Southeast Asian Journal of Tropical Medicine and Public Health
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Item Quality assessment in clinical chemistry: a Thailand experience.(1999-12-05) Promptmas, C; Prijavudhi, A; Pavaro, UA Thailand quality assessment program called "The External Quality Assessment in Clinical Chemistry, EQAC" was found in 1986. Ablind lyophilized control serum is monthly-cycle distributed to the participants and the returned test-report values are evaluated by a computed program. Evaluated report Variance Index Scores (VIS) and grades of test and mean score of all tests are posted back to the participants including a back of "The Newsletter of the EQAC". The development has been indicated by an increasing number of active participants and an improvement due to decreasing Variance Index Scores. In 1998 the program was applied by 324 laboratory participants of which 59% of general hospital and community health hospital laboratory, 29% of private hospital laboratory including polyclinics, and 12% of the others. By now as many as 144 trials of 23 biochemistry tests at different methods were assessed from the EQAC program. Participant communication, knowledge update and enhanced quality encouragement have been managed by mean of participants' VIS from 120 to 93 during 1987-1998.Item Application of real-time polymerase chain reaction (PCR) analysis for detection and discrimination of malaria parasite species in Thai patients.(2004-01-24) Katakai, Yuko; Chiabchalard, Rachatawan; Komaki-Yasuda, Kanako; Kawazu, Shin-ichiro; Singhasivanon, Pratap; Krudsood, Srivicha; Looareesuwan, Sornchai; Kano, ShigeyukiA TaqMan real-time PCR system was used to detect and discriminate the 4 species of human malaria parasites in clinical blood samples. A 150-base pair (bp) region of the small subunit ribosomal RNA (SSU rRNA) gene of each malaria parasite, including species-specific sequences to be detected by TaqMan probe, was used as a target for PCR analysis. The PCR method used universal primers and species-specific TaqMan probes for Plasmodium falciparum, P. vivax, P. ovale, and P. malariae. The detection threshold for the method, as determined with serial dilution of cultured P. falciparum-infected erythrocytes, was 5 parasite-infected erythrocytes per reaction. Fifty blood samples of falciparum malaria and a second set of 50 samples of vivax malaria, diagnosed by microscopic examination at the Hospital for Tropical Diseases, Mahidol University, Thailand, were analyzed by real-time PCR. In the 50 samples of microscopically-diagnosed falciparum malaria, 40 were regarded as P. falciparum single infection, 7 were P. falciparum and P. vivax mixed infections, and 3 were P. vivax single infection by real-time PCR. In the second set of 50 samples of microscopically diagnosed vivax malaria, all were considered P. vivax single infection by PCR. Neither P. ovale nor P. malariae infection was identified in the 100 blood samples. Real-time PCR analysis was shown to be more sensitive and accurate than routine diagnostic methods. Application and extension of the PCR method reported here will provide a powerful tool for further studies of malaria.Item Serodiagnosis of paragonimiasis by enzyme-linked immunosorbent assay and immunoelectrophoresis.(1989-06-01) Waikagul, JAntigens from 4 species of Paragonimus were used to develop ELISA for the diagnosis of paragonimiasis in 50 patients infected with P. westermani, 6 patients with P. miyazakii, 64 patients with other helminthic infections and 17 healthy blood donors. There was no significant difference between the ELISA values of the same sera tested against crude antigens prepared form P. westermani, P. miyazakii, P. heterotremus and P. siamensis. When pooled sera from patients with westermani and miyazakii paragonimiasis were absorbed with homologous and heterologous antigens, reduction in ELISA values was observed to be more pronounced with the homologous antigens. A similar result was obtained when a rabbit hyperimmune serum against P. siamensis was absorbed with the crude antigens from these 4 species of Paragonimus. The antigens from P. siamensis recognised by rabbit hyperimmune serum were analysed by immunoelectrophoresis. Precipitating bands were observed as early as 7 days after immunization with a maximum number of bands in the 6th and 7th weeks after immunization.Item Enhanced maturation and proliferation of beta-thalassemia/Hb E erythroid precursor cells in culture.(2005-09-28) Kittikalayawong, Yaowaree; Sila-asna, Monnipha; Bunyaratvej, AhnondUpon erythroid cell maturation in vivo, beta-thalassemic erythroid cells accumulate unmatched unstable alpha-globin chains that are believed to be a causal factor in such cell destruction. This study showed that beta-thalassemia/Hb E erythroid precursor cells from peripheral blood had accelerated maturation, and could mature to the terminal erythroid stage. During the early period of cell culture, erythroid precursor cells derived from subjects with the more severe form of beta-thalassemia/Hb E had higher rate of erythroid maturation. In addition, peripheral blood mononuclear cells from beta-thalassemia/Hb E subjects had higher erythroid proliferative potential than cells derived from normal controls. Erythroid proportion in the more severe beta-thalassemia/Hb E cases was less than that of the milder cases. Premature apoptosis was not observed during the 15 days of erythroid cell culture from both beta-thalassemia/Hb E and normal subjects.Item Preliminary report on new cercariae from Bellamya and Pila snails in Peninsular Malaysia.(1974-09-01) Lim, H K; Colley, F C; Ow-Yang, C KItem Thrombo-embolism in minimal change nephrotic syndrome.(1979-09-01) Vanapruks, V; Meckangvan, PA case report of thrombo-embolism in minimal change nephrotic syndrome was presented. Autopsy revealed massive bilateral pulmonary emboli, edema and congestion, bilateral adrenocortical atrophy and left renal vein thrombosis. Thrombo-embolic phenomenon should be borne in mind during management and treatment of nephrotic syndrome.Item Schistosomiasis japonica in China: a brief review.(1976-06-01) Cross, J HItem Physical activity and risk factors for hip fractures in Thai men.(2001-03-04) Suriyawongpaisal, P; Rajatanavin, R; Takkinstien, A; Wanvarie, S; Apiyasawat, P; ,To test the hypothesis that hip fracture is associated with physical activity in Thai elderly men, a case-control study was conducted in Bangkok, Thailand. A total of 187 men aged 51 years over, resident in Bangkok, admitted consecutively with a radiologically confirmed first hip fracture were studied. 177 age-matched community controls were randomly recruited from the same neighborhood of the cases. Physical activity was independently associated with reduced risk of hip fracture after controlling for confounding factors. Very active and active past physical activity markedly reduced risk of hip fracture in comparison to subjects with inactive past physical activity. Recent active physical activity was also protective against hip fracture. This prompts a need to identify strategy to promote physical activity among the elderly and at an early age.Item Heparin therapy in Russell's viper bite victims with disseminated intravascular coagulation: a controlled trial.(1992-06-01) Tin Na Swe,; Myint Lwin,; Khin Ei Han,; Tin Tun,; Tun, P eA controlled clinical trial of low dose heparin was carried out in confirmed cases of Russell's viper bite. Twenty patients with systemic envenoming were included in the study. They were randomized to receive low dose heparin in an initial dose of 50 units/kg body weight intravenously immediately after antivenom followed by a continuous infusion of 10 unit 3 kg/hour in isotonic saline for 24 hours, or antivenom alone. Response to treatment was assessed clinically as well as by serial measurements of coagulation factors and biochemical values. No significant difference was observed in the outcome among two groups, the recovery rate from the clotting defect being similar in both. The mean serum creatinine values of the two groups were also not statistically different. The results indicated that there is no beneficial effect of adding heparin to the standard treatment by antivenom.Item An outbreak of ascariasis with marked eosinophilia in the southern part of Kyushu District, Japan, caused by infection with swine ascaris.(1997-03-01) Maruyama, H; Nawa, Y; Noda, S; Mimori, TAscariasis has been a representative soil-transmitted intestinal parasitic disease in warm climates. In Japan, this disease was a major and serious public health problem only a few decades ago. However, the incidence of the disease nowadays is reportedly less than 0.01%. Recently in 1994 through 1995, we experienced a total of 14 cases who were suspected as having ascariasis. They were characterized by peripheral blood eosinophilia (30-70%), high serum titers against Ascaris antigen, and most notably, they were absolutely negative for Ascaris eggs in repeated fecal examinations. Specific antibody titers against Ascaris antigen correlated well with the degree of eosinophilia. All patients were living in narrow areas of Kyushu, Japan, where a lot of porcine farms were located. Most of the patients were asymptomatic and pointed out to have eosinophilia during follow-up studies of chronic diseases or in regular check-up. Only one patient had a clear sign of Löffler's syndrome and another had subcutaneous eosinophilic granuloma. However, laboratory examinations revealed moderate liver dysfunction in 7 patients and pulmonary infiltrations in 5 patients. Based on circumstantial and serological evidence, these patients were diagnosed as having been infected with Ascaris lumbricoides suum, a swine Ascaris.Item Differential serodiagnosis of cystic and alveolar echinococcosis using native and recombinant antigens in Japan.(2001-03-04) Ito, A; Sako, Y; Ishikawa, Y; Nakao, M; Nakaya, KOur group at Asahikawa Medical College has established differential serodiagnosis for zoonotic larval cestodiases such as alveolar echinococcosis (AE), cystic echinococcosis (CE) and neurocysticercosis (NCC) using purified specific antigens. In this brief review, we introduce (a) four imported CE cases in Japan, easily identified serologically, (b) most recent advances in serology for differentiation of AE and monitoring of prognosis of AE in Japan. It includes application of affinity purified Em18 and prototype of a recombinant Em18 antigen. Serology using affinity purified Em18 antigens is showing much higher sensitivity for detection of AE cases which are usually undetectable by the ongoing serology for AE authorized in Hokkaido, Japan. As serology for AE, CE or NCC is still not popular in the majority of Asian countries, we expect that this review paper stimulates researchers who are interested in serology or serodiagnosis for these larval cestodiases including AE, CE and NCC.Item Cysticercosis: IgG-ELISA evaluations of peak1 antigen and <30 kDa antigen of delipidized extract of Taenia solium metacestodes.(2004-03-27) Dekumyoy, Paron; Waikagul, Jitra; Vanijanonta, Sirivan; Thairungroj, Malinee; Nakao, Minoru; Sako, Yasuhito; Watanabe, Sonoyo; Ito, AkiraThe antigenicity of ether-delipidized Taenia solium metacestode extract (DLPAg) was investigated by IgG-ELISA. The antigen showed higher antigenicity than that of non-delipidized antigen (NDLPAg). Then the DLPAg was subjected to Sephacryl S-200 gel chromatography and a partially purified antigen (DLPP1Ag) was identified as the promised antigen by IgG-ELISA using 25 sera from cysticercosis cases, 177 cases of 24 heterologous infections, and healthy controls. Sensitivity was 52% and specificity was 91.8% at the cut-off value (X + 7SD), 0.399. Cross-reactivity occurred with 17 cases of eight diseases: cystic echinococcosis (7/11), taeniasis (1/16), gnathostomiasis (2/8), strongyloidiasis (1/12), angiostrongyliasis (1/12), paragonimiasis heterotremus (2/15), opisthorchiasis (1/9) and fascioliasis (2/7). When DLPP1Ag was fractionated through Ultra free centrifugal tube (retained 30 kDa) and Amicon (PM10), MWCOP1Ag (<30-10> kDa) was obtained; the antigen showed better results than DLPP1Ag with 88% sensitivity and 95.6% specificity at the cut-off value (X + 4SD), 0.264. Nine cases of six diseases cross-reacted with this antigen: cystic echinococcosis (2/11), gnathostomiasis (2/8), trichinellosis (2/12), toxocariasis (1/5), schistosomiasis (1/6), and fascioliasis (1/7). MWCOP1Ag gave higher sensitivity than that of DLPP1Ag but some cross-reactivity occurred.Item Application of multiplex pcr for species discrimination using individual metacercariae of Paragonimus occurring in Thailand.(2006-05-06) Sugiyama, Hiromu; Morishima, Yasuyuki; Rangsiruji, Achariya; Binchai, Sutheewan; Ketudat, Punsin; Kawanaka, MasanoriA total of 6 lung fluke species have been documented in Thailand, of which P. heterotremus is the most important, since it affects humans. Although P. westermani is found as metacercariae in the same crab species as P. heterotremus in Thailand, human infections with P. westermani have not been confirmed. To accurately discriminate between the individual metacercariae of these two species, we established a multiplex PCR method. Using this method, two products each were amplified from the metacercarial DNA samples of P. heterotremus (ca. 310 and 520 bp) and P. westermani (ca. 140 and 520 bp). In contrast, 520-bp products alone were found to be generated from the DNA samples of P. siamensis, P. bangkokensis and P. harinasutai, 3 other species of lung flukes known to occur in Thailand. Digestion of these 520-bp products with the restriction enzyme ScrFI could unequivocally discriminate species by the number and size of the produced band(s): 3 bands (ca. 60, 210 and 250 bp) for P. harinasutai, 2 bands (ca. 250 and 270 bp) for P. bangkokensis, and an uncut band (520 bp) for P. siamensis. The established multiplex PCR used in combination with restriction enzyme digestion (PCR-RFLP with ScrFI) is effective for discriminating the 5 different species of lung flukes occurring in Thailand, even at the metacercarial stage.Item Benchmarks of Fairness for health care reform in Thailand--combining evidence with opinion of the civic group.(2006-03-28) Pannarunothai, Supasit; Faramnuayphol, PinijThe concept of the Benchmarks of Fairness was tried in Thailand before the big reform of universal coverage policy in 2001. The first phase of the Benchmarks in 1999 involved the analysis of the national health reform proposal as well as the analysis of ongoing field trials of health reforms in two provinces. Though the participants were predominately health personnel, the results suggested the power of combining qualitative viewpoints of participants with the quantitative indicators within the province to move health reforms to more equitable, more efficient and more democratic directions. The second phase of the Benchmarks of Fairness, therefore, tested the possibility of involving wider participation of the civic groups related, and not-related to health, in assessing their provincial health system. The health achievements of the provinces a measured by 81 indicators, in the 9 benchmarks, were provided to the civic groups before focus group discussions in 10 selected provinces to facilitate discussions based on evidence. More qualitative data were obtained from the discussions as well as their judgements on the fairness of their provincial health system. Having completed this second phase, it was recommended that the benchmarks tool could be further endorsed as the basis for monitoring the progress of health reform by province and the effect of health care decentralization. To accomplish this monitoring, the civic groups should have continuous access to evidence, in line with the benchmarks, and they should be provided with the opportunity to express their views, which is helpful in monitoring fairness in the long run.Item Activities of some carbohydrate metabolising enzymes in both the yeast-like and mycelial-like forms of Candida albicans.(1976-09-01) Ton, S H; Karunairatnam, M CItem Sporocyst of Echinostoma hystricosum.(1973-06-01) Lim, K H; Lie Kian Joe,; Boss, J M; Ow-Yang, C KItem Amniotic fluid embolism: report of five cases.(1979-09-01) Watananukul, P; Benjawongkulchai, S; Boonsiri, BItem Investigation of malaria prevalence at National Thermal Power Corporation, Shaktinagar, Sonbhadra District (Uttar Pradesh), India.(2000-12-21) Dua, V K; Nanda, N; Gupta, N C; Kar, P K; Subbarao, S K; Sharma, V PMalaria in industrial complexes is promoted by extensive mosquitogenic potential generated by excavations and importation of parasite through migratory labor. The National Thermal Power Corporation (NTPC), Shaktinagar, Sonbhadra district was surveyed for malariogenic conditions from 1994 to 1996. The major mosquito breeding sites were drains, storm-water drains, lakes, outside tanks, overhead tanks, sluice-valve chambers, ornamental tanks, wells, pit wells and water reservoirs, etc. Anopheles culicifacies was the major vector of malaria in this area. Sibling species identification of An. culicifacies revealed that species C predominated during the transmission season and responsible to transmit malaria. Insecticide susceptibility tests against An. culicifacies sl showed that An.culicifacies population was 100% susceptible to malathion, fenitrothorn and deltamethrin while it was found 44% resistant to DDT. The malaria cases recorded in 1994, 1995 and 1996 were 847, 590 and 409 respectively. In vitro study on P. falciparum cases showed that 41, 70, 50% of the isolates tested were resistant to chloroquine in 1994, 1995 and 1996 respectively while an in vivo follow-up study showed 20-30% P. falciparum cases resistant to chloroquine. An integrated approach involving alternate vector control measures along with judicious use of insecticides has been suggested to bring down malaria in industrial complexes.Item Highlights on the World Bank Loan Schistosomiasis Control Program in China (1991-1998): a special focus on Hunan Province.(1999-12-06) Dongbao, Y; Ross, A G; Musheng, X; Yuesheng, L; Yan, CA region-wide sampling survey was conducted in 1995 in order to evaluate the current epidemiological status of schistosomiasis japonica in Hunan Province, China. A total of 45,590 humans and 3,726 domestic animals, from 52 villages, were examined parasitologically and/or serologically for current Schistosoma japonicum infections. In uncontrolled endemic areas (43 villages) the overall human prevalence of S. japonicum was 7.81% across the different geographical subtypes. The geometric mean intensity of infection was 17.71 eggs per gram (epg) among infected individuals and only 1.25 epg in the general population. The bovine prevalence, as determined by the hatching test, was 9.63% in the uncontrolled endemic villages. Only one sero-positive (by indirect hemagglutination assay) child was found among 1,072 children tested aged 10-14 years in the 9 endemic villages under effective control. No infection was confirmed by the Kato-Katz thick smear stool examination. When the results of this survey were compared to those seen at baseline (1989) an overall reduction of 45.65% was seen in the human prevalence but no significant change was apparent in the lake-beach ecotype. Additionally, there was more than a 60% reduction in the prevalence among bovines over the same sampling period. The results demonstrate that the World Bank Loan Schistosomiasis Program was successful in achieving its most basic objectives for this province - to reduce human and bovine infections by 40%.Item Parasitic contamination of selected vegetables sold in Metropolitan Manila, Philippines.(1992-03-01) de Leon, W U; Monzon, R B; Aganon, A A; Arceo, R E; Ignacio, E J; Santos, G