Blastocystis hominis has long been described as a non pathogenic protozoan parasite until recently when claims have been made that it can result in pathogenic conditions. Of the 729 stool samples (614 from survey and 115 from pediatric wards) examined, 18.1% of them were found to be positive for one or more intestinal protozoan cyst. The commonest was Giardia intestinalis (8.4%) Followed by Entamoeba coli (7.1%) and Entamoeba histolytica (5.1%) in the normal children without symptoms of diarrhea. When diarrheic stools were examined, the commonest parasite encountered was Giardia (20.4%), followed by E. coli (15.9%) and E. histolytica (9.7%). Blastocystis was observed in 4.4% of the children who had diarrhea and 1.1% among the children taken from the normal population in the rural areas.
A survey of 4.112 primary school children living in and around Kuala Lumpur, Malaysia, revealed that 12.9% of the children were infested with Pediculus humanus capitis. Indians (28.3%) and Malays (18.9%) have a higher prevalence than Chinese (4.6%). The higher prevalence among Indians and Malays correlates well with their lower socio-economic status in the community; long hair also contributes to the higher rates of pediculosis among them. The prevalence rate was found to be related to socio-economic status, length of hair, family size, age, crowding and personal hygiene. Treatment with 0.2% and 0.5% malathion in coconut oil gave cure rates of 93% and 100%. Treatment with gammexane and actellic at 0.5% concentration gave a cure rate of 100% against adults and nymphs of Pediculus humanus capitis.
A survey of 308,101 primary school children in Peninsular Malaysia conducted in 1979 by the School Health Services, Ministry of Health, Malaysia, revealed that 10.7% of children were infested with Pediculus humanus capitis. The prevalence rate was higher in the economically less advanced states of Terenganu (34%), Kelantan (23%), and Perlis (21%) than in the other states (4-13%). Of 14,233 school children examined in the State of Melaka, 26% of Indians, 18.7% of Malays, 6.1% of Europeans, and 0.7% of Chinese had pediculosis. The prevalence rate, which has remained unchanged over the past 5 years, does not appear to vary with age but is higher in children with long hair and those from the lower socioeconomic groups. Boys have a lower infestation rate than do girls. The higher incidence in Indians and Malays correlates well with their lower socioeconomic status in the community, and their cultural habit of maintaining longer hair than do the Chinese. The difference become less apparent in the higher socioeconomic groups.
A questionnaire survey of student nurses and nurses at a premier hospital in Malaysia reveals that the majority of nurses support the use of corporal punishment on schoolchil-dren. Malay nurses who had received corporal punishment were more likely to endorse corporal punishment than those who had not received it. The number of non-Malay nurses was too small for comment. These findings reveal that nurses need to re-examine their attitudes and their training with respect to child discipline and child rearing practices. Nurses need to be educated on the cycle of violence and the root causes of child abuse in the community. Nurses need to change their attitudes to violence on children and to condemn any such acts, whether it be in the home or at school.
Fecal specimens collected from 456 school children in Gombak, Malaysia, revealed an overall prevalence rate of 62.9%. The most common parasite found was Trichuris trichiura (47.1%) followed by Giardia intestinalis (14.7%), Entamoeba coli (11.4%), Entamoeba histolytica (9.9%) and Ascaris lumbricoides (7.9%). Infection rates were high among the Indonesian immigrant workers' children (90%) followed by the Orang Asli (79.5%), Malay (59.4%) and Indians (36.4%). Females (66.3%) had a higher prevalence rate than the males (58.5%). The prevalence of infection was found to be associated with the socio-economic status, water supply, sanitary disposal of feces and family size. Albendazole administered as a single dose (400 mg) was found to be effective against Ascaris (100%) and hookworm (92.3%) but was not effective against Trichuris (39.2%).
To verify the actual immunisation coverage in Kuala Lumpur, City Hall Health Department and the Malaysian Paediatric Association (NGO ) carried out a survey. The survey revealed that the immunisation coverage determined at the child's first birthday for BCG was 95%, DPT 3 94%, OPV 3 94%, and measles = 27% (59% at 2 years). These figures correspond closer to City Hall's estimated coverage rather than the rates projected by the Ministry of Health. The main reasons for immunisation failure were, child ill 31.8% (not brought = 20.1%, brought but not given vaccine 11.7%), lack of information 28.6%, lack of motivation 9.1%, mother too busy 9.1%. Measles immunisation coverage at 1 year was low because of wrong information on schedules. Tetanus toxoid immunisation coverage of pregnant women was low. Only 27% of children were protected against neonatal tetanus although 97% of pregnant women received antenatal care and 50% had attended other health facilities as well during pregnancy. Private medical practitioners were responsible for more than 40% of all immunisations but were not submitting returns to the Health Department. Recommendations to improve immunisation coverage include education and motivation of the public and also doctors and health personnel on prevention of missed opportunities, contraindictions to immunisation and correct schedules. (Copied from article).
An outline is given of a simple cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF.
PIP: A cost-effective strategy aimed at the immunization of all children and pregnant women residing in the plantation sector of Malaysia is outlined. It is based on a partnership between government, nongovernmental organizations and the private sector, and is supported by UNICEF. Over a million people reside on the Malaysian plantation estates: only 17% of the estates have their own hospitals; immunization services exist on only 1.5%; 40% of the estates are at least 5 kilometers from the nearest government health facility; and 64% lack transport for workers and their dependents to seek care away from the plantations. Two nongovernmental organizations, the Malaysian Paediatric Association and the Malaysian Society of Health, initiated discussions with the United Planting Association of Malaysia. A pilot study was undertaken by the groups on 6 estates in Selangor State, which included all the children at their first birthday. Tuberculosis, diphtheria/pertussis/tetanus, poliomyelitis, and measles immunization coverages were 88%, 44%, 59%, and 66%, respectively. The association of plantations accepted the organizations' proposals for all estates to: register all births; provide free transportation to government health clinics for the immunization of all eligible children and pregnant women; and enforce immunization schedules and record-keeping. The Ministry of Health agreed to provide free immunization of children and pregnant women; send mobile teams to estates that could assemble 20 or more eligible people for immunization; provide the estates with educational materials dealing with immunization; arrange that the maintenance of the cold chain be supervised by local medical officers of health; consider the training of estate hospital assistants with the help of the nongovernmental organizations. The total immunization plan was launched in September 1990. A manual was distributed to the estate managers, hospital assistants on the estates, and the medical officers who would implement and monitor the program. It is expected that total child immunization will be achieved in the foreseeable future in the estate sector.