Arine Fadzlun Ahmad

Genetic assemblage of Sarcocystis spp. in Malaysian snakes

BackgroundSarcocystis species are protozoan parasites with a wide host range including snakes. Although there were several reports of Sarcocytis species in snakes, their distribution and prevalence are still not fully explored.MethodsIn this study, fecal specimens of several snake species in Malaysia were examined for the presence of Sarcocystis by PCR of 18S rDNA sequence. Microscopy examination of the fecal specimens for sporocysts was not carried as it was difficult to determine the species of the infecting Sarcocystis.ResultsOf the 28 snake fecal specimens, 7 were positive by PCR. BLASTn and phylogenetic analyses of the amplified 18S rDNA sequences revealed the snakes were infected with either S. nesbitti, S. singaporensis, S. zuoi or undefined Sarcocystis species.ConclusionThis study is the first to report Sarcocystis infection in a cobra, and S. nesbitti in a reticulated python.

Effect of ethnicity and socioeconomic variation to the gut microbiota composition among pre-adolescent in Malaysia

Gut microbiota plays an important role in mammalian host metabolism and physiological functions. The functions are particularly important in young children where rapid mental and physical developments are taking place. Nevertheless, little is known about the gut microbiome and the factors that contribute to microbial variation in the gut of South East Asian children. Here, we compared the gut bacterial richness and composition of pre-adolescence in Northern Malaysia. Our subjects covered three distinct ethnic groups with relatively narrow range of socioeconomic discrepancy. These included the Malays (n = 24), Chinese (n = 17) and the Orang Asli (indigenous) (n = 20). Our results suggested a strong ethnicity and socioeconomic-linked bacterial diversity. Highest bacterial diversity was detected from the economically deprived indigenous children while the lowest diversity was recorded from the relatively wealthy Chinese children. In addition, predicted functional metagenome profiling suggested an over-representation of pathways pertinent to bacterial colonisation and chemotaxis in the former while the latter exhibited enriched gene pathways related to sugar metabolism.

Detection of Naegleria Species in Environmental Samples from Peninsular Malaysia

Background In Malaysia, researchers and medical practitioners are unfamiliar with Naegleria infections. Thus little is known about the existence of pathogenic Naegleria fowleri, and the resultant primary amoebic meningoencephalitis (PAM) is seldom included in the differential diagnosis of central nervous system infections. This study was conducted to detect the presence of Naegleria species in various environmental samples. Methods/Findings A total of 41 Naegleria-like isolates were isolated from water and dust samples. All these isolates were subjected to PCR using two primer sets designed from the ITS1-ITS2 regions. The N. fowleri species-specific primer set failed to produce the expected amplicon. The Naegleria genus-specific primers produced amplicons of 408 bp (35), 450 bp (2), 457 bp (2) or 381 bp (2) from all 41 isolates isolated from aquatic (33) and dust (8) samples. Analysis of the sequences from 10 representative isolates revealed that amplicons with fragments 408, 450 and 457 bp showed homology with non-pathogenic Naegleria species, and 381 bp showed homology with Vahlkampfia species. These results concurred with the morphological observation that all 39 isolates which exhibited flagella were Naegleria, while 2 isolates (AC7, JN034055 and AC8, JN034056) that did not exhibit flagella were Vahlkampfia species. Conclusion To date, pathogenic species of N. fowleri have not been isolated from Malaysia. All 39 isolates that produced amplicons (408, 450 and 457 bp) from the genus-specific primers were identified as being similar to nonpathogenic Naegleria. Amplicon 408 bp from 5 representative isolates showed 100% and 99.7% identity to Naegleria philippinensis isolate RJTM (AM167890) and is thus believed to be the most common species in our environment. Amplicons 450 bp and 457 bp were respectively believed to be from 2 new species of Naegleria, since representative isolates showed lower homology and had a longer base pair length when compared to the reference species in the Genbank, Naegleria schusteri (AJ566626) and Naegleria laresi (AJ566630), respectively.

Gastrointestinal parasites in rural dogs and cats in Selangor and Pahang states in Peninsular Malaysia

To estimate the current prevalence of gastrointestinal (GI) parasites in dogs and cats, a total of 105 fresh faecal samples were collected from rural areas in Peninsular Malaysia. Each faecal sample was examined for the presence of GI parasites by microscopic examination after formalin-ether concentration technique and for protozoa, trichrome and Ziehl-Neelsen staining were employed. The overall prevalence of GI parasitic infection was 88.6% (95% CI = 82.5–94.7) in which 88.3% of dogs and 89.3% of cats were infected with at least one parasites species, respectively. There were 14 different GI parasites species (nematodes, cestodes and protozoa) detected, including Ancylostoma spp. (62.9%), Toxocara spp. (32.4%), Trichuris vulpis (21.0%), Spirometra spp. (9.5%), Toxascaris leonina (5.7%), Dipylidium caninum (4.8%), Ascaris spp. (2.9%), Hymenolepis diminuta (1.0%) and others. General prevalence of GI parasites showed a significant difference between helminth (84.4%) and protozoa (34.3%) infections. Monoparasitism (38.1%) was less frequent than polyparasitism (46.7%). As several of these GI parasites are recognized as zoonotic agents, the results of this investigation revealed that local populations may be exposed to a broad spectrum of zoonotic agents by means of environmental contamination with dogs and cats faeces and this information should be used to mitigate public health risks. Prevention and control measures have to be taken in order to reduce the prevalence rates especially in socioeconomically disadvantaged communities where animals live in close proximity to people, poor levels of hygiene and overcrowding together with a lack in veterinary attention and zoonotic awareness.

Enterobius vermicularis Salpingitis Seen in the Setting of Ectopic Pregnancy in a Malaysian Patient

ABSTRACT We report a rare and unusual case of invasive Enterobius vermicularis infection in a fallopian tube. The patient was a 23-year-old Malaysian woman who presented with suprapubic pain and vaginal bleeding. A clinical diagnosis of ruptured right ovarian ectopic pregnancy was made. She underwent a laparotomy with a right salpingo-oophorectomy. Histopathological examination of the right fallopian tube showed eggs and adult remnants of E. vermicularis, and the results were confirmed using PCR and DNA sequencing.

Free-Living Amoebae in Southeast Asia

In Southeast Asia (SEA), human infections caused by free-living amoebae (FLA) such as species of Acanthamoeba, Naegleria, Balamuthia, Vahlkampfia and Hartmannella were occasionally reported. To date, human cases or research work on these FLA have only been detected or performed in five countries which were Thailand, Malaysia, Singapore, Vietnam and the Philippines. Acanthamoeba keratitis (AK) has been increasingly recognised and diagnosed, along with the spread of contact lens use, and most cases were reported from Thailand, Malaysia and Singapore. As for granulomatous amoebic encephalitis (GAE) and Balamuthia amoebic encephalitis (BAE) cases, the only available reports were from Thailand. At least 11 GAE cases (8 were fatal and 3 were cured) have been reported sporadically since the first highlighted case in 1992. While for BAE, only a single fatal case was reported in a 23-year-old healthy male after falling into a swamp during a motorbike accident in 2004. For primary amoebic meningoencephalitis (PAM), an acute fulminant necrotising meningoencephalitis caused by Naegleria fowleri has only been reported in two countries; 12 (10 were fatal and 2 were cured) and 2 fatal cases were from Thailand and Vietnam, respectively. Almost all of the individuals with PAM cases had a history of water-related activities including swimming in canals, rivers, community pools and exposure to contaminated water during a traditional Thailand festival called ‘Songkran’, where people splash water at each other. All of the lethal PAM cases reported in SEA were misdiagnosed as microbial meningitis due to the inability to detect the amoebic trophozoite in the CSF. In cases where amoebae were detected early, a good treatment outcome was achieved and three GAE and two PAM cases in Thailand were cured. The delay in the diagnosis of AK cases may result in severe visual outcomes and require surgical treatment. Finally, the absence of reports or cases from other countries in SEA region does not imply that there were absolutely no human infections. In fact, there might be cases which were undiagnosed, misdiagnosed or overlooked. As most of the FLA diseases have a rapid progression and may also cause death, awareness of the diseases by clinician and laboratory personnel together with the availability of suitable diagnostic tools are crucial in successful treatments of infected individuals. In addition, FLA ecological studies should be regularly performed in order to understand their geographical distribution, environment niche and risk to humans.

Liver cirrhosis and splenomegaly associated with Schistosoma mansoni in a Sudanese woman in Malaysia: A case report

We report a case of a patient with Schistosoma mansoni infection who presented with liver cirrhosis and splenomegaly. She was diagnosed by a serological test and Kato-Katz thick smear stool examination. The patient was a 52-year-old woman from Sudan who came to Malaysia for a week to visit her sons. The patient lives in the middle of Rabak region, Sudan, a highly endemic area for schistosomiasis where her daily routine includes rearing of cows and farming. The site of toilet and sources of drinking water are canals and wells; both infested with snails. Patient had a long history of exposure and coming into contact with water from these canals and wells.

Sarcocystis spp. and Pentastomes in Southeast Asia

Sarcocystis and pentastomes infections are uncommon zoonoses of worldwide distribution. In most of the cases, they were detected as an incidental finding at autopsy or necropsy. Recently, serious attention has been given to Sarcocystis when large human outbreaks have been reported in Malaysia. Similarly, the detection of a recent human pentastomiasis case in East Malaysia since nearly four decades ago has alerted that pentastomes should not be ignored by the medical and laboratory personnel. In addition, understanding the routes of infection is crucial in preventing further cases. This chapter will focus on sarcocystosis and pentastomiasis cases among humans and animals.