutrition rates in the region, exceeding both the provincial and national averages reported in 2018. According to WHO standards, the area falls under the medium category for underweight and high category for both stunting and wasting. Dietary intake analysis using the Calculator of Inadequate Micronutrient Intake (CIMI) showed that only 55.2% of the children met energy requirements, while 50.5% and 53.3% met the needs for iron and zinc respectively. Alarmingly, nearly all (98.1%) had insufficient intake of vitamin A. This indicates that micronutrient deficiencies are a significant issue. It may have an impact on kids’ development and health. To address this problem, better diets, supplementation, and nutrition education are required.
INFLUENCE OF MUROTTAL QS AL FATIHAH THERAPY ON STRESS AMONG OLDER PEOPLE IN UPT PSTW KHUSNUL KHOTIMAH, RIAU, INDONESIA
Stress is a problem that is often experienced by the older people. QS Al-Fatihah murottal therapy is an effective complementary therapy to overcome the psychosocial problems. This study aimed to determine the effect of QS Al-Fatihah murottal therapy on the stress of the older people at UPT PSTW Khusnul Khotimah, Riau, Indonesia. The study design was quasi-experimental with a pre- and post-test and a control group. QS Al-Fatihah murottal therapy intervention was provided twice a week for two weeks with 30-45 minutes for each session to a group of participants. Participants were recruited by the consecutive sampling technique, and a total number 36 older people participated. The instrument used for identifying respondent characteristic data was a characteristics questionnaire and that for evaluating the stress conditions of respondents was the DASS 42. Data analysis used were the dependent and independent t-tests. The results showed that most of the respondents were 60-74 years of age (63.9%), being female (55.5%), of Malay ethnicity (38.8%), had completed primary school (63.8%), were unemployed (100%), and had non-communicable disease (100%). The effects of QS Al-Fatihah murottal therapy were positive on reducing stress (p-value <0.001). This study recommends QS Al-Fatihah murottal therapy as a complementary therapy that nurses do for the older people with a psychoreligious approach.
COST-EFFECTIVENESS ANALYSIS OF USING METFORMIN AND GLIMEPIRIDE IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN YOGYAKARTA, INDONESIA
Cost-effectiveness analysis (CEA) is a pharmacoeconomic method that assists in decision-making about the selection of benefit-effective and cost-effective therapies. The average cost-effectiveness ratio (ACER) is expressed as the dollar amount generated for each specific clinical outcome, regardless of comparison. The incremental cost-effectiveness ratio (ICER) reveals the costs to obtain one outcome unit relative to its comparison. Metformin is an oral antidiabetic for people with type 2 diabetes mellitus. Glimepiride can effectively improve glucose control in people with type 2 diabetes mellitus who possess a good health profile. This research aimed to determine the effectiveness of therapy, average cost, and cost-effectiveness of using metformin and glimepiride in people with type 2 diabetes mellitus. This research employed an observational study. Data collection was carried out retrospectively using total sampling at the community health centers in Yogyakarta. Data were analyzed using ACER or ICER to determine a more cost-effective therapy for lowering blood glucose levels. The cost-effectiveness analysis involving a total of 192 patients, 133 patients receiving metformin and 59 patients receiving glimepiride, disclosed that glimepiride was more cost-effective than metformin. The clinical results also unveiled the higher effectiveness of glimepiride therapy over metformin in reducing blood glucose levels. The average cost of glimepiride was IDR 6,101, exhibiting an effectiveness of 77.96% and an ACER value of IDR 78. The ICER calculation was omitted due to the low average cost, high effectiveness, and low ACER value of glimepiride in comparison to metformin. Therefore, glimepiride demonstrated more cost-effectiveness than metformin in people with type 2 diabetes mellitus at the community health centers in Yogyakarta.
MAGNESIUM INTAKE AS A POTENTIAL THEURAPEUTIC APPROACH FOR OBESITY AND METABOLIC SYNDROME: A LITERATURE REVIEW
Magnesium plays a crucial role in metabolic processes, influencing various aspects of health, including glucose regulation, insulin sensitivity, and lipid metabolism. This literature review aims to summarize current evidence on the potential role of dietary magnesium intake as a therapeutic strategy for managing obesity and metabolic syndrome. A selection of relevant articles published from 2019 to 2024 was reviewed based on defined inclusion and exclusion criteria. The articles were sourced from PubMed, ScienceDirect, and Google Scholar databases. This review was conducted following the PRISMA guidelines to ensure a systematic and transparent approach. Out of 8,662 articles initially retrieved, 14 met the eligibility criteria and were proceeded to the review. Of the selected articles, 4 employed RCTs including different dosage of magnesium supplement 250-300 mg/day, with duration 12-24 weeks were entered to this study. Furthermore, 1 RCT recommends an RDA of magnesium intake for children and adolescents of 360-410 mg/day. Five articles utilized cross-sectional designs while there were 3 cohort studies and 1 case-control study. An inverse association has been consistently reported between magnesium intake, whether from diet or supplementation, and the risk of metabolic disorders. This review highlights various studies that examine the effects of magnesium supplementation on health outcomes, alongside those focusing on the benefits of consuming magnesium-rich foods. By exploring both dietary and supplemental magnesium intake, this review provides a balanced perspective on how magnesium affects health, considering different sources and forms of intake.
MOLECULAR DETECTION OF ENTAMOEBA DISPAR FROM SURFACE WATER SAMPLES IN THAILAND
Accurate identification of Entamoeba species is crucial for a better understanding of the nature of these protozoan parasites and obtaining precise epidemiological data. Humans typically become infected with Entamoeba through the fecal-oral route, particularly from contaminated water in areas with poor sanitation. Therefore, it becomes important to determine the prevalence of human Entamoeba in surface water samples. We extracted DNA from surface 140 water samples collected along locations along canals, Pathum Thani Province, Thailand, for analysis of the presence of Entamoeba dispar, E. histolytica and E. moshkovskii using quantitative PCR, and of Entamoeba coli using nested PCR. Samples (14%) were positive for E. dispar and negative for the other three species. Although infection with E. dispar is generally non-pathogenic, intestinal symptoms in E. dispar infected patients have beebn reported in various regions. Routine surveillance of Entamoeba spp in surface water samples should help reduce the prevalence of amebiasis in Thailand.
MICROORGANISMS AND ANTIBIOTIC RESISTANCE IN PEDIATRIC ICU PATIENTS: A RETROSPECTIVE STUDY, MOGADISHU, SOMALIA
Antimicrobial resistance is a major public health issue, especially in developing countries. This study retrospectively assessed microorganisms and antibiotic resistance in patients from a pediatric intensive care unit (PICU) of a tertiary hospital in Mogadishu, Somalia, between January 2022 and December 2023. Cultures and antibiotic susceptibility tests were conducted on clinical samples collected. Standard bacteriological methods identified 24.5% of the samples (n = 1,424) as positives, 85% from patients ≤1 year of age, with 66% being male. Cultures were predominantly from blood (73%), followed by urine (10%) and then wound (7%), with Gram-negative bacteria accounting for 58%, Gram-positive bacteria 27% and Candida spp 15% of the samples. The most frequent Gram-negative and -positive bacteria were Escherichia coli (26%) and coagulase-negative staphylococci (19%). Antibiogram profiling revealed that the Gram-negative bacteria isolates were resistant to amoxicillin/clavulanic acid (59%), ampicillin/sulbactam (60%), and trimethoprim/sulfamethoxazole (52%), while Gram-positive bacteria isolates were resistant to ciprofloxacin (69%), levofloxacin (72%) and methicillin (51%). Although the data were limited to a single hospital, the high prevalence of antibiotic resistance emphasizes the need for maintaining an up-to-date antibiogram database for appropriate antibiotic use, especially among the very young PICU patients in Somalia and elsewhere.
EFFECT OF SOCIODEMOGRAPHIC AND CLINICAL FACTORS ON LENGTH OF HOSPITAL STAY FOR ADULT DENGUE PATIENTS: A RETROSPECTIVE STUDY AT A TERTIARY CARE HOSPITAL, JAKARTA, INDONESIA
Dengue infection is prevalent, yet data on factors associated with prolonged hospital stays are limited. This study aimed to identify factors related to prolonged hospital stays in adult patients admitted with dengue infection at a tertiary hospital. We conducted an observational retrospective cohort study utilizing secondary data from medical records between 2020 and 2024. Clinically confirmed dengue patients were divided into two groups based on hospital stay duration, namely ≤4 days and >4 days. We compared clinical and laboratory characteristics using appropriate statistical methods. Of the 272 patients, 48% had prolonged hospital stays, with a mean hospital stay of 4.7 ± 1.6 days. Multivariate analysis revealed that patients with comorbidities (adjusted odds ratio (aOR) = 2.08) had an increased likelihood of prolonged hospital stays. Patients admitted to the hospital after 4 days of illness had a 0.27 lower likelihood of experiencing prolonged hospital stays. Nadir platelet counts <20×103 cells/µl, low white blood cell counts, vomiting, and low hemoglobin level were predictors of prolonged hospital stay (aORs = 3.47, 2.74, 1.93, and 1.92, respectively). Our research indicated that comorbidities of adult dengue patients, viz low hemoglobin, low platelet and white blood cell counts, and vomiting, are significantly associated with prolonged hospital stay, factors that the attending clinicians should take into consideration.
INTEGRATED RESPONSE TO HEXAVALENT CHROMIUM RIVER POLLUTION FOR ENVIRONMENTAL AND HUMAN HEALTH PROTECTION
An analysis of hexavalent chromium, Cr(VI), pollution in river ecosystems was carried out using the Driver, Pressure, State, Impact, Response (DPSIR) framework to identify key drivers, pressures, water quality decline, and the resulting environmental, health, and socio-economic impacts. The DPSIR approach effectively highlights the interconnections between these elements and supports pollution prevention and water quality management efforts in the Opak River. Cr(VI) contamination is primarily driven by economic and political pressures, weak regulations, and overlapping institutional authority. The discharge of untreated Cr(VI)-containing waste leads to serious ecological degradation, health risks, and socio-economic challenges, threatening community well-being and business sustainability. Addressing this issue requires a comprehensive strategy that includes clear policy formulation and enforcement, improved river ecosystem management, institutional coordination, and enhanced community awareness and capacity building to promote long-term sustainability and protect public health and the environment.
READINESS FOR DIGITAL ANTENATAL NUTRITION EDUCATION: PERSPECTIVES OF PREGNANT WOMEN, FAMILIES AND HEALTHCARE PROFESSIONALS
Proper nutrition education is essential for improving pregnant women’s knowledge, awareness, and dietary practices. Digital platforms offer a promising alternative for antenatal nutrition education, particularly when traditional methods are insufficient. This study explored the readiness of pregnant women, their families, and healthcare professionals in Malang City, Indonesia, to utilize digital media for delivering and accessing antenatal nutrition education. A qualitative study using in-depth interviews was conducted with eleven pregnant women, six family members, and five healthcare professionals in October 2023 and September 2024. The qualitative data were analyzed using thematic analysis. The findings revealed that inadequate nutrition education was a significant concern, with many women reporting a lack of direct guidance from healthcare professionals and limited use of existing educational platforms. Pregnant women often turned to digital media for nutrition information, but their concerns about the accuracy and reliability of online content remained. While digital platforms offer valuable opportunities to increase accessibility to nutrition education, challenges such as low interactivity and delayed response times limit their effectiveness. The study suggests enhancing digital education platforms by improving accessibility, providing personalized and scientifically accurate content, and integrating interactive features such as real-time consultations and peer support networks. These improvements could significantly enhance the impact of digital nutrition education, ultimately improving maternal health outcomes. In conclusion, addressing the gaps in digital nutrition education could lead to more effective support for pregnant women, improving their health and well-being during pregnancy.
FALL OCCURRENCE AND ASSOCIATION WITH KNOWLEDGE AND PRACTICE ON FALL PREVENTION AMONG ELDERLY RESIDENTS IN NURSING HOMES, PR CHINA
Falls among the elderly are of a significant global health concern. While falls in nursing homes are a growing issue, limited attention has been given to the role of the residents’ knowledge and practices in fall prevention, particularly in nursing homes in China. We used a cross-sectional study to determine the prevalence of falls and their association with knowledge and practices in fall prevention among the elderly (n = 341), age 60 years and above, residing in nursing homes in three districts of Jinzhou City, Liaoning Province, PR China. Data were collected using validated structured questionnaires and evaluated using a logistic regression analysis, with results reported as odds ratios (ORs) and 95% confidence intervals (CIs). Participants (28%) experienced at least one fall in the previous 12 months. The multivariate analysis revealed that a higher score in knowledge of fall prevention was significantly associated with greater occurrence of falls (adjusted odds ratio (aOR) = 1.16; 95% CI: 1.06-1.27, p-value = 0.002), while there was no significant association with practice in fall prevention. The female sex (aOR = 1.76; 95% CI: 1.03-2.99, p-value = 0.038), a history of stroke (aOR = 3.12, 95% CI: 1.64-5.93, p-value = 0.001), and impaired mobility (aOR = 2.07, 95% CI: 1.21-3.55, p-value = 0.008) were positively associated with falls. However, having completed a college education was inversely associated with fall occurrence (aOR = 0.40, 95% CI: 0.17-0.98, p-value = 0.044). In conclusion, falls were common among elderly residents in nursing homes in Jinzhou City. These findings underscore the importance of implementing targeted interventions that extend beyond a knowledge-based approach to effectively reduce incidents of falls within this at-risk growing population.
ROLE OF BROWN RICE BIOACTIVES IN MODULATING LIPID METABOLISM AND ADIPOGENESIS: IMPLICATIONS FOR OBESITY MANAGEMENT
Obesity is a global public health issue with a steadily increasing prevalence. Based on the 2023 Indonesian Health Survey, the prevalence of obesity among adults (>18 years old) increased from 21.8% in 2018 to 23.4% in 2023. Globally, the World Obesity Atlas 2023 reported that 38% of the world’s population is overweight or obese, and this figure is projected to reach 51% by 2035. Obesity contributes to various metabolic disorders such as insulin resistance, dyslipidemia, and inflammation. Nutritional interventions that can modulate these metabolic pathways, particularly those involving functional foods, are important strategies for managing obesity. This literature review aims to examine the potential of bioactive compounds in brown rice in regulating lipid metabolism and adipogenesis as a preventive and therapeutic strategy against obesity. This study employed a systematic literature review method by analyzing original experimental studies (in vitro and in vivo) published between 2020 and 2024. Articles were selected from reputable databases such as PubMed, ScienceDirect, and Scopus using keywords related to brown rice bioactive compounds (eg, γ-oryzanol, GABA, tocopherol, ferulic acid, phytosterols, polyphenols) and their roles in lipid metabolism and adipogenesis. Inclusion criteria focused on full-text, peer-reviewed studies examining the metabolic effects of these compounds on obesity-related parameters. Several bioactive compounds in brown rice - including γ-oryzanol, GABA, ferulic acid, phytosterols, and polyphenols - show anti-obesity potential through multiple mechanisms, such as inhibiting lipogenesis, enhancing lipolysis, promoting mitochondrial biogenesis and thermogenesis, improving insulin sensitivity, and reducing chronic inflammation in adiposetissue. Germination and other processing methods have also been shown to increase the concentration and bioavailability of these compounds. Brown rice is a promising functional food rich in bioactive compounds with potential anti-obesity effects. These compounds play crucial roles in modulating lipid metabolism, reducing adipose tissue inflammation, and supporting metabolic health. The development of brown rice-based dietary interventions could serve as an effective, evidence-based strategy for obesity prevention and management.
SEROPREVALENCE OF HIV, HBV, HCV, AND VD AMONG PREGNANT WOMEN IN SOMALIA: A RETROSPECTIVE STUDY
In resource-limited settings, infectious diseases during pregnancy remain a significant public health concern due to their serious impacts on maternal and neonatal health. We retrospectively reviewed the medical records of pregnant women (n = 5,335), 15-45 years of age, who attended the maternity clinic of a tertiary hospital in Mogadishu, Somalia, between 2021 and 2023. Data was obtained from the hospital’s electronic information system on the presence of HIV, HBV, HCV, and venereal disease (VD) as well as sociodemographic characteristics. HBsAg, anti-HCV antibody, anti-HIV antibody, and VD positivity among the subjects was 4.3, 1.1, 0.4, and 0.9%, respectively. Yearly differences in HBsAg, anti-HCV antibody and VD positivity are statistically significant (p-value = 0.002, 0.009 and 0.007, respectively), as well as across all ages (p-value = 0.031, 0.028 and <0.001, respectively). These findings highlight the ongoing burden of hepatitis B, hepatitis C and VD infections among pregnant women in Mogadishu (and possibly the whole country) and emphasize the need for routine antenatal screening. Large-scale screening initiatives and maternal health education programs are crucial for preventing these infections and reducing perinatal transmission.
TRIMERESURUS TRUONGSONENSIS BITE: A CASE REPORT FROM VIETNAM
Trimeresurus truongsonensis is a species of venomous snake belonging to the viper family. In this study we report a case of a T. truongsonensis bite. The study subject is a 20-year-old male who was mountain climbing in Quang Binh Province, Vietnam when he found, caught and brought home a T. truongsonensis viper to keep as a pet. He was feeding the snake on 9 January 2025 when he was bitten on the back of his right hand by the snake. Two hours and forty-five minutes later he presented to Bach Mai Hospital Poison Control Center with pain and swelling at the bite site. He was admitted to hospital and liver and kidney function tests, electrolyte levels, CK (creatine kinase) level and highly sensitive troponin T tests were performed and all the results came back normal but on a complete blood count the white blood cell count was elevated (13.46 g/l), as was the percent neutrophils (81.27%) and the fibrinogen level was low (1.58 g/l; normal range: 2-4 g/l). The fibrinogen level continued to decrease until it reached a nadir at 10 hours post snake bite (1.44 g/l) and then gradually increased to normal (2.07 g/l) 34 hours post snake bite. The patient was supported with intravenous fluids; he was given a dose of anti-tetanus serum, and given prophylactic clindamycin intravenously at a dose of 1,800 mg/day. The patient was not given antivenin. He was discharged home 48 hours post snake bite with no pain and normal blood tests. We review the clinical management of this type of snake below.
SYSTEMATIC REVIEW WITH A META-ANALYSIS OF THE EFFICACY OF SUPERVISED TOOTHBRUSHING ON CARIES PREVENTION AMONG PRIMARY SCHOOL CHILDREN
Dental caries among children is a public health problem worldwide and proper toothbrushing is an important preventive strategy. In this study, we aimed to compare the efficacy of supervised toothbrushing (STB) with unsupervised tooth brushing (control group) to prevent caries among primary school children by conducting a systematic review with a meta-analysis in order to inform efforts to prevent caries in the study population. We searched for studies that aimed to compare the efficacy of STB with a control group to prevent caries among primary school children (aged 5-12 years). A total of 10 studies were included in this systematic review. A meta-analysis was performed on 6 of these 10 studies. The total number of systematic review subjects was 3,905: 1,943 in STB groups and 1,962 in control groups. The total meta-analysis study population consisted of 3,014 subjects: 1,504 in STB groups and 1,510 in control groups. The systematic review revealed STB did not significantly reduce caries among study subjects compared to controls. The meta-analysis also revealed STB did not significantly reduce caries among study subjects compared to controls (risk ratio = 0.92; 95% confidence interval (CI): 0.84-1.01; p-value >0.05). In summary, we found no significant benefit of STB among study subjects to prevent caries. We conclude other caries prevention methods should be employed in the study population to prevent caries. Further studies are needed to determine why STB was ineffective in preventing caries in the study population and what methods can be used to correct this.
FOSFOMYCIN AGAINST CARBAPENEM-RESISTANT KLEBSIELLA PNEUMONIAE BLOODSTREAM INFECTION: IN VITRO ACTIVITY, CORRELATION OF SUSCEPTIBILITY TESTING METHODS AND TREATMENT CHARACTERISTICS
Fosfomycin is an adjunctive therapy for carbapenem-resistant Klebsiella pneumoniae (CRKP) infection, despite the lack of defined breakpoints. Treatment decisions rely on pharmacokinetics/pharmacodynamics (PK/PD) targets. The study evaluated fosfomycin efficacy against CRKP isolates harboring various carbapenemase genotypes, the association between disc diffusion zone diameters and Etest MIC values, and treatment regimens of patients ≥20 years of age with CRKP bloodstream infection from four hospitals across Thailand. The most prevalent carbapenemase genotype identified by PCR was blaOXA-48-like (62%). Of the CRKP isolates (n = 133), 19 and 34% demonstrated fosfomycin MIC values ≤32 and ≥128 μg/ml, respectively. A categorical agreement of 99% (1% error rate) between the two sensitivity assay methods was achieved for isolates with MIC ≤ 128 μg/ml and zone diameter ≥16 mm. Over half of the patients received a combination therapy of fosfomycin plus colistin and the most prevalent comorbidity was chronic kidney disease (56%). The 14-day all-cause mortality rate was 32%. Fosfomycin is still considered necessary in situations where alternative effective drugs are not available, highlighting the need for standardized susceptibility testing methods.
Fosfomycin, CRKP, bloodstream infections, disk diffusion, E-test
COMPARISON OF THE EFFECTIVENESS OF WRITTEN LITERATURE ONLY VERSUS AN INTERVENTION PROGRAM TO REDUCE COVID-19 VACCINE HESITANCY AMONG HIGH SCHOOL STUDENTS IN PAKISTAN
Coronavirus disease-2019 (COVID-19) vaccine hesitancy can interfere with efforts to control the disease. In this study we aimed to compare the efficacy of a school-based program versus an already used educational brochure to reduce COVID-19 vaccine hesitancy among 9th and 10th grade students in Balochistan, Pakistan, in order to inform efforts to improve vaccine uptake in the study population. Study subjects were recruited from 30 schools in Balochistan, Pakistan during September 2023 - February 2024. Inclusion criteria for study subjects were, being a 9th or 10th grade student at a study school and being willing to participate in the study. Exclusion criteria for study subjects were being unwilling to participate in the study or attending a non-study school. Study subjects were divided into 2 groups: an intervention group and a control group. Intervention subjects underwent an educational program about COVID-19 and the COVID-19 vaccine that consisted of lectures and presentation of various media. Control subjects were given a routinely used educational brochure about COVID-19 and the COVID-19 vaccine. Both control and intervention subjects were asked to complete a questionnaire both prior to and after the intervention. The questionnaire assessed subject knowledge about COVID-19 and the COVID-19 vaccine, subject confidence (subject trust in the efficacy and safety of the COVID-19 vaccine and subject trust in healthcare professionals and policymakers endorsing the vaccine), vaccine convenience (subject perceived ease of being vaccinated with the COVID-19 vaccine) and subject complacency (subject perceived risk and necessity of receiving the COVID-19 vaccine). Each question was given a score, and the scores were totaled and classified. Subject knowledge, subject confidence, vaccine convenience and subject complacency were classified by percentile: having a low score (<34th percentile), medium score (34th-66th percentile) and high score (>67th percentile). For complacency, a higher score indicated a lower complacency. A total of 780 subjects were included in the study: 386 (49.5%) (with 59.3% males) in the intervention group and 394 (50.5%) (with 56.6% males) in the control group. The mean (±standard deviation (SD)) ages of intervention and control subjects were: 16 (±1.3) (range: 10-19) and 15.6 (±1.3) (range: 10-19) years, respectively. The mean (±SD) knowledge scores in the intervention and control groups increased significantly (p=0.001 and p=0.001, respectively) from before intervention (8.7 (±2.9) and 9.0 (±2.7), respectively) to after the intervention (11.7 (±2.5) and 9.6 (±2.3), respectively). The mean (±SD) subject knowledge scores in the intervention and control groups prior to the intervention were not significantly different from each other (p=0.120). The mean subject knowledge score in the intervention group after the intervention was significantly higher (p<0.001) than the control group after the intervention. The mean (±SD) subject confidence score in the intervention group decreased significantly (p<0.001) from before the intervention (41.4 (±6.4)) to after the intervention (40.5 (±6.5)) and the mean (±SD) subject confidence score in the control group increased significantly (p<0.001) from before the intervention (41.0 (±6.3)) to after the intervention (42.8 (±6.2)). The mean subject confidence scores in the intervention and control groups before the intervention were not significantly different from each other (p=0.330). The mean subject confidence score in the intervention group was significantly lower than the control group (p<0.001) after the intervention. The mean (±SD) vaccine convenience score in the intervention group increased significantly (p<0.001) from before the intervention (38.5 (±7.6)) (to after the intervention (40.1 (±6.2)) but the mean (±SD) vaccine convenience score in the control group decreased significantly (p<0.001) (from before the intervention (37.9 (±7.1)) to after the intervention (35.8 (±5.3). The mean vaccine convenience scores were not significantly different between the intervention and control groups before the intervention. The mean vaccine convenience score was significantly higher (p<0.001) in the intervention group after the intervention than in the control group after the intervention. The mean (±SD) subject complacency score in the intervention group increased significantly (p=0.006) in the intervention group from before the intervention (30.6 (±6.4)) to after the intervention (34.2 (±0.7)) and the mean (±SD) subject complacency score in the control group increased significantly (p=0.006) from before the intervention (31.5 (±5.8)) to after the intervention (35.5 (±5.8)). The mean subject complacency scores in the intervention and control groups before the intervention were not significantly different from each other (p=0.034). The mean subject complacency score after the intervention was significantly higher in the intervention than the control group (p=0.006), indicating lower complacency and greater recognition of COVID-19 risks and need for vaccination in the intervention group. Significantly more (adjusted odds ratio (aOR) = 3.716; 95% confidence interval (CI): 1.323-10.443; p=0.013) subjects in the intervention (51.0%) than the control group (35.0%) stated they would be willing to receive the COVID-19 vaccine after the intervention. In the intervention group, there was a significant positive association between being willing to have the COVID-19 vaccine and having a high knowledge score (aOR = 6.085; 95% CI: 2.523-14.676; p<0.001), having a high vaccine convenience score (aOR = 4.899: 95% CI: 1.984-12.094; p=0.001) and having a high subject complacency score (aOR = 4.521: 1.887-10.828; p=0.001). Female subjects in the intervention group, but not in the control group, were significantly more likely to receive the COVID-19 vaccine than male subjects (aOR = 4.761; 95% CI: 1.711-13.251; p=0.001). Prior to the intervention, 43.0% of subjects in the intervention group and 35.0% of subjects in the control group were willing to receive the COVID-19 vaccine (p=0.022) and after the intervention, 51.0% of subjects in the intervention group and 35.5% of subjects in the control group (p<0.001) were willing to receive the vaccine. The percentage of subjects in the intervention group who were willing to receive the vaccine after the intervention increased significantly (p<0.001) and the percentage of subjects in the control group who were willing to receive the vaccine after the intervention also increased significantly (p<0.001) but to a lower extent. Our results show the school-based intervention significantly improved subject knowledge and subject convenience and decreased subject complacency and subject confidence about receiving the COVID-19 vaccine and was more effective than the control brochure. After the intervention, subjects in the intervention group were significantly more likely than subjects in the control group to receive the COVID-19 vaccine. However, the proportion of subjects who were willing to receive the vaccine was still low (only 51.0%). Further studies are needed to determine what interventions might improve the willingness to receive the COVID-19 vaccine.
ETIOLOGICAL DIAGNOSTIC VALUE OF TARGETED NEXT-GENERATION SEQUENCING FOR PNEUMONIA
Pneumonia is a common respiratory infection and a significant contributor to global mortality. Prompt identification of the pathogens responsible for pneumonia is crucial for ensuring effective treatment of patients. The study assessed the efficacy of targeted next-generation sequencing (tNGS) using bronchoalveolar lavage fluid samples from pneumonia patients (n = 338). The tNGS assay identified 70 pathogens, including 38 bacteria species, 14 types of viruses, 13 fungi species, 2 Mycoplasma spp, Ureaplasma urealyticum, Ureaplasma parvum, and Chlamydia. Among infections with a single pathogen, Candida albicans (12%) and Mycobacterium tuberculosis complex (11%) were the most common pathogens, while the fungi/viruses combination was predominant (28%) in cases of infection with multiple pathogens. Notably, tNGS method had a significantly higher positive detection rate (90%; 95% confidence interval (CI) of 86 to 93%) and higher coincidence rate (92%; 95% CI of 89 to 95%) compared to the conventional method (33%; 95% CI of 28 to 38%) and 82%; 95% CI of 76 to 85%) with p-values <0.001 and 0.008 respectively), particularly in identifying M. tuberculosis and atypical pathogens (C. psittaci, Chlamydia pneumoniae, Coxiella burnetii, Legionella spp, and Mycoplasma pneumoniae). Treatment in 50% of the cases was based solely on tNGS results. We conclude that tNGS is an important diagnostic tool in treating pulmonary infection, owing to its high sensitivity, specificity and rapidity in detecting causal pathogenic bacteria, atypical organisms, fungi and viruses, allowing targeted drug treatment irrespective of prior empirical medication, thereby potentially improving patients’ clinical outcomes and survival.
FACTORS INFLUENCING OCCUPATIONAL HEALTH LITERACY OF WORKERS IN NEW FORMS OF EMPLOYMENT, GANSU PROVINCE, PR CHINA
The study examined factors, which affected occupational health literacy and hampered improvement among workers in new employment models, focusing on Gansu Province, China. As the gig economy and flexible work arrangements, such as freelancing, part-time and remote work, expand, workers in these sectors face unique health risks. Yet, they often lack sufficient legal protection and health support, making them even more vulnerable to occupational hazards than those in the traditional work sector. This research assessed current levels of occupational health literacy, identified key influencing factors and suggested practical strategies for improvement. A survey was conducted of workers (n = 511) from 14 cities in Gansu Province using a structured questionnaire and face-to-face interviews. The results showed that while these workers have moderate health literacy, significant differences were found based on age, education and employment type. Older workers and those with higher education tended to have better occupational health literacy, while gig and self-employed workers generally had lower literacy levels. Barriers to improving workplace health literacy include time constraints, limited access to relevant information and lack of training opportunities. The study highlighted the need for focused occupational health education programs, improved workplace conditions and more substantial institutional support to boost occupational health literacy. These findings should provide valuable data for the improvement of policies aimed at local governments, businesses and organizations interested in improving the health and well-being of workers, particularly in less developed regions like Gansu Province.
PATHOGENIC ACANTHAMOEBA GRIFFINI GENOTYPE T3 ISOLATED FROM A GEOTHERMAL WATER PARK, MALAYSIA
Free-living amoebae of the genus Acanthamoeba can cause amoebic encephalitis and keratitis infections. Investigations have been conducted to identify the direct and indirect virulence parameters to establish the pathogenic potential of this amphizoic amoeba due to its widespread distribution. The current study sampled ten sites along a stream in Sungai Klah Geothermal Park, Perak, Malaysia, and seven sites showed the presence of Acanthamoeba. Using a combination of morphology examination and molecular analysis, the samples were identified as A. castellanii, A. griffini, A. lenticulate (putative), and A. polyphaga, belonging to genotypes T3 (n = 2), T4 (n = 4) and T5 (n = 1). An isolate SKGP-5, A. griffini genotype T3 exhibited the highest level of cytotoxicity (based on a HeLa cell monolayer assay and detection of secreted serine proteases) and potential pathogenicity as evidenced by tolerance to the temperature of 42°C and 1M mannitol (hyperosmotic solution). This is the first discovery of a pathogenic A. griffini genotype T3 isolate at a public recreational hot spring in Malaysia, indicating the need for regular monitoring of microorganisms that pose a threat to public health in such settings.
FACTORS ASSOCIATED WITH DEVELOPING COVID-19 AMONG HOSPITAL PERSONNEL AT A PEDIATRIC TERTIARY CARE CENTER IN BANGKOK, THAILAND
Hospital personnel (HP) are at greater risk for contracting coronavirus disease-2019 (COVID-19). In this retrospective study, we aimed to determine factors significantly associated with contracting COVID-19 among HP in order to inform efforts to prevent this from occurring. Factors were compared between those who did and did not contract COVID. Study subjects were HP who participated in a COVID-19 screening program at a tertiary care pediatric hospital in Bangkok, Thailand during April 2021- March 2022. During the screening program, all participating HP who were exposed to someone with COVID-19 or who developed COVID-19, had a confirmatory RT-PCR test or rapid antigen test performed and were included in the study. A total of 1,619 subjects were included in the study, 13.7% (n = 222) males. The median (±interquartile range) age of study subjects was 37 years (30-47 years). Of the total of 1,619 subjects, 177 (10.9%) developed COVID-19, defined as having symptoms and a positive test for COVID-19. The factors significantly associated with contracting COVID-19 among study subjects were: having an underlying disease (odds ratio (OR) = 1.527, 95% confidence interval (CI): 1.037-2.248, p = 0.032), working in a frontline role other than those of physicians, dentists, nurses and nurse assistants (eg, pharmacists, laboratory technicians, and radiologists) (OR = 2.511, 95% CI: 1.375-4.585, p=0.003), contracting COVID-19 when the omicron variant predominated (OR = 5.050, 95% CI: 3.403-7.493, p<0.001), sharing a sleeping space with someone with COVID-19 (OR = 5.046, 95% CI: 1.531-16.638, p = 0.008) and using inappropriate personal protective equipment (PPE) during exposure (OR = 1.930, 95% CI: 1.061-3.510, p = 0.031). In summary, factors significantly associated with contracting COVID-19 by subjects in our study were having an underlying disease, working in a frontline role other than being a physician, dentist, nurse or nurse assistant, working during the period when the omicron variant predominated, sleeping in the same room as someone with COVID-19 and not using appropriate PPE when exposed to people with COVID-19. We conclude, HP at the study institution should be educated about these factors. Further studies are needed to determine if educating HP about these factors will reduce their risk of contracting COVID-19.
EVALUATION OF LEPTOSPIROSIS CASES IN TÜRKIYE USING A GEOGRAPHIC INFORMATION SYSTEM
Leptospirosis is a public health problem in Türkiye with cases occurring sporadically and occasionally in outbreaks. In this study we aimed to retrospectively map leptospirosis cases in Rize Province, Türkiye during 2016-2022 using a geographic information system (GIS) in order to inform leptospirosis control efforts. Data regarding numbers and locations of leptospirosis cases in the study province were obtained from an Infectious Disease Surveillance and Early Warning System and entered into GIS software and examined for spatial patterns. A total of 97 subjects were included in the study, 59% males. The mean (±standard deviation) age of study subjects was 59 (±11) years. During the study period, the year with the largest number of leptospirosis cases was 2018 (n = 37) (p<0.001) and the month of the year during the study period with the most cases was September (n = 32) (p<0.001). The incidence of cases was highest during June-October (n = 85) (p<0.001). The districts in Rize Province where the most leptospirosis cases occurred were the 3 contiguous coastal districts of Merkez (n = 31), Çayeli (n = 16) and Pazar (n = 12) (p<0.001). Cases were also reported in Güneysu District (n = 11) (p<0.001). The other cases of leptospirosis were distributed sporadically. In summary, leptospirosis cases in Rize Province occurred primarily in clusters in 3 contiguous provinces during the study period and were more common during 2018 and during September. We conclude these patterns need to be taken into consideration by efforts to reduce the incidence of leptospirosis in the study area. Further studies are needed to determine why there are more cases in these specific districts during September and if they have preventable origins in order to improve leptospirosis control efforts in Rize Province, Türkiye.
KNOWLEDGE, ATTITUDE AND READINESS TO PRACTICE DISASTER PREPAREDNESS AMONG HEALTHCARE PROFESSIONALS IN MYANMAR: ADAPTATION AND VALIDATION OF DISASTER PREPAREDNESS EVALUATION TOOL
Disaster management globally emphasizes the need for effective preparedness and response strategies, particularly within the healthcare systems, to mitigate the impact of disasters. Myanmar is highly vulnerable to disasters, underscoring the need to assess healthcare professionals’ knowledge, attitude and readiness to practice (KAP) in alignment with the national framework named Myanmar Action Plan on Disaster Risk Reduction (MAPDRR). However, Myanmar lacks the assessment tool for disaster preparedness of healthcare professionals. The Disaster Preparedness Evaluation Tool (DPET) was adapted into a Myanmar version (DPET-M) to fill the research gap. The adapted DPET-M was then evaluated by seven experts using a scale-level content validity index (S-CVI). To assess its psychometric properties, 303 healthcare professionals from public and private healthcare institutions participated in a cross-sectional survey in August 2024. The findings demonstrated that 62% of participants had moderate knowledge, 38% had high knowledge and no participant was in the low category. Attitude scores showed 54% and 46% of the participants with high and moderate score respectively, indicating a strong willingness to engage in disaster preparedness activities. Readiness to practice among the participants was moderate (54%), with low readiness only in 1% and the remaining with high readiness. Prior disaster training and workplace settings were significantly found to influence KAP scores. The adapted DPET-M demonstrated strong reliability, with a Cronbach’s Alpha of 0.94 and high Composite Reliability, confirming its suitability for assessing healthcare professionals’ disaster preparedness and offering a critical tool to strengthen Myanmar’s disaster resilience.
PREVALENCE AND INFLUENCING FACTORS OF DEMODEX INFECTION AMONG COLLEGE STUDENTS IN ZHENGZHOU, PR CHINA
Demodex spp are ectoparasites living in human hair follicles and sebaceous glands, and are considered to play a pathogenic role in facial dermatoses such as acne vulgaris. This study investigated the prevalence and influencing factors of Demodex spp infection among college students in Zhengzhou, PR China. College students (n = 500) were enrolled and a cellophane tape method was used to determine Demodex infection after students washed their faces with cool (n = 300) or warm water (n = 200). Relevant factors were investigated by a questionnaire. The positive detection rate was 38% and 26% for samples collected from students washing with warm and cool water respectively. There is a significantly higher positive detection rate of Demodex foliculorum compared to D. brevis under both face washing conditions (χ2cool = 40.26, df = 1, p-valuecool <0.0001; χ2warm = 6.028, df = 1, p-valuewarm = 0.014). The rate of Demodex infection is significantly higher for students with oily skin compared to dry or a combination of oily and dry skin (χ2warm =11.635, df =2, p-valuewarm = 0.003). Our observations suggest that Demodex infection, particularly D. folliculorum, is fairly common among college students in Zhengzhou. Oily skin may increase susceptibility to Demodex infection, and washing the face with warm water before applying the cellophane tape method can improve the detection rate.
INVESTIGATION OF ENTEROBIUS VERMICULARIS INFECTION AND RELATED RISK FACTORS AMONG CHILDREN FROM A KINDERGARTEN IN SOUTHWEST CHINA
Enterobius vermicularis (pinworm) infection is common among the children population. Studies have not produced consistent results regarding the prevalence and risk factors of pinworm infection among preschool children. A cross-sectional study was undertaken in December 2020 on the prevalence of pinworm infection in a kindergarten located in Qingxi, Sichuan Province, PR China, and to identify risk factors for infection. An adhesive tape method was used to collect perianal pinworm egg specimens and a questionnaire was distributed to the parent/legal guardian of all children (n = 97) attending the kindergarten. Eleven percent of the children were positive for pinworm infection. Multivariate logistic regression analysis of replies to the questionnaire revealed girls (p-value = 0.033), being >54 months of age (p-value = 0.034) and having older sister(s) (p-value = 0.026) as risk factors for pinworm infection. In conclusion, this strategy provided a feasible means to rapidly obtain data on pinworm infection prevalence and associated risk factors among kindergarten children, thereby enabling treatment of infected individuals and providing information to curtail transmission among siblings and other children attending the same kindergarten.
Copyright (c) 2024 The Southeast Asian Journal of Tropical Medicine and Public Health
HPV GENOTYPES AND CYTOLOGIC ASSESSMENT IN WOMEN INFECTED WITH HUMAN PAPILLOMAVIRUS, HO CHI MINH CITY, VIETNAM
Up-to-date data on HPV infection and cervical abnormalities are essential for effective screening and prevention of cervical cancer. This study evaluated the association among cytologic abnormalities, HPV prevalence and genotype distribution among women undergoing cervical screening in Ho Chi Minh City, Vietnam. A descriptive, cross-sectional study was conducted in women (n = 589) 18 years of age and above from May to July 2022. Cytologic diagnosis was performed using the Papanicolaou test, and HPV genotypes were identified using quantitative PCR. The HPV prevalence was 9.8%, with 86% infected with a single genotype. The high-risk HPV genotypes, HPV-16 (22.5%) and HPV-58 (27.5%) were most prevalent. Cytologic abnormalities were observed in 5.9% (n = 35) of the cases, primarily atypical squamous cells of undetermined significance (4.1%) and low-grade squamous intraepithelial lesions (1.9%). HPV-16 and HPV-58 infections showed a significant association with abnormal cytologic findings. These findings demonstrate the importance of integrating HPV genotyping with cytologic screening in helping to improve the country’s cervical cancer prevention programs.
SAFETY AND IMMUNOGENICITY OF A NEXT GENERATION PURIFIED VERO RABIES VACCINE AS A SIMULATED INTRADERMAL POST-EXPOSURE PROPHYLAXIS IN ADULTS AND CHILDREN IN THAILAND: A PHASE 3, RANDOMIZED STUDY
The aim of this Phase 3, randomized study was to assess the immunogenicity and safety of a purified Vero cell rabies vaccine, PVRV-NG2, compared with the current rabies standard of care vaccine (PVRV), using a simulated post-exposure prophylaxis regimen with intradermal (ID) vaccination on day (D) 0, D3, D7, and D28 in healthy pediatric (≥1 to <18 years of age) and adult (≥18 years of age) participants, with concomitant administration of rabies immunoglobulin [RIG]). Rabies virus neutralizing antibody (RVNA) titers were determined on D0, D14, D42, and D90. Enrolled participants (n = 402) consisted of pediatrics (n = 168) divided into two groups, Group 1 receiving PVRV-NG2 (n = 112) and Group 2 receiving PVRV (n = 56), and of adults (n = 234) divided into 4 groups, Group 3 receiving PVRV-NG2+equine RIG (ERIG, n = 26), Group 4 receiving PVRV+ERIG (n = 14), Group 5 receiving PVRV-NG2+human RIG (HRIG, n = 129), and Group 6 receiving PVRV+HRIG (n = 65). By D14, nearly all pediatric participants achieved RVNA titer ≥0.5 IU/ml, while only 52-75% of adults achieved this titer when both vaccines were co-administered with RIGs. By D42, 96 and 100% of adults who received PVRV-NG2 and PVRV respectively, had RVNA titers ≥0.5 IU/ml. By D90, all, except two, pediatric participants had RVNA titers that persisted at ≥0.5 IU/ml, while 75 and 78% of adults who received PVRV-NG2 and PVRV respectively, had maintained this titer. No safety concerns were identified, and safety profiles were similar across groups. Overall, the immunogenicity and safety profiles of PVRV-NG2 when administered alone or co-administered with HRIG were comparable with those of PVRV, supporting the application of intradermal administration for post-exposure vaccination using the updated Thai Red Cross vaccination schedule (Clinicaltrials.gov no: NCT04478084).
INSECTICIDE RESISTANCE PREVALENCE OF DENGUE VECTORS IN MALAYSIA: A SYSTEMATIC REVIEW AND META-ANALYSIS
A comprehensive understanding of insecticide resistance in dengue vectors is crucial, especially given the increasing global incidence of dengue. This concern underscores the need to assess the resistance status of Aedes aegypti and Aedes albopictus, the vectors responsible for transmitting the virus. In Malaysia, chemical-based insecticides remain the primary intervention for prevention efforts. Preventing the failure of these interventions requires an understanding of the prevalence of insecticide resistance. To provide an overview of resistance reported in Aedes mosquitoes, this review analyzed the reported resistance status of Ae. aegypti and Ae. albopictus in Malaysian Aedes mosquitoes from 30 eligible studies published from 2005 to 2022. The resistance and susceptibility trends were analyzed according to location, insecticide class and over time, revealing widespread resistance of Ae. aegypti to deltamethrin, malathion and permethrin, the insecticides most studied. On the other hand, Ae. albopictus exhibits variable susceptibility trends to these insecticides, with resistance to the carbamates and organochlorines being more pronounced than in Ae. aegypti. A meta-analysis with a random-effect model was also conducted to assess publication bias. Substantial variations were noted, possibly due to the sampling methods and number of samples screened, but the results confirm the abovementioned conclusions. The data obtained from the literature review will help fill the gaps in knowledge of the insecticidal susceptibility status of Aedes mosquitoes in Malaysia.
THE PRESENCE OF DOT/ICM, LVH, AND RTXA GENES IN LEGIONELLA SPECIES FROM PUBLIC FACILITIES IN BUSAN, KOREA 2020-2022
Legionella spp are prevalent worldwide in both constructed and natural water systems and the rates of their detection have increased in environments such as buildings, public baths, and hospitals. The study focused on detecting Legionella spp in public water systems in Busan from 2020 to 2022 and on investigating the presence of the virulence genes dot/icm, lvh, and rtxA in Legionella-positive water samples. Legionella isolates (n = 660) were collected, with L. pneumophila and non-L. pneumophila species accounting for 80.8 and 19.2% respectively. Among L. pneumophila isolates (n = 533), 196 belonged to serogroup 1 and 337 to serogroups 2-14, both known to cause legionellosis. Among the non-L. pneumphila isolates (n = 127), L. anisa was the most common, followed by L. nautarum, then L. busanensis and L. londiniensis. At least one virulence gene was detected in 80.6% of all Legionella-positive isolates, with the majority of L. pneumophila carrying virulence genes compared to 9% of non-L. pneumophila spp. The presence of virulence genes in L. pneunophila and non-L. pneumophila spp collected from public water sources in Busan constitutes a potential risk of infection outbreaks within the city.