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Morality in Peninsular Malaysia has reached a level that is quite similar to that prevailing in the low mortality countries. This article systematically documents changes in mortality levels and differentials in Malaysia over time and relates these to changes in development indicators and health-related policies. Remedial measures undertaken by the authorities including the expansion of hospital and health services into the estates, together with a comprehensive malaria-eradication program, improvements in sanitation laws, and increased provision of public utilities and education, resulted in beriberi being eliminated and the incidence of malaria, typhus, and smallpox being greatly reduced by the time of World War II. The gain in life expectancy over the period of 1957-1979 was greatest for the Malay, the most significant period being 1957-1967, which saw the introduction of rural health programs. The infant mortality rate and the neonatal and post-neonatal rates declined substantially for all ethnic groups in Peninsular Malaysia for the same time period. Although the lower infant mortality of the Chinese can be explained by their advantageous socioeconomic position the same reason cannot explain the lower decline in infant mortality levels of the Indians. Much still needs to be done to narrow, if not to eliminate, the existing mortality differentials of different groups in the country. Overall, the quality of life of the general population can be further enhanced by reducing the high mortality level of disadvantaged groups.
Asia Pac Popul J 1987 Mar
PMID:Socio-economic development and mortality patterns and trends in Malaysia. 1234 Oct 34

This article describes changes in population size, structure, and growth in Sri Lanka. The population aged under 15 years was 37% of total population in 1946, peaked at almost 42% in 1963, and declined to 31% in 1991. The age structure is the result of population growth patterns during 1946-91. The peak in 1963 and high rates of growth were due to improved mortality, effective application of DDT in malaria areas, improved health care, improved agricultural production, subsidized distribution of food, and expanded free education. The population growth rate declined primarily due to a decline in fertility. During 1980-93 the total fertility rate declined at an average annual rate of 4.0%. Fertility decline was strongly influenced by increased age at marriage and contraceptive prevalence. The mean age at marriage increased from 20.7 years in 1946 to 25.5 years in 1993. The contraceptive prevalence rate increased from 32.0% in 1975 to 66.1% in 1993. Fertility decline was initially influenced strongly by changes in nuptiality. After the early 1970s, fertility decline was primarily due to declines in marital fertility. During 1972-82, 75% of fertility decline was accounted for by contraceptive use. Given the present trends in fertility, mortality, and international migration, it is expected that Sri Lanka will increase in population size from 18.2 million in 1995 to 22.4 million in 2020. Stabilization of population is likely to occur around 24 million by 2050. Population size at stabilization would be 33% greater than present levels. Population age structure will continue to change. By 2030, the aging process will accelerate, and the working-age proportion will expand. The demands of this expanded population will be on health care services, employment, housing, and food. The demands on health care would be the greatest among persons aged 45-49 years.
Asia Pac Popul J 1996 Jun
PMID:Demographic implications of health care in Sri Lanka. 1234 41

For 197 adults and adolescents in four villages of three small islands in the Admiralty Islands, Papua New Guinea, antimalarial antibody titers were examined using the indirect fluorescent antibody test (IFAT) and malaria parasites were detected by the microtiter plate hybridisation (MPH) method using polymerase chain reaction (PCR) technique. The parasite rate (either Plasmodium falciparum or P. vivax, or both) averaged 39.2%, varying from 31.1% to 44.8% among the four villages due to natural and artificial microenvironmental conditions related to breeding sites of mosquitoes (Anopheles farauti). The lack of flat zones owing to geomorphological formation contributed to the lowest parasite rate in the extremely small island. However, human-modified environments such as a wet-land (naturally formed but artificially reformed) and an open well played significant roles in other inter-village differences. The present findings imply significant roles of microenvironment in diversified malaria prevalence and suggest some ways of mitigation of malarial hazards.
Asia Pac J Public Health 2001
PMID:Variation in malaria endemicity in relation to microenvironmental conditions in the Admiralty Islands, Papua New Guinea. 1259 4

This study investigates the health and health-seeking behaviour of the indigenous population of Chittagong Hill Tracts, Bangladesh by surveying 2,550 randomly selected households from five major ethnic groups residing in the region. A structured questionnaire was used for collecting data. Morbidity prevalence (23%) and child malnutrition (19%) was highest among Bangalis. Fever (40%), diarrhoeal diseases (37%) and malaria (16%) were the three most common illnesses reported among the study population. Around fifteen percent of the Bangalis sought care from the paraprofessionals while 'unqualified' allopaths were consulted more frequently by the Tripuras, Chakmas and the Marmas (60-70%). Qualified allopaths were mostly consulted by the Bangalis (26%). Sex, types of illness, ethnicity, household head's education and household's landholding were significant predictors of seeking treatment, and allopathic treatment in particular. The findings on the differential health and health-seeking behaviour among ethnic groups should help in the designing of any future health interventions in the area.
Asia Pac J Public Health 2001
PMID:Differing health and health-seeking behaviour: ethnic minorities of the Chittagong Hill Tracts, Bangladesh. 1259 7

The World Health Organisation established the Roll Back Malaria (RBM) strategy to reduce the global burden of malaria in 1998. A set of RBM indicators will not be suitable to the Republic of Korea due to the differences of the epidemiological and socio-cultural situation. Therefore, we have developed a framework and indicators for monitoring the outcomes and impact of the national malaria eradication programme that are appropriate for the situation in Korea. We reviewed the existing data in the national malaria eradication programme. We adopted general principles in developing a monitoring framework and indicators for monitoring RBM. Monitoring areas were recombined components and content that included the project plan, training health personnel, health education and public information, supply for manpower, equipment and materials, disease control, information system, supervision, community participation, intersectoral collaboration within practical guidelines for the national malaria eradication programme along with malaria control and RBM strategy of WHO. Twenty one monitoring areas were selected that identified critical areas for the national malaria eradication programme. Fifteen indicators of ten categories are proposed for use by the national malaria eradication programme in Korea.
Asia Pac J Public Health 2003
PMID:A framework for monitoring the malaria eradication programme in Korea. 1462 Apr 97

The prevalence of malaria parasitemia, bacteremia, certain hematological parameters, leucocyte migration index and nitroblue tetrazolium dye reduction were determined in 147 Nigerian children (4.24+/-2.88 years of age). Sixty (40.8%), 28(19.1%) and 26(17.7%) had malaria parasitemia only, bacteremia only and both malaria parasitemia and bacteremia, respectively. Four genera of bacteria, i.e E. coli, Proteus, Staphylococcus and Salmonella, were detected in subjects with both malaria parasitemia and bacteremia. The 4 bacterial genera and Klebsiella were detected in subjects with bacterial infection only. P. falciparum (68%), P. malariae (25%) and P. ovale (7%) were the species of malaria parasites identified in our subjects. Bacteremia was most prevalent in subjects with hemoglobin AA (HbAA) (60.7%) followed by HbAC (21.45%). Packed cell volume (PCV) and Hb concentration were similar in all groups but mean counts of red blood cells (RBC) and white blood cells (WBC) were statistically significantly lower in subjects with malaria parasites only compared to the controls. Leucocyte migration was significantly reduced in children with bacteremia only or both malaria parasitemia and bacteremia compared to controls, while the nitroblue tetrazolium assay was significantly reduced in children with bacteremia only. It may be concluded that malaria parasitemia significantly affects both leucocyte migration and nitroblue tetrazolium assay.
Asian Pac J Allergy Immunol 2004 Dec
PMID:Leucocyte migration and nitroblue tetrazolium assay in Nigerian children with bacteremia and malaria parasitemia. 1578 34

This study compares the role and performance of active case detection (ACD) and passive case detection (PCD) in Jepara district, Indonesia. The number of blood slides examined and positive for malaria reported from 1994-1998 was retrieved from the district surveillance registers. Age of cases, parasite species, types of drugs and dosage, and time lapse were recorded from malaria registers at the three most endemic health centres. The quality of diagnosis was examined by re-reading 153 slides at the Department of Parasitology, Faculty of Medicine, Gadjah Mada University. Almost 60% of the 10,493 confirmed cases in Jepara district were identified from ACD. ACD detected significantly higher P. falciparum gametocyte infections than PCD (14.7% vs. 5.7%; p=0.002). The duration for slides prepared for examination was longer in ACD than in PCD (2.3 vs. 1.1 days; p<0.001), but this was still within the presumptive treatment period. Based on this we conclude that in the transition period to a decentralised health system, ACD for malaria parasites should be continued in a specified endemic area and therefore, efforts to retain the village malaria workers should be considered.
Asia Pac J Public Health 2007
PMID:Comparison of active and passive case detection systems in Jepara District, Indonesia. 1778 54

This study reports on findings from the ex post evaluation of the Maewo Capacity Building project in Vanuatu which was funded by World Vision Australia. The objective of the evaluation was to examine the extent to which the infrastructure and systems left behind by the project contributed to the improvement of household food security, and health and nutritional outcomes in Maewo island, using Ambae island as a comparator The household food security of 817 households selected by a two stage cluster sampling method was assessed using a modified version of the Radimer-Comell hunger scale and the US National Measure of food security. Anthropometric measurement in children (6-59 months) and mortality data were also obtained. The prevalence of food insecurity without hunger was estimated at 15.3% (95%CI: 12.1% to 19.2%) in Maewo versus 38.2% (95%CI: 33.6% to 43.0%) in Ambae while food insecurity with hunger in children did not vary by location. After controlling for age, gender and household food security status, children aged 6-59 months in Maewo were less likely to be underweight than children of the same age in Ambae (OR: 0.66, 95%CI 0.38 to 0.99). No difference was detected between the two locations in terms of stunting and wasting prevalence. The crude mortality rate (CMR) was lower in Maewo (CTvIIR=0.47/10,000/day, 95%CI: 0.39 to 0.55) than Ambae (CMR= 0.59/10,000/day, 95%CI: 0.51 to 0.67) but no difference existed in mortality in children under five years old. The major causes of death were similar in both locations and the causes frequently reported were malaria, acute respiratory infection and dianheal diseases. The evaluation found that Maewo had better health and nutrition outcomes but the infrastructure left behind by the project and the livelihood system may have been weakened by cyclone Ivy that devastated the region from 25 to 27 February 2004.
Pac Health Dialog 2004 Mar
PMID:Food insecurity, malnutrition and mortality in Maewo and Ambae islands, Vanuatu. 2045 95

Plasmodium falciparum, the protozoan parasite responsible for severe malaria infection, undergoes a complex life cycle. Infected red blood cells (iRBC) sequester in host cerebral microvessels, which underlies the pathology of cerebral malaria. Using immunohistochemistry on post mortem brain samples, we demonstrated positive staining for vascular endothelial growth factor (VEGF) on iRBC. Confocal microscopy of cultured iRBC revealed accumulation of VEGF within the parasitophorous vacuole, expression of host VEGF-receptor 1 and activated VEGF-receptor 2 on the surface of iRBC, but no accumulation of VEGF receptors within the iRBC. Addition of VEGF to parasite cultures had a trophic effect on parasite growth and also partially rescued growth of drug treated parasites. Both these effects were abrogated when parasites were grown in serum-free medium, suggesting a requirement for soluble VEGF receptor. We conclude that P. falciparum iRBC can bind host VEGF-R on the erythrocyte membrane and accumulate host VEGF within the parasitophorous vacuole, which may have a trophic effect on parasite growth.
Asian Pac J Allergy Immunol 2008 Mar
PMID:Host vascular endothelial growth factor is trophic for Plasmodium falciparum-infected red blood cells. 1859 28

This article reviews studies examining the relationship between climate variability and the transmission of vector- and rodent-borne diseases, including malaria, dengue fever, Ross River virus infection, and hemorrhagic fever with renal syndrome. The review has evaluated their study designs, statistical analysis methods, usage of meteorological variables, and results of those studies. The authors found that the limitations of analytical methods exist in most of the articles. Besides climatic variables, few of them have included other factors that can affect the transmission of vector-borne disease (eg, socioeconomic status). In addition, the quantitative relationship between climate and vector-borne diseases is inconsistent. Further research should be conducted among different populations with various climatic/ecological regions by using appropriate statistical models.
Asia Pac J Public Health 2008
PMID:Climate change and the transmission of vector-borne diseases: a review. 1912


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