Asian Journal of Research in Infectious Diseases

Introduction: Dengue is the most prevalent viral mosquito-borne disease, with over 2.5 billion humans at risk given its endemicity in more than 100 countries.

Globally, 50-100 million cases of dengue occur annually, with approximately 0.7% resulting in dengue haemorrhagic fever (DHF), and 22,000 deaths.

In 2017, there were 83,849 reported cases of dengue fever in endemic under-reported Malaysia, with 177 deaths.

One of our authors (Verasingam K 2006) here, earlier published an article in the Med J Malaysia titled “Dengue Fever in Malaysia: Time for Review?” This Article is meant as a sequel.

Method: The Authors here narrate from their own personal-experiences, as well as from reviewing existing-literature.

Results and Conclusion: Clinical Management has brought about vast improvements in mortality and morbidity. Similarly, great advancements in Laboratory Diagnostics. Prevention and Control methods have been desiring of greater achievements, but also show greater promise with Newer Insecticides, Innovative Methods and Vaccines. Dengue Fever would very likely become near-eradicated just like all other vaccine-preventable diseases, once comprehensive mass-vaccination programmes are available globally, using safe and very-effective tetravalent-vaccines soon to be available.

Aims: The study characterised some intestinal bacterial and parasitic infections involved in diarrhoea causation in contiguous communities between October 2013 and April 2014.

Study Design: A total of 150 freshly-voided diarrhoeic samples of children attending PHC, Eket and General Hospital, Ibeno, and 50 non–diarrhoeic samples (Controls) were collected. The controls were recruited from subjects outside the health facilities.

Methodology: Standard bacteriological procedures were used in the identification while antibiotic susceptibility test was done. Questionnaires were also administered.

Results: The mean prevalence rate recorded for enteropathogens among children was 73%. A high prevalence of enteropathogens was observed in the parameters examined. The bacterial pathogens considered were Escherichia coli, Salmonella enteritidis, Shigella dysenteriae and Enterobacter species. Escherichia coli were the most prevalent with the rates of 43.5% and 45% in Eket and Ibeno, respectively. Enteropathogenic Escherichia coli (EPEC) O26 and O111 were identified with an overall prevalence of 46.7%. Antibiotic susceptibility result shows that the organisms were most susceptible to Ciprofloxacin and resistant to Cotrimoxazole. The analyses of the questionnaires revealed that in the study area, children, whose parents have no formal education were more commonly infected with enteropathogens.

Conclusion: A systematic education of caregivers and children on personal hygiene is the best approach to reduce the intestinal pathogens.

Background: Dengue infection is the common infectious disease in tropical countries caused by dengue virus, which has four serotypes (DEN 1, 2, 3 and 4). More data showed that dengue has caught worldwide attention due to its severe and fatal clinical outcome. This study aimed to describe the difference of clinical features of dengue infection between children and adults and among each dengue serotypes in Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand during 2011- 2013.

Study Design: This study was a hospital-based retrospective.  In- patient medical record of 50 children and 148 adults with clinical and laboratory confirmed dengue infection and admitted to Hospital for Tropical Diseases, Mahidol University, Bangkok, Thailand during July 2011- June 2013 were reviewed.

Results: We found that headache and myalgia/arthalgia were found in most of the cases (182/198, 91.9%; 178/198, 89.9%, respectively). Epistaxis and hypermenorrhea were more common in children. Retro-orbital pain was more common in adult. The spontaneous bleeding tended to be more common in children than adults. DEN2 (48.9%) was the most common serotype followed by DEN3 (23.7%), DEN1 (22.2%) and DEN4 (5.2%). Regarding dengue serotypes, subjects infected with DEN1 had more shock, hypermenorrhea and epistaxis than others. Lymphadenopathy and rash during febrile stage were found in subjects infected with DEN2 only. Subjects infected with DEN4 infection had more retro-orbital pain and petechiae than others.

Conclusion: The results show secondary dengue infection was most common and the most prevalent dengue serotype was serotype 2. Typical symptoms in adult involved retro orbital pain, nausea and arthralgia while children might suffer epistaxis and hypermenorrhea. We also found that DEN 1 tended to have more mucosa bleeding and shock. In DEN 4 infection, subjects had more retro-orbital pain and skin bleeding.

Background: Immunisation drop-out rate measures the effectiveness of the immunisation programme. When drop-outs exceed 10 percent it indicates a problem of utilisation of services. Receipt of vaccines at the recommended ages and intervals will ensure that children are adequately protected from target diseases at all times. Immunisation reminder and recall (RR) systems are cost-effective methods of improving adherence to recommended immunisation schedules. This study, therefore, determined the effect of immunisation reminders and recalls on reducing pentavalent vaccination drop-outs in Abakaliki.

Materials and Methods: This is a quasi-experimental study among caregivers of infants in rural health facilities in Abakaliki, Nigeria. Mile-Four and St. Vincent hospitals in Izzi and Ebonyi Local Government Areas (LGA) of Ebonyi State were selected purposively. Mile-Four was assigned the phone reminder/recall intervention group and St. Vincent as a control group. The sample size was determined using the formula for comparing two proportions.  Caregiver-child pair was enrolled into the two groups during the infants’ BCG or Pentavalent vaccines 1 immunisation visit and followed till the final scheduled immunisation visit for each child. Data were collected using questionnaire forms, proforma and checklist. Statistical Package for Social Science (SPSS) version 22.0 was used for analysis. Ethical approval was obtained from the Research and Ethics Committee (REC) of the Federal Teaching Hospital Abakaliki (FETHA), Nigeria.           

Results: The mean age of respondents were 26.6 ±4.9 years and 27.1±4.2 years in the intervention and control groups respectively. Thirty five point seven percent (35.7%) of infants dropped out of pentavalent vaccinnation 3 in pre-intervention phase when compared with 5.5% post-intervention. This difference in their proportions was found statistically significant (p<0.01).  In the control group, 47.7% dropped out of pentavalent vaccination 3 at the beginning of the study when compared with 22.1% at the end of the study, a difference that was statistically significant (p=0.02). Out of 145 infants who received pentavalent vaccines 1 in both groups, 137 (94.5%) infants received pentavalent vaccines 3 in the intervention group while 113 (77.9%) infants received pentavalent vaccines 3 in the control group. Far distance to health facility predicted immunisation drop-out in the control group. It is 2.8 times more likely to cause immunisation drop-out than near distance to health facility. No predictor was found in the intervention group.

Conclusion: Mobile phone reminders and recall has proven very effective in reducing pentavalent vaccines drop-out rate in Abakaliki. Implementation of immunisation reminders and recall systems are therefore recommended in immunisation clinics in developing countries especially in Nigeria for improved immunisation coverage in order to achieve Sustainable Developmental Goal 3 (SDG 3).

With thousands of people moving from one area to another day by day, in a chain of regions tightly more interconnected than other regions in a given large domain, an epidemic may spread rapidly around it from any point of borders. It might be sometimes urgent to impose travel restrictions to inhibit the spread of infection. As we aim to protect susceptible people of this chain to contact infected travelers coming from its neighbors, we follow the so-called travel-blocking vicinity optimal control approach with the introduction of the notion of patch for representing our targeted group of regions when the epidemic modeling framework is in the form of a Susceptible-Infected-Removed-Susceptible (SIRS) discrete-time system to study the case of the removed class return to susceptibility because of their short-lived immunity. A discrete version of the Pontryagin’s maximum principle is employed for the characterization of the travel-blocking optimal control. Finally, with the help of discrete progressive-regressive iterative schemes, we provide cellular simulations of an example of a domain composed with 100 regions and where the targeted chain includes 7 regions.