Sustainability of a successful malaria surveillance and treatment program in a Runggus community in Sabah, east Malaysia.

The district of Kudat has one of the highest and most persistent malaria transmission levels in Sabah, Malaysia, with annual parasite incidence of 102 per 1,000 inhabitants per year. Due to this situation and the failure of DDT spraying to control malaria, a community participation health program (Sukarelawan Penjagaan Kesihatan Primer or SPKP) was developed as an adjunct to current anti-malarial measures during 1987-1991. SPKP is made up of unpaid community workers known as village health volunteers (VHVs). VHVs are selected by a village development and security committees training and supervision a member of the Vector-Borne Diseases Control Program (VBDCP). The beneficiaries of SPKP consisted primarily of Runggus people and other remote, and mobile populations who visit the home of a VHV for diagnosis and treatment. This group of febrile patients and their children who attend a participating school submit finger prick blood and personal details to the VHV. and receive a presumptive treatment for malaria. Thick and thin blood smears are examined by a VBDCP microscopist who then prepare and forward a radical or curative treatment to the VHV so that it can be administered to the microscopically-positive patient free of charge. Between June 1987 to June 1991, VHVs from 32 kampungs (villages) and 22 schools collected 56,245 slides representing 24.7% of total slide collection compared to 74.9% collected by passive case detection (PCD) posts in health centers and district hospital. The average volunteer treated 11.8 (range 10.4-13.4) and 31.4 (range 26-49) patients per month in kampungs and schools respectively. In contrast, non-SPKP posts in a district hospital, health centers and flying doctor service treated an average of 616.3 patients per month (range 134.8-1032.8). The slide positivity rate of blood smears taken by VHVs was 8.43% compared with 7.37% for non-SPKP posts. Average slide collection and slide positivity rates varied considerably from one community to another, despite their close geographic proximity. The monthly number of VHV-diagnosed patients from the school and kampungs communities and the monthly number of true malaria patients in the two groups were significantly correlated. Sustainability of SPKP was linked to an ongoing process of social change which involved co-operative networking between the government health sector and the community. This in turn provided a stimulus for malaria abatement efforts. When Runggus people themselves control and maintain ownership of community-based malaria programs, the function of SPKP as a malaria surveillance system and an antimalarial drug distribution network is vastly improved.

Impact of permethrin-impregnated mosquito nets compared with DDT house-spraying against malaria transmission by Anopheles farauti and An.punctulatus in the Solomon Islands.

In villages of northern Guadalcanal in the Solomon Islands, where the predominant malaria vector is An.farauti No. 1 and An.puctulatus is also involved, malaria transmission rates were compared for three zones: (1) non-intervention: 438 people in seventeen villages; (2) residual DDT house-spraying two cycles per year: 644 people in thirty villages; (3) bednets impregnated with permethrin 0.5 g/m2 twice per year, used by 580 people in sixteen villages. Regular DDT spraying in zones 1 and 3 had been withdrawn 18 months previously. Malariological blood smear surveys of children aged 1-9 years in August 1986 to January 1987 showed a mean baseline malaria parasite rate of 38% (32/84). By February 1988, 18 months after introduction of impregnated bednets, the Plasmodium falciparum infection rate in children was lowest in the zone using impregnated bednets (21% of 29), intermediate in the untreated zone (29% of 34) and highest in the DDT zone (46% of 53), but these differences were not statistically significant. P. vivax infection rates were 9-14%. Using ELISA tests for malaria circumsporozoite antigen in the vectors, overall positivity rates were 0.7% of 49,902 An.farauti and 2.54% of 118 An.punctulatus, comprising 228 P.falciparum and 124 P.vivax infections. In the study zones, vector positivity rates were 0.93% of 31,615 An.farauti in the untreated zone; 0.32% of 16,883 An.farauti in the DDT zone; 0.07% of 1404 An.farauti and 2.54% of 118 An.puctulatus in the impregnated bednet zone. here was no significant correlation between malaria parasite rates in the vectors and the children.(ABSTRACT TRUNCATED AT 250 WORDS)

The effect of diethylcarbamazine citrate on incidence and recovery rates of Brugia malayi microfilaremia in Sabah, Malaysia.

Mass drug administration via 3 modes of delivery reduced the incidence and prevalence rates and intensity of Brugia malayi infection in 3 rural villages in the Bengkoka Peninsula, Sabah, in 1982-1983. A dosage of 6 mg diethylcarbamazine citrate (DEC-C)/kg body weight was administered either daily or weekly (total of 6 doses, 36 mg/kg body weight), and impact on B. malayi cases were comparable in the 3 villages. A total of 384 people participated in the DEC-C regimens, and all pregnant women and children under 2 years were excluded from the study. Bekessy's method of estimation of incidence and recovery rates was applied to data on B. malayi microfilaremia before drug administration. Treatment with DEC-C by any of the 3 modes of delivery drastically reduced the number of episodes of patent microfilaremia, incidence and prevalence, and median microfilarial density. Reduction was sustained for at least 18 to 24 months after treatment.

Oliva vidua fulminans, a marine mollusc, responsible for five fatal cases of neurotoxic food poisoning in Sabah, Malaysia.

This is the first report in which a marine mollusc, Oliva vidua fulminans (olives), generally not known to be poisonous, was responsible for death in five children after consuming boiled olives with tamarind. The onset of symptoms was rapid 10 to 20 min after consumption of the olives. Signs and symptoms included nausea, vomiting, abdominal pain, tingling sensation around the lips, numbness around the mouth, drowsiness, lethargy and generalized weakness with paraesthesia in the limbs. The five deaths occurred within 3 to 4 hours after eating the poisoned olives and resulted from respiratory failure. Left-over olives from the affected household and freshly collected live olives had a toxicity of 14,200 mouse units (M.U.) and 15,000 M.U. per 100 g meat respectively. No other common chemical poison and organophosphorus insecticides were detected. The neurotoxic agent was acid and heat stable and was toxic at pH less than 4. Its action was similar to that of paralytic shellfish poisoning which was caused by toxins from certain dinoflagellates.

A 400 MHz 1H-NMR Study of Seven Sarpagine-Type Alkaloids.

The chemical shifts and most of the main coupling constants of seven sarpagine alkaloids 1- 7 have been determined in a 400 MHz (1)H-NMR study.

Filariasis in Bengkoka Peninsula, Sabah, Malaysia: vector studies in relation to the transmission of filariasis.

Using seven methods of surveillance, 58 species of mosquitoes from nine genera were in Pantai and the two neighbouring villages during two visits in 1982. Ma. bonneae was the most prevalent species attracted to man. In the forest shade Ma. bonneae and Ma. dives showed activity throughout the 24 hours with peak biting during 1900-2100 hours. An. balabacensis exhibited peak activity shortly after midnight. Inside and outside house, Ma. bonneae showed similar activity except that it ceased during the day. Mansonia was only mildly zoophilic. CDC light traps gave poor yields of mosquitoes. Pyrethrum spray catch inside houses early morning did not include any Mansonia. Outdoor day resting catch included Ma. bonneae fed on man. Transmission of Brugia, probably human filariasis, by Ma. bonneae occurred in Pantai and in the two neighbouring villages. One infection in Ma. dives was found in Pantai. The monthly infective biting rate and monthly transmission potential for Ma. bonneae were estimated at the forest shade and outside the house in Pantai.

Mosquito fauna of the Bengkoka Peninsula, Sabah, Malaysia.

A total of 37 species of mosquitoes from seven genera were collected in six villages in the Bengkoka Peninsula, Sabah State, during two visits in 1981 in connection with studies on malaria and filariasis. Fifty-five per cent of the total mosquitoes collected were Mansonia. An. collessi constituted a new record of the species from Sabah. An. balabacensis was found to be naturally infected with sporozoites. Ma. bonneae was found to be naturally infected with Brugia, probably B. malayi. Parous rates of An. balabacensis and Ma. bonneae were very high with consequent high probability of survival ideally suiting transmission of malaria and filariasis.

[Monomeric Indole Alkaloids from Kopsia officinalis.]. / Alcaloïdes Indoliques Monomères de Kopsia officinalis.

Ten monomeric indole alkaloids have been identified from the roots of KOPSIA OFFICINALIS. Four of them are known: (-)-kopsinine 1, (+)-5,22-dioxokopsane 2, (-)-tetrahydroalstonine 4, and (-)-quebrachamine 3; and six are new: (-)-isoeburnamine 5 (enantiomer of the known alkaloid (+)-isoeburnamine), (-)-N-methoxycarbonyl-12-methoxykopsinaline 7, (-)-N-methoxycarbonyl-11,12-methylenedioxy kopsinaline 8, (-)-N-methoxycarbonyl-11,12-dimethoxykopsinaline 9, (-)-11,12-methylenedioxykopsinaline 10, and (-)-12-methoxykopsinaline 11.

Monomeric Indole Alkaloids from Ervatamia hainanensis.

Eleven monomeric indole alkaloids have been isolated from the roots of Ervatamia hainanensis. Nine of them are known: coronaridine 1, coronaridine hydroxyindolenine 2, heyneanine 3, vobasine 4, perivine 5, ibogamine 6, geissoschizol 7, 10-hydroxygeissoschizol 8 and 3-oxocoronaridine 9; and two are new: 10-hydroxyheyneanine 10 and 3-(beta-hydroxyethyl)-coronaridine 11.

[Determination of structures by H NMR at 400 MHz: albifloranine, a new alkaloid from Tabernaemontana albiflora]. / Détermination de structures par RMN du 1H à 400 MHz: albifloranine, un nouvel alcaloïde de Tabernaemontana albiflora.

The structure of albifloranine 1, a new alkaloid of ibogane type from the stem bark of Tabernaemontana albiflora (M IQ.) Pull. (Apocynaceae) has been determined. A detailed (1)H NMR study of albifloranine 1, coronaridine 2 and heyneanine 3 is presented.