Pneumonia and diarrhoeas are an important cause of toddler mortality and morbidity in developing countries. Of the 147 children admitted to the University Hospital at Kuala Lumpur in 1971 for pneumonia and diarrhoeas 50 (34%) were found to be suffering from protein-calorie malnutrition of varying degrees of severity. The malnourished children tended to come from poorer homes, and to have a larger number of siblings born in rapid succession when compared with normal weight children. Anemia was more common among the malnourished children. The interaction of infection and malnutrition and the social implications of these diseases are important. It is vital that hospitals in developing countries promote health in addition to their traditional curative role.
A trial of suppression of malaria by administration of combined sulphadoxine-pyrimethamine tablets every 28 days was undertaken in West Malaysia during 1972. One thousand subjects were followed over a 10-month period, including control groups on placebo and on weekly chloroquine. Subjects were examined monthly for parasitaemia, drug reactions, leucopenia, teratogenicity and haemolysis among the subjects deficient in glucose-6-phosphate dehydrogenase. Rates of new infections in the placebo group were 8.0% with Plasmodium falciparum and 6.2% with P. vivax; in the group receiving weekly chloroquine, 5.1% P. falciparum and 0.3% P. vivax; and in the group receiving monthly sulphadoxine-pyrimethamine, 0.3% P. Falciparum and 1.0% P. vivax. The effective rate of cure of new infections with P. falciparum by a single suppressive dose of combined sulphadoxine-pyrimethamine given the following month was 88.7%. No serious side effects were observed.
Chloroquine resistance is a well established entity in South East Asia, and presents a problem of increasing importance. Strains of P. falciparum resistant to chloroquine have also been found to be resistant to amodiaquine and a combination of pyrimethamine and sulphadoxine. Knowledge of the drug sensitivity of the strains of malaria parasite in a given locality is important so that the right choice of drugs can be made in treatment of the disease. The treatment of chloroquine resistant malaria in West Malaysia is a subject of another paper but suffice it to say that increased doses of chloroquine have still been found to be effective in treating many cases of falciparum malaria from areas of chloroquine resistance.
A variety of traditional medical systems thrive with vigour in Malaysia among the Malay, Orang Asli, Iban, Kadazan and Chinese peoples. The bases of these systems reflect the cultural concept of the “universe” of each ethnic group. It is noted that traditional medicine accomodates a larger proportion of illness thought to be due to supernatural causes than does modern medicine. Traditional medicine is supportive, personal and holistic in its approach in contrast with modern scientific medicine which tends to be mechanistic, impersonal, organ-oriented and individualistic. Modern and traditional medical systems are viewed as potentially complementary rather than contradictory. The traditional medicine-man can be viewed as a ritual specialist and a focus of social and emotional support for the patient, such a role being complementary to the role of the modern physician.
MeSH terms: Child; Culture*; Ethnic Groups; Female; Humans; India; Malaysia; Male; Medicine*; Medicine, Chinese Traditional*; Medicine, East Asian Traditional*; Medicine, Traditional; Pregnancy; Preventive Medicine
The organisation of the radiological services in Malaysia is described and those diseases in which radiology plays an important part in diagnosis are discussed. As radiology embraces all specialities a pattern of diseases emerges which is different from that seen in the West. The control of infectious diseases, the general improvement in health care and the more sophisticated radiological investigations now available mean that in future radiology will play a much more important part in diagnosis and management of patients.
MeSH terms: Biliary Tract Diseases/radiography; Bone Diseases/radiography; Cardiovascular Diseases/radiography; Communicable Diseases/radiography; Community Health Services; Diagnostic Services; Gastrointestinal Diseases/radiography; Humans; Joint Diseases/radiography; Lung Diseases/radiography; Malaysia; Neoplasms/radiography; Radiology*; Urinary Tract Infections/radiography
R. sabanus and R. muelleri are very common in the lowland forests of Malaysia. In nature they are infected with Breinlia sp. and D. ramachandrani. In an attempt to determine whether they are also susceptible to subperiodic B. malayi and thereby being potential reservoirs of infection of the disease, 24 R. muelleri and 17 R. sabanus were experimentally infected with the parasite. Results show that although they can support the full development of the parasite, they are poor hosts. This confirms the observation that in Malaysia natural infection of Rattus spp. with the parasite has not been seen. These rats therefore are probably not important in the zoonotic transmission of subperiodic B. malayi in Malaysia.