Asian Pacific Journal of Tropical Medicine

Issue 1,2024 Table of Contents

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  • 1  Mapping COVID-19 in India: Southern states at the forefront of new JN.1 variant
    Rabin Debnath
    2024(1):1-3. DOI: 10.4103/apjtm.apjtm_2_24
    [Abstract](4) [HTML](0) [PDF 336.94 K](148)
    2  Ferritin and mortality in hemodialysis patients with COVID-19: A systematic review and meta-analysis
    Ni Wayan Anantika Riani
    2024(1):4-11. DOI: 10.4103/apjtm.apjtm_624_23
    [Abstract](2) [HTML](0) [PDF 373.97 K](154)
    Objective: To investigate the difference in serum ferritin levels between deceased and surviving regular hemodialysis patients with COVID-19. Methods: We conducted a systematic search across four databases following the PRISMA statement guidelines. Studies reporting ferritin levels and mortality of regular hemodialysis patients with COVID-19 were included. Employing the random-effects model, we performed a meta-analysis to determine the mean difference in serum ferritin levels between the studied groups, along with their corresponding 95% confidence intervals. The meta-analysis was carried out using Review Manager 5.4 and Stata 16. Results: A total of 1 013 patients from seven studies were included in this study. Our meta-analysis showed higher mean serum ferritin in the deceased compared to surviving regular hemodialysis patients with COVID-19, with a mean difference of 449.43 ng/mL [95% CI (244.07, 654.80), P<0.000 1; I2=58%, P=0.003]. Conclusions: Our study found a higher mean of serum ferritin levels in the deceased compared to surviving regular hemodialysis patients with COVID-19.
    3  Iron supplementation during malaria infection in pregnancy and childhood: A review
    Neha Surela
    2024(1):12-20. DOI: 10.4103/apjtm.apjtm_435_23
    [Abstract](1) [HTML](0) [PDF 478.32 K](156)
    Malaria presents a significant global public health challenge, with severe malarial anaemia being a primary manifestation of the disease. The understanding of anaemia caused by malaria remains incomplete, making the treatment more complex. Iron is a crucial micronutrient essential for haemoglobin synthesis, oxygen delivery, and other vital metabolic functions in the body. It is indispensable for the growth of human beings, as well as bacteria, protozoa, and viruses in vitro and in vivo. Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life. Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis, leading to anaemia. Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy, infancy, and childhood. Dietary intake alone may not suffice to meet adequate iron requirements, thus highlighting the vital role of iron supplementation. While iron supplementation can alleviate iron deficiency, it can exacerbate malaria infection by providing additional iron for the parasites. However, in the context of pregnancy and childhood, iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development, respectively. This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.
    4  Informing policy makers in developing countries: Practices and limitations of geriatrichome medication review in Malaysia-A qualitative inquiry
    Ahlam Sundus
    2024(1):21-29. DOI: 10.4103/apjtm.apjtm_614_23
    [Abstract](17) [HTML](0) [PDF 287.71 K](432)
    Objective: To explore existing practices and challenges in the delivery of geriatric home medication review (HMR). The study was part of a larger study aimed to offer solution to expand the range of geriatric HMR. Methods: This study employed qualitative exploratory design through semi-structured individual in-depth interviews with the public pharmacists involved in the delivery of geriatric HMR at public hospitals. The purpose of the interviews was to explore challenges faced by them in the delivery of geriatric HMR. Results: Based on the emerging themes from the qualitative data, the study reveals that geriatric HMR in Malaysia is integrated as part of multidisciplinary home care visits, encompassing a diverse patient population with various healthcare needs. However, it faces challenges such as the lack of outcome monitoring, formal training, and workforce constraints. Despite these hurdles, there is a pressing need for the expansion of this service to better serve the community, and collaboration with community pharmacists holds potential to broaden its scope. Ultimately, the findings suggest that pharmacistled HMR is both warranted and feasible within the Malaysian healthcare context. In order to optimize medicine-use among older people living in the community, approaches for expanding geriatric HMR services in Malaysia must be developed. Conclusions: This study holds profound implications as it attempts to illuminate policy makers in developing countries, enabling them to formulate effective HMR plans. By considering the challenges highlighted within this research, policy makers can design a comprehensive HMR service that caters adeptly to the healthcare needs of the mass population.
    5  Occurrence of K1 and K2 serotypes and genotypic characteristics of extended spectrum β-lactamases-producing Klebsiella pneumoniae isolated from selected hospitals in Malaysia
    Nurul Syazrah Anuar
    2024(1):30-38. DOI: 10.4103/apjtm.apjtm_303_23
    [Abstract](1) [HTML](0) [PDF 514.64 K](163)
    Objective: To determine the distribution, phenotypic and genetic background of extended spectrum β-lactamases (ESBL)-producing Klebsiella (K.) pneumoniae clinical isolates associated with K1 and K2 serotypes in two selected hospitals in Malaysia. Methods: A total of 192 K. pneumoniae isolates were collected and subjected to antibiotic susceptibility, hypermucoviscosity test and multiplex PCR to detect the presence of K1- and K2- serotype associated genes. Multilocus sequence typing (MLST) was performed on ESBL-producing K. pneumoniae isolates presented with K1 and K2 serotypes, followed by phylogenetic analysis. Results: A total of 87 out of 192 (45.3%) of the K. pneumoniae isolates collected were ESBL producers. However, only 8.3% (16/192) and 10.9% (21/192) of the total isolates were detected to carry K1- and K2-serotype associated genes, respectively. Statistical analysis showed that K1 and K2 capsular serotypes were not significantly associated with ESBL phenotype (P=0.196). However, they were significantly associated with hypervirulent, as demonstrated by the positive string test (P<0.001). MLST analysis revealed that ST23 as the predominant sequence type (ST) in the K1 serotype, while the ST in the K2 serotype is more diverse. Conclusions: Although the occurrence of ESBL-producing isolates among the hypervirulent strains was low, their coexistence warrants the need for continuous surveillance. MLST showed that these isolates were genetically heterogeneous.
    6  Fatal cases in pediatric patients after post-exposure prophylaxis for rabies: A report of two cases
    Hekmatollah Khoubfekr
    2024(1):39-42. DOI: 10.4103/1995-7645.390169
    [Abstract](1) [HTML](0) [PDF 210.40 K](157)
    Rationale: Rabies is a zoonotic disease with a high mortality, primarily transmitted through the bite of infected mammals, particularly dogs and cats. Despite being a well-known disease since ancient times, it continues to cause a significant number of human deaths worldwide, with approximately 65 000 fatalities reported annually. Patient concerns: We present two fatal cases of rabies in a 12-yearold immigrant boy and a 7-year-old boy. The first case was subject to a 24-hour delay in receiving appropriate medical attention and rabies preventive measures due to the lack of awareness among emergency hospital staff, leading to the administration of wound dressing only. The second case received timely rabies immunoglobulin administration; however, there was a 4-day delay in administering the fourth dose of the rabies vaccine, despite presenting evident symptoms of rabies. Diagnosis: Postmortem examination of brain samples from both patients confirmed the presence of rabies virus. Interventions: Post-exposure prophylaxis for rabies. Outcomes: Both patients were admitted to the hospital after the manifestation of rabies-related symptoms, with the 12-year-old child seeking medical care 47 days after the animal bite and the 7-year-old child seeking medical care 58 days after the exposure. Finally, the first patient died after 27 days and the second patient died after 40 days of hospitalization. Lessons: There is an urgent need for heightened awareness and education among both healthcare professionals and the public regarding the urgency of seeking immediate medical attention after potential rabies exposure. Timely recognition and initiation of postexposure prophylaxis are pivotal in preventing the progression of the disease. Strengthening surveillance and reporting systems, coupled with continuous training for healthcare professionals, can contribute to early detection and management of rabies cases.
    7  Clinical profile and risk factors of Strongyloides stercoralis infection
    Rupak Chatterjee
    2024(1):39-42. DOI: 10.4103/1995-7645.391779
    [Abstract](0) [HTML](0) [PDF 329.60 K](150)
    8  Unveiling health rights: A call to action for sex workers' HIV care in the Philippines
    Sheikh Mohd Saleem
    2024(1):45-46. DOI: 10.4103/1995-7645.391780
    [Abstract](1) [HTML](0) [PDF 179.71 K](181)

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