Island health differs from other health care systems, particularly in that there are limited resources and referral faculties available. With globalisation and climate change, island populations have become increasingly vulnerable to natural disasters and global pandemics. This study will identify, explore, compare and report on island health issues facing in the western Pacific, before making appropriate recommendations. A review of selected health indicators in Pacific islands was collected from the World Health Organization (WHO) and other publicly available resources. In the Pacific region, 15 islands saw lower health expenditure (

Rubella is a common cause of childhood rash and fever. Congenital rubella syndrome (CRS) can lead to deafness, heart disease, cataracts, and a variety of other permanent manifestations. In order to identify the disease burden of rubella infection, CRS surveillance among infants in Yangon was conducted for two consecutive years from December 2000 to December 2002, as a WHO-funded study. Among the 13 participating hospitals, the Special Care Baby Unit of the Central Women‘s Hospital in Yangon reported 17 infants with suspected CRS. Interestingly, three sets of twins with suspected CRS were reported. One ml of blood was collected from each infant after obtaining informed consent, then tested for the presence of rubella antibody (Immunoglobulin M and G) by the ELISA method, and for the presence of rubella viral RNA by the RT-PCR method. Furthermore, nucleotide sequencing and genotype identification of samples from two cases with positive rubella RNA were performed. All 3 sets of twins were IgM negative. However, rubella RNA was detected by RT-PCR in twin 1A who showed no obvious clinical signs, and in twin 2B who had patent ductus arteriosus, splenomegaly and hepatomegaly. Nucleotide sequences of PCR positive cases revealed genotype Ia sequences. Twin 2B was identified as having deafness of the left ear on audiometry assessment conducted at 5 years and 4 months of age. Both twins of twin set-2 were IgG positive at age 12 days, but turned out to be negative by the age of 9 months. Both twins of twin set-3 presented with splenomegaly and died before 2 months of age, probably due to other infections. Our findings revealed the different scenario of twins with suspected CRS. It is expected to serve as a valuable addition to the medical literature as there were very few reports on twins with CRS.

The lower percentage of water, sanitation and hygiene are the root causes of diarrhoea and cholera. Cholera is a sudden onset of acute watery diarrhoea which can progress to severe dehydration and death if untreated. The current pandemic, Vibrio Cholera O1 started in 1961. This study explores water, sanitation, hygiene and cholera and diarrhoea in three affected villages of Beluran District, Sabah Malaysia to support effective and timely public health intervention. This cross sectional study uses purposive sampling. All (114) households were interviewed and household water samples collected. The study reported lower coverage improved sanitation facilities (35.3% to 52.3%), no latrine at home (37% to 63%), improved water supply (52% to 60%), and prevalence of hand washing after toilet (57% - 74%). For water quality, Ecoli was present in household water (32% to 37%) but Vibrio cholerae was not isolated in any of the water samples tested. Statistically significant associations were found for; 1) occupation−non-agriculture and unimproved sanitation facility and 2) house ownership and correct knowledge of ORS preparation. Predictors for household water quality were: latrine at home, and improved household toilet. Aggressive strategies to improve water supply, sanitation and hygiene−hand washing after toilet−were recommended for future prevention of cholera and diarrhoea in the affected area.
Cholera ; Sanitation ; Rural Population

Objectives: To determine the distribution of Plasmodium (P) species including Plas-modium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis. Methods: The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and confirmed by nested PCR. Results: Among the participants, 57 (63.3％) were positive and 33 (36.7％) were negative by microscopy. Of positive samples, 39 (68.4％) were Plasmodium falciparum, 17 (29.8％) Plasmodium vivax and 1 (1.8％) Plasmodium malariae, whereas 59-amplified by PCR were 40 (67.8％), 18 (30.5％) and 1 (1.7％) respectively. PCR amplified 2 mi-croscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale, P. knowlesi and mixed infections. Microscopy had a very good measure of agreement (k= 0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diag-nosis of P. falciparum were 92.5％(95％CI:79.6–98.4) and 96.0％(95％CI:86.3–99.5) respectively, whereas for P. vivax were 83.3％(95％CI:58.6–96.4) and 97.2％(95％CI:90.3–99.7). Conclusions: P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria, those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.

ary phytochemical screening. The resultsshowed that the ethanolic crude extract of the leaf containhigh phytochemical activity hence B.oleraceavaracephalais rich in flavonoids, phenolic compounds, carbohydratesand phytosterols. Materials and methods: The ethanolic extract was used tosynthesise copper nanoparticles. The copper nanoparticleswere successfully synthesised from copper sulphatesolution which was identified by the colour change fromdark green colour of the extract. Thus the B.oleracea varacephala is a good source to synthesis coppernanoparticles. The synthesised copper nanoparticles werecharacterised using Scanning Electron Microscope (SEM)analysis. The SEM image displayed the high-densitynanoparticles synthesised by leaf extracts and that thenanoparticles were crystals in shape. Results: The copper nanoparticles (CNP) bind to the leafextract. B.oleraceavaracephalaalso has shown theantimicrobial and antioxidant activity. A comparative studywas done between ethanolic its crude extract andnanoparticles. Both extracts exhibited zone of inhibition andbetter antioxidant potential but the CuNPs shows majorzone of inhibition and showed more antioxidant activity.Anticancer activity of B.oleraceavaracephalaagainstCervical HeLa cell line was confirmed using ethanolic crudeextract and CNP. The results showed that HeLa cellsproliferation was inhibited with increasing concentration ofethanolic crude extract and copper nanoparticles. From theresults, it was seen that percentage viability of the cancercells decreased with increased concentration of the sampleswhereas cytotoxicity against HeLa cell lines increased withthe increased concentration of the samples. Conclusion: Thus B.oleraceavaracephalapossessesanticancer activity against HeLa cell lines.

Malaria, tuberculosis, and hepatitis are common and notorious infectious diseases in Myanmar. Despite intensive efforts to control these diseases, their prevalence remains high. For malaria, which is a vector-borne disease, a remarkable success in the reduction of new cases has been achieved. However, the annual number of tuberculosis cases has increased over the last few decades, and the prevalence of chronic viral hepatitis infection has been high in Myanmar and other nearby countries. Early detection and prompt treatment are crucial to control these diseases. We have devoted our research efforts to understanding the status of these infectious diseases and working towards their eventual elimination for the last four years with the support of the Korea International Cooperation Agency. In the modern era, an infection that develops in one geographical area can spread globally because national borders do not effectively limit disease transmission. Our efforts to understand the status of infectious diseases in Myanmar will benefit not only Myanmar but also neighboring countries such as Korea.
Communicable Diseases ; Hepatitis* ; International Cooperation ; Korea ; Malaria* ; Myanmar* ; Prevalence ; Tuberculosis*

Rapid Rural Appraisal (RRA) is a systematic, semi-structured activity carried out in the field by a multidisciplinary team that is designed to obtain new information and hypotheses about rural life. This article reports the results of an RRA conducted in Kampung Paris 1 (KGP1), Kinabatangan, Sabah under the Annual Health Promotion Program of the School of Medicine, Universiti Malaysia Sabah. A systematic random sampling was used to recruit the villagers and data was obtained through compilation of pre-existing data, field observation, structured interviews with key informants and villagers. Cardiorespiratory diseases were prevalent in KGP1. Common water sources such as rain water collected in dug wells in KGP1 were unhygienic. Dangerous toxic fumes were produced by the burning of municipal wastes nearby village houses. The villagers of KGP1 were exposed to various farm animals, which may harbor zoonoses. Health care services are limited in KGP1. Villagers who were not poor (>RM897) represented 48% of the population, followed by the poor (RM503-897), 20% and the hardcore poor (1.00 person per bedroom. Poor water hygiene, polluted air from open burning, exposure to farm animals, poverty, poor education, overcrowding and inadequate health care services were among the few possible factors affecting the health of villagers in KGP1. Formal rigorous research should be conducted in the future to facilitate specific health interventions in areas of need such as KGP1.
Rural Population ; Rural Health ; Rural Health Services ; Health Status ; Malaysia

In the era of (pre) elimination setting, the prevalence of malaria has been decreasing in most of the previously endemic areas. Therefore, effective cost- and time-saving validated pooling strategy is needed for detection of malaria in low transmission settings. In this study, optimal pooling numbers and lowest detection limit were assessed using known density samples prepared systematically, followed by genomic DNA extraction and nested PCR. Pooling strategy that composed of 10 samples in 1 pool, 20 µl in 1 sample, was optimal, and the parasite density as low as 2 p/µl for both falciparum and vivax infection was enough for detection of malaria. This pooling method showed effectiveness for handling of a huge number of samples in low transmission settings (<9% positive rate). The results indicated that pooling of the blood samples before DNA extraction followed by usual nested PCR is useful and effective for detection of malaria in screening of hidden cases in low-transmission settings.
DNA* ; Limit of Detection ; Malaria* ; Mass Screening ; Methods ; Parasites ; Plasmodium falciparum ; Plasmodium vivax ; Polymerase Chain Reaction ; Prevalence

Objectives To determine the distribution of Plasmodium (P) species including Plasmodium knowlesi and to compare the specificity and sensitivity of microscopy with nested PCR in malaria diagnosis. Methods The study was conducted in Kawthaung, southern Myanmar. Ninety clinically suspected malaria patients were screened for malaria by Giemsa stained microscopy and confirmed by nested PCR. Results Among the participants, 57 (63.3%) were positive and 33 (36.7%) were negative by microscopy. Of positive samples, 39 (68.4%) were Plasmodium falciparum, 17 (29.8%) Plasmodium vivax and 1 (1.8%) Plasmodium malariae, whereas 59-amplified by PCR were 40 (67.8%), 18 (30.5%) and 1 (1.7%) respectively. PCR amplified 2 microscopy negative samples. Two samples of P. falciparum detected by microscopy were amplified as P. vivax and vice versa. All samples were negative for Plasmodium ovale, P. knowlesi and mixed infections. Microscopy had a very good measure of agreement (κ = 0.95) compared to nested PCR. Sensitivity and specificity of microscopy for diagnosis of P. falciparum were 92.5% (95% CI: 79.6–98.4) and 96.0% (95% CI: 86.3–99.5) respectively, whereas for P. vivax were 83.3% (95% CI: 58.6–96.4) and 97.2% (95% CI: 90.3–99.7). Conclusions P. knowlesi was not detected by both microscopy and PCR. Giemsa stained microscopy can still be applied as primary method for malaria diagnosis and is considered as gold standard. As to the lower sensitivity of microscopy for vivax malaria, those with previous history of malaria and relapse cases should be diagnosed by RDT or PCR combined with microscopy. Inaccuracy of species diagnosis highlighted the requirement of training and refresher courses for microscopists.

This work investigates the Musa Paradisiaca plant and its tepal extracts. The research findings show that the tepal extracts of M. Paradisiaca contain high phytochemical activity. Hence we can conclude that these plants have a number of beneficial properties. Phytochemical analysis concludes that the plant is rich in flavonoids, phenolic compounds, tannins, terpenoids, and phytosterol. In the current work, silver nanoparticles (AgNPs) have revealed the antioxidant properties of M. Paradisiaca. The results show that the methanolic extracts of these tepals exhibit antioxidant potential and are also sources of natural antioxidant compounds, though comparatively, AgNPs have shown the best antioxidant activity. This work investigates the link between the ethnopharmacological statements and the bioactive constituents found in M. Paradisiaca toward all probable markers for cervical cancer via in vivo studies and molecular docking, to form a pharmacophore setting for the active target. However, most of the mechanisms of action of herbal medicines are not in total agreement, and the information collected from their traditional remedies over the years must not be neglected. Hence, it is sensible to investigate the options available in herbal medicine for cancer progression. Biosynthesised AgNPs are principally spherical and nanosized. It was also found that tepalmediated AgNPs exhibit excellent antimicrobial efficacy against tested human pathogens. This green method can be used as a better alternative source than the chemical fabrication of nanomaterials and the biosynthesised nanoparticles can be used in antibacterial medicines. The methanolictepal extract of M. Paradisiaca with AgNPs displayed proficient antidiabetic properties in the diabetes rat model and so could have a possible development for medical use in the future