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Medicine in Malaysia: microbiology and infectious diseases

Lim VK

Med J Malaysia, 1995 May;50 Suppl A:S56-9.
PMID: 10968017
Matched MeSH terms: Communicable Disease Control/trends*
Clean water provision in rural areas of less developed countries

Roundy RW

Soc Sci Med, 1985;20(3):293-300.
PMID: 3975696

The decade of the 1980s is declared as a time to solve global domestic water supply problems. By 1990 international goals include the provision of adequate quantities of clean water to every person on earth. Such goals are justified on the basis of human health, economic well being, political development and equity and public safety. Drawing upon observations from Ethiopia, Malaysia and Liberia, cases where attempts to provide domestic water to villagers and rural town dwellers are presented. In all cited cases attempts to provide safe water have failed or are in jeopardy. Conclusions drawn from these cases include acknowledgement that global goals will best be achieved by approaching local problems one-by-one and recognizing the technical, environmental and human constraints upon safe water provision interact differently from one site to another. To properly plan, implement and maintain safe water systems the current technical solutions must be combined with the contributions of social and environmental scientists on a case-by-case basis.

Matched MeSH terms: Communicable Disease Control/trends
Tuberculosis in Malaysia: problems and prospect of treatment and control

Iyawoo K

Tuberculosis (Edinb), 2004;84(1-2):4-7.
PMID: 14670340

In the early 1940s and 1950s, tuberculosis (TB) was the number one cause of death in Malaysia. Patients with TB were admitted to the many sanatoria we had in various parts of the country and were often managed by surgical means. TB chemotherapy became available only in the late 1950s. At this time, TB was already a major cause of morbidity and mortality. Realizing its seriousness, the Malaysian government launched its National TB Control Programme (NTP) in 1961. At that time, the recommended treatment for TB was a combination of three drugs, namely, streptomycin, isoniazid and paraaminosalicylic acid (PAS) given for 2 months followed by isoniazid and PAS given for 12 months. Generally the treatment used to last for 1-2 years. The National TB Centre in Kuala Lumpur functioned as the headquarters of the NTP, and the state general hospitals with their chest clinics functioned as the state directorates. From the operational point of view, every state has a state TB directorate which is known as the State TB Managerial Team (Fig. 1). This team is responsible for the implementation of the activities of the NTP at the state and district levels. Ever since 1995, the national TB directorate has been shifted to the Public Health Division of the Ministry of Health (MOH) and is now under the Director of Disease Control (Fig. 2). The National TB Centre has now been renamed as The Institute of Respiratory Medicine. Over the years from being the number one cause of death, TB has dropped to being below number 10 (Fig. 3).

Matched MeSH terms: Communicable Disease Control/trends
Time trends of chronic HBV infection over prior decades - A global analysis

Ott JJ, Horn J, Krause G, Mikolajczyk RT

J Hepatol, 2017 Jan;66(1):48-54.
PMID: 27592304 DOI: 10.1016/j.jhep.2016.08.013

BACKGROUND & AIMS: Information on trends in chronic hepatitis B virus (HBV) prevalence across countries is lacking. We studied changes in chronic HBV infection over previous decades by country, and assessed patterns of change between and within WHO-defined regions.
METHODS: Based on data from a published systematic review on chronic HBV, we applied a linear model on the logit scale to assess time trends in country-specific prevalence. Estimated HBsAg prevalence in 2000 and relative changes in prevalence over time were evaluated by country and region.
RESULTS: Sufficient data were available for 50 countries, mostly showing reductions in prevalence over time. Various degrees of heterogeneity were observed within regions, with a relatively homogenous pattern in the Eastern Mediterranean region with strong decreases in HBsAg prevalence. Europe showed a mixed pattern: higher and stable chronic HBsAg prevalence in Eastern, and constantly low prevalence in Western Europe. In Africa, some countries demonstrated no change in prevalence; increases were seen in Uganda (odds ratio 1.05 per year; 95% confidence interval 1.04-1.06), Nigeria (1.02; 1.02-1.02), Senegal (1.01; 1.01-1.02), and South Africa (1.02; 1.01-1.02). With some exceptions, country-patterns overlapped among countries of South East Asian and Western Pacific regions, characterized by low-medium HBsAg decreases, most prominent in China and Malaysia.
CONCLUSIONS: Most countries experienced decreases in HBsAg prevalence. Dynamics varied, even within regions; decreases occurred mostly before the direct effects of childhood vaccination may have manifested. These findings together with stable and increasing HBsAg prevalence in some countries of Africa and Eastern Europe indicate the need for further tailored country-specific prevention.
LAY SUMMARY: This study investigated time trends in prevalence of chronic HBV infection in 50 countries worldwide over the last decade, by estimating relative changes in prevalence. Results show decreases in chronic HBV infection in most countries; no changes or increases in prevalence are noted in some African countries. Reasons for time changes need to be investigated further; based on the results, various prevention measures have contributed to reductions, and further tailored HBV prevention is required to combat the disease on a global level.

Matched MeSH terms: Communicable Disease Control/trends