1.Comparison of Calcofl uor White M2R Fluorescence and Modifi ed Gram Chromotrope Kinyoun
I Nur Raihana ; O Malina ; MS Fatmah ; M Norhayati ; AR Eni Juraida ; RA Hamat
Malaysian Journal of Medicine and Health Sciences 2013;9(2):63-68
Routine diagnosis of intestinal microsporidiosis in clinical diagnostic laboratories relies mostly on
detection of microsporidial spores via special staining and microscopic techniques. This paper describes
the comparative evaluation of Calcofl uor White M2R method, with modifi ed Gram-chromotrope
Kinyoun method as the reference standard. One hundred and six stool samples were examined for the
presence of microsporidial spores. Sensitivity, specifi city, positive and negative predictive values of
the Calcofl uor White M2R method compared to the reference technique were 95.2%, 4.3%, 78.2%
and 20.0%, respectively. The positive predictive value (PPV) was 78.2% and the negative predictive
value (NPV) was 20.0%. Despite low specifi city of the CFW method due to its ability to stain
chitinous wall of microorganisms, the presence of distinct deep-blue horizontal or equitorial stripes in
microsporidial spores in modifi ed Gram-chromotrope Kinyoun would likely reduce the false positive
results obtained in the Calcofl uor White M2R. Hence, the simultaneous use of these two methods
would give better performance and accuracy for the detection of microsporidial spores in patients
with intestinal microsporidiosis.
2.Diphtheria Anti-toxoid Antibody Levels Among Pre-clinical Students and Staff in an Institute of Higher Learning in Malaysia: Are They Protected?
RA Hamat ; O Malina ; YJ Chua ; KL Seng ; M Zubaidah ; K Norhanim ; SS Chong ; PL Weng ; J Farida
Malaysian Journal of Medicine and Health Sciences 2011;7(1):27-34
Introduction: Little is known about the sero-prevalence of diphtheria anti-toxoid antibody levels
among medical students in Malaysia. They too, just like other health care workers (HCWs) are at
risk of contracting and transmitting diphtheria. Fortunately, this can be prevented by giving a specific
vaccine: the diphtheria, tetanus and pertussis (DTP) vaccine. Nonetheless, data from local or regional
surveys are needed before any decision is made by the respective authorities. General objective: We
studied the epidemiology of diphtheria anti-toxoid antibody levels and vaccination history amongst
medical students and staff in Faculty of Medicine and Health Sciences, Universiti Putra Malaysia.
Specific objectives: We determined the level of diphtheria anti-toxoid antibodies amongst pre-clinical
students and staff. Methodology: A total of 152 sera were collected from subjects aged 19 to 63, and
diphtheria anti-toxoid levels were measured by an enzyme-linked immunosorbent assay. Results: One
hundred and fifty-two (94.4%) blood samples out of 161 participants were successfully withdrawn,
which comprised 105 (69.1%) and 47 (30.9%) medical students and staff, respectively. A total of 77.6%
and the other 22.4% of the subjects had full and basic protection, respectively. Higher levels were
predominant amongst males and they were 1.3 times more protected than females in 20-29 year-old
group (85.1% vs 66.2%; odd ratios 1.25 [95% CI 1.03-1.50]; P=0.03). No significant difference in the
levels of immunity among subjects for ethnicity and academic position (P>0.05). Recommendations:
Level of full protection against diphtheria toxin should be clearly defined by broad population based
studies using several comparable detection methods. Medical students and staff with basic protection
should be closely monitored or should be given a booster dose for those who are at high risk of acquiring
the disease. Thus, a standard degree of coverage should be clearly determined for health workers to
prevent a potential outbreak. Conclusion: Students and staff possess immunity towards diptheria toxin
however the level of full protective antibody is yet to be determined in future.