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Fulltext Interventional Pulmonology and COVID-19: Experience from a Malaysian Tertiary Hospital

Huan NC, Ng KL, Tang JT, Kua HN, Daut UN, Muhammad NA, et al.

Ann Acad Med Singap, 2020 12;49(12):1013-1017.
PMID: 33463660 DOI: 10.47102/annals-acadmedsg.2020364

The ongoing pandemic of COVID-19 has presented multiple challenges to global healthcare services, dictating changes in almost every aspect of daily medical practice. Performing aerosol generating procedures (AGPs) in the field of interventional pulmonology can lead to profound formation of aerosols, leading to a high risk of infection among healthcare workers (HCWs). We share our experiences on performing AGPs in the midst of a COVID-19 pandemic by focusing on changes in AGP practices. In a pandemic, HCWs ought to adapt to the ever-changing situation and use available resources to provide the best possible healthcare to patients, ensure safety of staff, and continue medical education of future pulmonologists.

Matched MeSH terms: Infectious Disease Transmission, Patient-to-Professional/prevention & control*
Congenital Tuberculosis Complicated by Hemophagocytic Lymphohistiocytosis

Osowicki J, Wang S, McKenzie C, Marshall C, Gard J, Ke Juin W, et al.

Pediatr Infect Dis J, 2016 Jan;35(1):108-10.
PMID: 26398869 DOI: 10.1097/INF.0000000000000932

We present the case of a male infant with congenital tuberculosis in a nonendemic setting complicated by hemophagocytic lymphohistiocytosis, who was treated successfully with antituberculous therapy and corticosteroids. We review the pediatric literature concerning the unusual association of these 2 rare conditions.

Matched MeSH terms: Tuberculosis/transmission*
[Emergence of new viruses in Asia: is climate change involved?]

Chastel C

Med Mal Infect, 2004 Nov;34(11):499-505.
PMID: 15620053

Tropical Africa is not the only area where deadly viruses have recently emerged. In South-East Asia severe epidemics of dengue hemorrhagic fever started in 1954 and flu pandemics have originated from China such as the Asian flu (H2N2) in 1957, the Hong-Kong flu (H3N2) in 1968, and the Russian flu (H1N1) in 1977. However, it is especially during the last ten years that very dangerous viruses for mankind have repeatedly developed in Asia, with the occurrence of Alkhurma hemorrhagic fever in Saudi Arabia (1995), avian flu (H5N1) in Hong-Kong (1997), Nipah virus encephalitis in Malaysia (1998,) and, above all, the SARS pandemic fever from Southern China (2002). The evolution of these viral diseases was probably not directly affected by climate change. In fact, their emergential success may be better explained by the development of large industry poultry flocks increasing the risks of epizootics, dietary habits, economic and demographic constraints, and negligence in the surveillance and reporting of the first cases.

Matched MeSH terms: Virus Diseases/transmission
Fulltext Reiseangst: travel anxiety and psychological resilience during and beyond the COVID-19 pandemic

Flaherty GT, Nasir N

J Travel Med, 2020 12 23;27(8).
PMID: 32870275 DOI: 10.1093/jtm/taaa150
Matched MeSH terms: Disease Transmission, Infectious/prevention & control
Vector competence of Malaysian Aedes albopictus with and without Wolbachia to four dengue virus serotypes

Joanne S, Vythilingam I, Teoh BT, Leong CS, Tan KK, Wong ML, et al.

Trop Med Int Health, 2017 09;22(9):1154-1165.
PMID: 28653334 DOI: 10.1111/tmi.12918

OBJECTIVE: To determine the susceptibility status of Aedes albopictus with and without Wolbachia to the four dengue virus serotypes.
METHODS: Two newly colonised colonies of Ae. albopictus from the wild were used for the study. One colony was naturally infected with Wolbachia while in the other Wolbachia was removed by tetracycline treatment. Both colonies were orally infected with dengue virus-infected fresh blood meal. Dengue virus load was measured using quantitative RT-PCR at four-time intervals in the salivary glands, midguts and ovaries.
RESULTS: Wolbachia did not significantly affect Malaysian Ae. albopictus dengue infection or the dissemination rate for all four dengue virus serotypes. Malaysian Ae. albopictus had the highest replication kinetics for DENV-1 and the highest salivary gland and midgut infection rate for DENV-4.
CONCLUSION: Wolbachia, which naturally exists in Malaysian Ae. albopictus, does not significantly affect dengue virus replication. Malaysian Ae. albopictus is susceptible to dengue virus infections and capable of transmitting dengue virus, especially DENV-1 and DENV-4. Removal of Wolbachia from Malaysian Ae. albopictus would not reduce their susceptibility status.

Matched MeSH terms: Dengue/transmission*
A longitudinal study of the prevalence of Nipah virus in Pteropus lylei bats in Thailand: evidence for seasonal preference in disease transmission

Wacharapluesadee S, Boongird K, Wanghongsa S, Ratanasetyuth N, Supavonwong P, Saengsen D, et al.

Vector Borne Zoonotic Dis, 2010 Mar;10(2):183-90.
PMID: 19402762 DOI: 10.1089/vbz.2008.0105

After 12 serial Nipah virus outbreaks in humans since 1998, it has been noted that all except the initial event in Malaysia occurred during the first 5 months of the year. Increasingly higher morbidity and mortality have been observed in subsequent outbreaks in India and Bangladesh. This may have been related to different virus strains and transmission capability from bat to human without the need for an amplifying host and direct human-to-human transmission. A survey of virus strains in Pteropus lylei and seasonal preference for spillover of these viruses was completed in seven provinces of Central Thailand between May 2005 and June 2007. Nipah virus RNA sequences, which belonged to those of the Malaysian and Bangladesh strains, were detected in the urine of these bats, with the Bangladesh strain being dominant. Highest recovery of Nipah virus RNA was observed in May. Of two provincial sites where monthly surveys were done, the Bangladesh strain was almost exclusively detected during April to June. The Malaysian strain was found dispersed during December to June. Although direct contact during breeding (in December to April) was believed to be an important transmission factor, our results may not entirely support the role of breeding activities in spillage of virus. Greater virus shedding over extended periods in the case of the Malaysian strain and the highest peak of virus detection in May in the case of the Bangladesh strain when offspring started to separate may suggest that there may be responsible mechanisms other than direct contact during breeding in the same roost. Knowledge of seasonal preferences of Nipah virus shedding in P. lylei will help us to better understand the dynamics of Nipah virus transmission and have implications for disease management.

Matched MeSH terms: Henipavirus Infections/transmission
Fulltext Personal protective equipment usage, recycling and disposal among spine surgeons: An Asia Pacific Spine Society survey

Chiu CK, Chan CYW, Cheung JPY, Cheung PWH, Gani SMA, Kwan MK

J Orthop Surg (Hong Kong), 2021 2 12;29(1):2309499020988176.
PMID: 33569998 DOI: 10.1177/2309499020988176

PURPOSE: In this study we investigated on the personal protective equipment (PPE) usage, recycling, and disposal among spine surgeons in the Asia Pacific region.
METHODS: A cross-sectional survey was carried out among spine surgeons in Asia Pacific. The questionnaires were focused on the usage, recycling and disposal of PPE.
RESULTS: Two hundred and twenty-two surgeons from 19 countries participated in the survey. When we sub-analysed the differences between countries, the provision of adequate PPE by hospitals ranged from 37.5% to 100%. The usage of PPE was generally high. The most used PPE were surgical face masks (88.7%), followed by surgical caps (88.3%), gowns (85.6%), sterile gloves (83.3%) and face shields (82.0%). The least used PPE were powered air-purifying respirators (PAPR) (23.0%) and shoes/boots (45.0%). The commonly used PPE for surgeries involving COVID-19 positive patients were N95 masks (74.8%), sterile gloves (73.0%), gowns (72.1%), surgical caps (71.6%), face shields (64.4%), goggles (64.0%), shoe covers (58.6%), plastic aprons (45.9%), shoes/boots (45.9%), surgical face masks (36.5%) and PAPRs (21.2%). Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE items compared to general waste.
CONCLUSIONS: The usage of PPE was generally high among most countries especially for surgeries involving COVID-19 positive patients except for Myanmar and Nepal. Overall, the most used PPE were surgical face masks. For surgeries involving COVID-19 positive patients, the most used PPE were N95 masks. Most PPE were not recycled. Biohazard bins were the preferred method of disposal for all types of PPE.

Matched MeSH terms: Disease Transmission, Infectious/prevention & control*
Fulltext Survey of Dengue Knowledge and Prevention Practices Associated with Sociodemographic Status: A Cross-Sectional Study Among the Community Living in an Urban Area of Selangor, Malaysia

Roslan MA, Ngui R, Vythilingam I, Fatt CK, Soon OP, Keat LC, et al.

J Am Mosq Control Assoc, 2020 06 01;36(2):115-119.
PMID: 33647124 DOI: 10.2987/19-6904.1

The present study aimed to explore the current status of knowledge and practices of dengue prevention associated with sociodemographic status among the community living in an urban area of Selangor, Malaysia. A total of 441 participants were interviewed regarding sociodemographic status, knowledge of dengue, and self-reported prevention practices. Participants over 40 years old were more likely (odds ratio [OR] = 4.210, 95% CI = 1.652-10.733, P = 0.003) to have better dengue knowledge. Participants whose average monthly household income was more than MYR3,000 (US$715) were more likely (OR = 1.607, 95% CI = 1.059-2.438, P = 0.026) to have better practices of dengue prevention measures. The finding suggests that both government and community efforts are essential in order to continue to educate about dengue and reduce the frequency of dengue cases nationwide.

Matched MeSH terms: Dengue/transmission
Improved Aedes/dengue field surveillance using Gravid Oviposition Sticky trap and dengue NS1 tests: Epidemiological, entomological outcomes and community acceptance

Liew JWK, Selvarajoo S, Phang WK, Mah Hassan M, Redzuan MS, Selva Kumar S, et al.

Acta Trop, 2021 Apr;216:105829.
PMID: 33465350 DOI: 10.1016/j.actatropica.2021.105829

The aim of this study is to investigate the feasibility and outcomes of using Gravid Oviposition Sticky (GOS) trap and dengue NS1 antigen tests for indoor and outdoor dengue/Aedes surveillance in the field. A one-year community-based study was carried out at Sungai Buloh Hospital Quarters, Selangor, Malaysia. GOS traps were first placed outdoors in three apartment blocks (Anggerik, Bunga Raya and Mawar). Beginning 29th week of the study, indoor traps were set in two apartment units on every floor in Anggerik. All female Aedes mosquitoes caught were tested for the presence of dengue NS1 antigen. Dengue seroprevalence and knowledge, attitude and practices on dengue prevention of the community and their reception to the surveillance approach were also assessed. Dengue-positive mosquitoes were detected at least 1 week before a dengue onset. More mosquitoes were caught indoors than outdoors in block Anggerik, but the total number of mosquitoes caught in all 3 blocks were similar. There was a significant difference in distribution of Ae. aegypti and Ae. albopictus between the 3 blocks. 66.1% and 3.4% of the community were positive for dengue IgG and IgM, respectively. Most respondents think that this surveillance method is Good (89%) and support its use nationwide. Dengue case ratio in the study apartment blocks decreased from year 2018 to 2019. This study demonstrated the practicality of performing proactive dengue/Aedes surveillance inside apartment units using the GOS traps. This surveillance method can be performed with immediate result output in the field.

Matched MeSH terms: Dengue/transmission
Fulltext Larvicidal efficacy of different plant parts of railway creeper, Ipomoea cairica Extract Against Dengue Vector Mosquitoes, Aedes albopictus (Diptera: Culicidae) and Aedes aegypti (Diptera: Culicidae)

AhbiRami R, Zuharah WF, Thiagaletchumi M, Subramaniam S, Sundarasekar J

J Insect Sci, 2014;14:180.
PMID: 25368088 DOI: 10.1093/jisesa/ieu042

Natural insecticides from plant origin against mosquito vectors have been the main concern for research due to their high level of eco-safety. Control of mosquitoes in their larval stages are an ideal method since Aedes larvae are aquatic, thus it is easier to deal with them in this habitat. The present study was specifically conducted to explore the larvicidal efficacy of different plant parts of Ipomoea cairica (L.) or railway creeper crude extract obtained using two different solvents; methanol and acetone against late third-stage larvae of Aedes albopictus (Skuse) and Aedes aegypti (L.) (Diptera: Culicidae). Plant materials of I. cairica leaf, flower, and stem were segregated, airdried, powdered, and extracted using Soxhlet apparatus. Larvicidal bioassays were performed by using World Health Organization standard larval susceptibility test method for each species which were conducted separately for different concentration ranging from 10 to 450 ppm. Both acetone and methanol extracts showed 100% mortality at highest concentration tested (450 ppm) after 24 h of exposure. Results from factorial ANOVA indicated that there were significant differences in larvicidal effects between mosquito species, solvent used and plant parts (F=5.71, df=2, P<0.05). The acetone extract of I. cairica leaf showed the most effective larvicidal action in Ae. aegypti with LC50 of 101.94 ppm followed by Ae. albopictus with LC50 of 105.59 ppm compared with other fractions of I. cairica extract obtained from flower, stem, and when methanol are used as solvent. The larvae of Ae. aegypti appeared to be more susceptible to I. cairica extract with lower LC50 value compared with Ae. albopictus (F=8.83, df=1, P<0.05). Therefore, this study suggests that the acetone extract of I. cairica leaf can be considered as plant-derived insecticide for the control of Aedes mosquitoes. This study quantified the larvicidal property of I. cairica extract, providing information on lethal concentration that may have potential for a more eco-friendly Aedes mosquito control program.

Matched MeSH terms: Dengue/transmission
Fulltext Influence of container design on predation rate of potential biocontrol agent, Toxorhynchites splendens (Diptera: Culicidae) against dengue vector

Mohamad N, Zuharah WF

Trop Biomed, 2014 Mar;31(1):166-73.
PMID: 24862057 MyJurnal

Toxorhynchites splendens larvae are a natural predator of dengue vector mosquito larvae, Aedes albopictus. This study was carried out to evaluate the predation rate of Tx. splendens third instar larvae on Ae. albopictus larvae in 24 h. Each predator was offered prey at a density between 10 to 50 individuals. Predation rate of Tx. splendens were also tested with two manipulated factors; various types of container and different water volumes. The experiment was evaluated in man-made containers (tin cans, plastic drinking glasses and rubber tires) and natural container (bamboo stumps) which were filled with different water volumes (full, half full, 1/4 full, and 1/8 full). The prey density and the characteristics of the container were found as significant factors which influence the predation rate of Tx. splendens. The predator consumed significantly more prey at higher prey densities (40 and 50 preys) compared to the lowest density (10 preys) (F=3.935, df=4, p=0.008). The results showed significantly higher consumption in horizontal shaped container of rubber tire than in vertical shape of bamboo stumps (F=3.100, df=3, p=0.029). However, the water volume had no significant effect on predation rate of Tx. splendens (F=1.736, df=3, p=0.162). We generally suggest that Tx. splendens is best to be released in discarded tires or any other containers with horizontal shape design with wide opening since Tx. splendens can become more effective in searching prey in this type of container design. This predator is also a suitable biocontrol candidates to be introduced either in wet and dry seasons in Malaysia.

Matched MeSH terms: Dengue/transmission
Fulltext Aedes larval population dynamics and risk for dengue epidemics in Malaysia

Rohani A, Suzilah I, Malinda M, Anuar I, Mohd Mazlan I, Salmah Maszaitun M, et al.

Trop Biomed, 2011 Aug;28(2):237-48.
PMID: 22041742

Early detection of a dengue outbreak is an important first step towards implementing effective dengue interventions resulting in reduced mortality and morbidity. A dengue mathematical model would be useful for the prediction of an outbreak and evaluation of control measures. However, such a model must be carefully parameterized and validated with epidemiological, ecological and entomological data. A field study was conducted to collect and analyse various parameters to model dengue transmission and outbreak. Dengue prone areas in Kuala Lumpur, Pahang, Kedah and Johor were chosen for this study. Ovitraps were placed outdoor and used to determine the effects of meteorological parameters on vector breeding. Vector population in each area was monitored weekly for 87 weeks. Weather stations, consisting of a temperature and relative humidity data logger and an automated rain gauge, were installed at key locations in each study site. Correlation and Autoregressive Distributed Lag (ADL) model were used to study the relationship among the variables. Previous week rainfall plays a significant role in increasing the mosquito population, followed by maximum humidity and temperature. The secondary data of rainfall, temperature and humidity provided by the meteorological department showed an insignificant relationship with the mosquito population compared to the primary data recorded by the researchers. A well fit model was obtained for each locality to be used as a predictive model to foretell possible outbreak.

Matched MeSH terms: Dengue/transmission
Fulltext Plasmodium knowlesi in humans: a review on the role of its vectors in Malaysia

Vythilingam I

Trop Biomed, 2010 Apr;27(1):1-12.
PMID: 20562807 MyJurnal

Plasmodium knowlesi in humans is life threatening, is on the increase and has been reported from most states in Malaysia. Anopheles latens and Anopheles cracens have been incriminated as vectors. Malaria is now a zoonoses and is occurring in malaria free areas of Malaysia. It is also a threat to eco-tourism. The importance of the vectors and possible control measures is reviewed here.

Matched MeSH terms: Malaria/transmission*
Fulltext Wings of the common house fly (Musca domestica L.): importance in mechanical transmission of Vibrio cholerae

Yap KL, Kalpana M, Lee HL

Trop Biomed, 2008 Apr;25(1):1-8.
PMID: 18600198

The importance of house fly (Musca domestica L) wings in mechanical transmission of bacteria was studied. A droplet of phosphate-buffered saline containing Vibrio cholerae was rolled along one wing of each house fly. None adhered to the wings but small proportions of the bacterium were isolated from about half the wings. Vibrio cholerae was spread onto the ventral wing surfaces of each unconscious house fly which then was placed inside a bottle. When it regained consciousness, the types of activity it performed over five minutes were noted before the house fly was killed and the bacteria on its wings numerated. Control were house flies killed before inoculation. The proportion of house flies with bacteria on their wings and the mean number of bacteria remaining were significantly less on live house flies than killed controls. Among the live house flies, bacteria were detected on fewer house flies which flew (25%) than those which did not fly (81%). In addition, the mean number of bacteria on the former was significantly less than the latter (5 against 780 colonies). However, both these parameters were not significantly different between the group which performed and the group which did not perform wing grooming; takeoff and alighting over short distances, and somersaulting. Wings of unconscious house flies tethered by their thoraxes were inoculated with V. cholerae. After regaining consciousness, the house flies were allowed to move their wings in flight motions for up to 30 seconds. Small proportions of bacteria remained on all the house flies. House flies were placed in a chamber containing a liquid bait spiked with V. cholerae. After two hours, 10 were removed sequentially and cultured for V. cholerae. The bacterium was isolated from four house flies: two from the legs, and two others from their bodies minus legs and wings. In conclusion, house fly wings do not play an important role in mechanical transmission of bacteria suspended in a non-adhering liquid medium because of the low transfer rate of the bacteria to the wings and poor retention of bacteria on the wings during normal house fly activities.

Matched MeSH terms: Cholera/transmission*
Fulltext Bacteria fauna from the house fly, Musca domestica (L.)

Nazni WA, Seleena B, Lee HL, Jeffery J, T Rogayah TA, Sofian MA

Trop Biomed, 2005 Dec;22(2):225-31.
PMID: 16883292 MyJurnal

The house fly, Musca domestica has long been considered a potential agent for disease transmission ever since its existence. The general truth of this assertion remains undisputed till the present day in spite of increasing awareness toward an improved sanitation and better hygiene. The habitual movement of house fly from filthy substrata such as human faeces, animal excreta, carcasses, garbage, etc. makes them ideal candidates for disease transmission such as cholera, shigellosis, salmonellosis and others when settling on food. Fly as a potential mechanical vector of pathogenic bacteria was elucidated in this study by examining flies from various breeding sites such as food courts, dumping ground, food processing areas and poultry farm in Peninsular Malaysia. The flies were baited with 10% sugar solution on a glass slide in the field. All materials used for collection of samples were sterile. Bacteria from fly sample were isolated using the normal isolation technique. Bacillus sp., Coccobacillus sp., Staphylococcus sp., Microccus sp., Streptococcus sp., Acinetobacter sp., Enterobacter sp., Proteus sp., Escherichia sp., Klebsiella sp. and yeast cells were isolated from feaces, vomitus, external surfaces and internal organs of house fly. Newly emerged house fly did not harbour any bacteria.

Matched MeSH terms: Bacterial Infections/transmission
Fulltext Dengue vector surveillance in urban residential and settlement areas in Selangor, Malaysia

Chen CD, Benjamin S, Saranum MM, Chiang YF, Lee HL, Nazni WA, et al.

Trop Biomed, 2005 Jun;22(1):39-43.
PMID: 16880752

Ovitrap surveillance was conducted in two urban residential areas (Taman Samudera Timur and Taman Samudera Selatan) and in a settlement area (Kampung Banjar), which is located 16 km from Kuala Lumpur city center, Malaysia. In Taman Samudera, dengue cases were reported monthly in 2003/2004. Thus, a study was initiated to determine the distribution and abundance of dengue vectors, Aedes aegypti and Ae. albopictus. The ovitrap surveillance indicated that Ae. aegypti and Ae. albopictus were present both indoors and outdoors. The residential sites had 73 - 79% of the ovitraps with just Ae. aegypti population and Kg. Banjar had 56% of the ovitraps with just Ae. aegypti. In the indoor and outdoor of the residential areas, together with the settlement area, the Ae. aegypti density was significantly more than Ae. albopictus (p < 0.05) by 3 - 50 folds. There was no significant difference in the larval numbers of Ae. aegypti between indoors and outdoors (p > 0.05), thus implicating that adult gravid female Ae. aegypti are present both indoors and outdoors and they do oviposit indoors and outdoors. Ae. aegypti can be incriminated as the principal dengue vector in the urban residential site, Taman Samudera and in the settlement area, Kg. Banjar.

Matched MeSH terms: Dengue/transmission*
Fulltext Transmission potential of Wuchereria bancrofti by Culex quinquefasciatus in urban areas of Malaysia

Vythilingam I, Tan CH, Nazni WA

Trop Biomed, 2005 Jun;22(1):83-5.
PMID: 16880760 MyJurnal

Laboratory strain of the Malaysian Culex quinquefasciatus was susceptible to Wuchereria bancrofti. Thirty three percent of the Cx. quinquefasciatus that fed on W. bancrofti patient were infective after 12-14 days. There is a possibility for W. bancrofti to occur in the urban areas of the Malaysia in the near future.

Matched MeSH terms: Filariasis/transmission
Fulltext Lack of insecticidal effect of mosquito coils containing either metofluthrin or esbiothrin on Anopheles gambiae sensu lato mosquitoes

Lukwa N, Chiwade T

Trop Biomed, 2008 Dec;25(3):191-5.
PMID: 19287356

Use of mosquito coils for personal protection against malaria and mosquito nuisance is advocated under mosquito and malaria control programmes. We performed field studies of mosquito coils containing either metofluthrin or esbiothrin in experimental huts situated in Kamhororo village, Gokwe district, Zimbabwe. All tests were performed on 3-5 day old reared female Anopheles gambiae sensu lato mosquitoes. The burning times were 9hr 20min for mosquito coils containing metofluthrin and 8 hr for those containing esbiothrin and the results were significantly different (p = <0.001). The mean knock down rate for mosquito coils containing metofluthrin was 90% and that for esbiothrin was 73.3% and the results were significantly different (p = 0.00). Mosquito coils containing metofluthrin had a mean repellence of 92.7% as compared to 85.4% for esbiothrin and the results were not significantly different (p=0.27). The protection time as required by EPA (1999) was 6 hr for mosquito coils containing metofluthrin and 5 hr for those containing esbiothrin. The mean insecticidal effect of mosquito coils containing metofluthrin was 84% as compared to 83% for those containing esbiothrin and the results were not significantly different (p = 0.56). Both mosquito formulations could not be classified as having insecticidal effect since none of them met the 95% mortality rate criteria.

Matched MeSH terms: Malaria/transmission
Antiretrovirals shortage in Kenya amid COVID-19

Ullah I, Hassan W, Tahir MJ, Ahmed A

J Med Virol, 2021 Oct;93(10):5689-5690.
PMID: 34143897 DOI: 10.1002/jmv.27134
Matched MeSH terms: HIV Infections/transmission
Fulltext A systematic review of the epidemiology of Hepatitis E virus infection in South - Eastern Asia

Raji YE, Toung OP, Mohd Taib N, Sekawi ZB

Virulence, 2021 12;12(1):114-129.
PMID: 33372843 DOI: 10.1080/21505594.2020.1865716

Hepatitis E virus (HEV) infection is an emerging zoonotic viral disease, with an increasingly international public health challenge. Despite the concerns that the global disease burden may be underestimated. Therefore, evaluation of the disease epidemiology in South - eastern Asia through a systematic review will assist in unraveling the burden of the disease in the subregion. A priori protocol was prepared for the systematic review and followed by a literature search involving five electronic databases. Identified publications were screened for high quality studies and the elimination of bias and relevant data extracted. A total of 4157 citations were captured, and only 35 were included in the review. A wide range of HEV seroprevalence was recorded from 2% (urban blood donors in Malaysia) to 77.7% (lowland communities in Lao PDR). Sporadic HEV infection and epidemics were also detected in the subregion. Indicating hyperendemicity of the disease in South - eastern Asia.

Matched MeSH terms: Hepatitis E/transmission

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