Screening for Intestinal Parasitic Infections Among Myanmar Migrant Workers in Thai Food Industry: A High-Risk Transmission

The impact of intestinal parasitic infections on public health has been neglected. Millions of Myanmar natives have migrated to work in Thailand. We performed a study of intestinal parasitic infections in Myanmar-migrants working in the Thai food industry. A total of 338 Myanmar migrant workers in a food plant at Samut Sakhon Province, Thailand, were recruited for this study. 284 (84%) returned requested stool samples. Samples were examined for intestinal parasites by means of simple smear, formalin-ether concentration, Locke-Egg-Serum medium, and Harada-Mori culture methods. We found parasites in 177 (62.3%) migrants (29 of 46 males; 148 of 238 females). The majority (89.3%) were infected with parasites transmitted by fecal-oral route, including Blastocystis hominis (41.5%), Trichuris trichiura (22.2%), Giardia lamblia (14.1%), and Ascaris lumbricoides (1.8%). Mixed infections were common (40.7%). The highest prevalence (73.3%) was found among migrants from Kohsong city, Myanmar. This high parasite infection rate in Myanmar migrant workers is an obvious public health hazard.     

Genotypic profile of Streptococcus suis serotype 2 and clinical features of infection in humans, Thailand

To examine associations between clinical features of Streptococcus suis serotype 2 infections in humans in Thailand and genotypic profiles of isolates, we conducted a retrospective study during 2006-2008. Of 165 patients for whom bacterial cultures of blood, cerebrospinal fluid, or both were positive for S. suis serotype 2, the major multilocus sequence types (STs) found were ST1 (62.4%) and ST104 (25.5%); the latter is unique to Thailand. Clinical features were examined for 158 patients. Infections were sporadic; case-fatality rate for adults was 9.5%, primarily in northern Thailand. Disease incidence peaked during the rainy season. Disease was classified as meningitis (58.9%) or nonmeningitis (41.1%, and included sepsis [35.4%] and others [5.7%]). Although ST1 strains were significantly associated with the meningitis category (p<0.0001), ST104 strains were significantly associated with the nonmeningitis category (p<0.0001). The ST1 and ST104 strains are capable of causing sepsis, but only the ST1 strains commonly cause meningitis.     

Distribution of mosquito (Diptera: Culicidae) species and <Emphasis Type="Italic">Wolbachia</Emphasis> (Rickettsiales: Rickettsiaceae) infections during the bird immigration season in Pathumthani province,central Thailand

Mosquito distribution in the immigration bird-nested area, Pathumthani province, was investigated from August to December in 2006. Mosquitoes were collected by using CO₂-baited Centers for Disease Control light traps in which dry ice was used as a source of CO₂ to attract mosquitoes. Six traps were operated from 4 p.m. until 7 a.m. on each study day. Four genera, which were Anopheles, Armigeres, Culex, and Mansonia with 14 species of mosquitoes were collected. Culex gelidus (13.94–59.41%) and Culex tritaeniorhynchus (32.87–70.30%) were most collected species in this area for every month. Other two species with moderate distribution in this area were Anopheles barbirostris (0.76–3.30%) and Mansonia uniformis (1.55–11.36%). Polymerase Chain Reactions were performed for testing Wolbachia infection in Cx. gelidus and Cx. tritaeniorhynchus only. Fifty-four percent (15/28 pools) of Cx. gelidus and none (0/20 pools) of Cx. tritaeniorhynchus were positive for Wolbachia infection. Wolbachia infection in other mosquito species collected in this and other areas need to be investigated to understand species and geographic variation of Wolbachia infection in mosquitoes in nature.     

Development and evaluation of a novel multiplex PCR technology for molecular differential detection of bacterial respiratory disease pathogens

The ResPlex I assay (Qiagen) was designed to amplify and detect DNA of six bacterial respiratory pathogens. This assay was compared with real-time PCR assays based upon the same target sequences for the ability detect the target bacteria by use of both stock strains and specimens from respiratory disease patients. The ResPlex I assay is somewhat less sensitive than real-time PCR assays but offers the advantage of multiple assays in a single reaction.     

Infected endometrioma in pregnancy masquerading as acute appendicitis

Background A pregnancy complicated by ovarian endometrioma is rare. Other complications of ovarian endometrioma in pregnancy, i.e., rupture and infection are also rare.Case A 35-year-old woman, gravida 2, para 0-0-1-0, at 35 weeks pregnancy, came to the hospital with a right abdominal pain. She also had a history of diarrhea. She had history of infertility and preexisting right endometrioma. The investigations revealed leukocytosis with neutrophils predominant. The preoperative diagnosis was acute appendicitis. Infected right ovarian endometrioma was demonstrated during exploratory laparotomy, opened and drainage of the right endometrioma and appendectomy were performed. The final diagnosis was infected ovarian endometrioma in pregnancy, later confirmed by a pathological report.Conclusion Although complication of ovarian endometrioma such as infected endometrioma during pregnancy is rare, it should be included in the differential diagnosis of pelvic pain during pregnancy, especially in the patient who has history of ovarian endometrioma.     

Ovarian teratoma with diffused peritoneal reactions mimicking advanced ovarian malignancy

Background Benign cystic teratomas are one of the most common benign ovarian neoplasms. Although its rupture is rare, once occurred it can cause complications such as granulomatous peritonitis, mimicking metastatic ovarian malignancy. Case A 39-year-old woman, Para 0–0-0–0, presented to the hospital with rapid abdominal distention for 3 months. Her physical examination and ultrasonographic findings led to a diagnosis of advanced stage ovarian carcinoma. An exploratory laparotomy was performed and the operative impression was that of stage III ovarian carcinoma. Total hysterectomy with bilateral salpingo-oophorectomy and surgical staging were done. The postoperative pathology revealed a benign cystic teratoma of right ovary with chronic granulomatous peritonitis. She was well at discharge and at her 1-year follow-up. Conclusion Although ruptured a benign cystic teratoma is rare, it can cause granulomatous peritonitis, the clinical findings of which mimic advanced stage ovarian carcinoma. This warrants physicians to be aware of and intraoperative frozen section should be used, its correct management will provide a good outcome with less complication.     

Frequent Haemophilus influenzae type B colonization in rural Thailand

In Asia, there is uncertainty regarding whether the burden of Haemophilus influenzae type b (Hib) disease is great enough to warrant vaccination. In this nasopharyngeal carriage study in rural Thailand, 7% of children younger than 5 years of age carried Hib, a prevalence similar to that found in countries with high rates of Hib disease before vaccine introduction.     

A novel Online‐to‐Offline (O2O) model for pre‐exposure prophylaxis and HIV testing scale up

Introduction : PrEP awareness and uptake among men who have sex with men (MSM) and transgender women (TG) in Thailand remains low. Finding ways to increase HIV testing and PrEP uptake among high‐risk groups is a critical priority. This study evaluates the effect of a novel Adam's Love Online‐to‐Offline (O2O) model on PrEP and HIV testing uptake among Thai MSM and TG and identifies factors associated with PrEP uptake. Methods : The O2O model was piloted by Adam's Love ( www.adamslove.org ) HIV educational and counselling website. MSM and TG reached online by PrEP promotions and interested in free PrEP and/or HIV testing services contacted Adam's Love online staff, received real‐time PrEP eCounseling, and completed online bookings for receiving services at one of the four sites in Bangkok based on their preference. Auto‐generated site‐ and service‐specific e‐tickets and Quick Response (QR) codes were sent to their mobile devices enabling monitoring and check‐in by offline site staff. Service uptake and participant's socio‐demographic and risk behaviour characteristics were analyzed. Factors associated with PrEP uptake were assessed using multiple logistic regression. Results : Between January 10th and April 11th, 2016, Adam's Love reached 272,568 people online via the PrEP O2O promotions. 425 MSM and TG received eCounseling and e‐tickets. There were 325 (76.5%) MSM and TG who checked‐in at clinics and received HIV testing. Nine (2.8%) were diagnosed with HIV infection. Median (IQR) time between receiving the e‐ticket and checking‐in was 3 (0–7) days. Of 316 HIV‐negative MSM and TG, 168 (53.2%) started PrEP. In a multivariate model, higher education (OR 2.30, 95%CI 1.14–4.66; p = 0.02), seeking sex partners online (OR 2.05, 95%CI 1.19–3.54; p = 0.009), being aware of sexual partners’ HIV status (OR 2.37, 95%CI 1.29–4.35; p = 0.008), ever previously using post‐exposure prophylaxis (PEP) (OR 2.46, 95%CI 1.19–5.09; p = 0.01), and enrolment at Adam's Love clinic compared to the other three sites (OR 3.79, 95%CI 2.06–6.95; p < 0.001) were independently associated with PrEP uptake. Conclusions : Adam's Love O2O model is highly effective in linking online at‐risk MSM and TG to PrEP and HIV testing services, and has high potential to be replicated and scaled up in other settings with high Internet penetration among key populations.