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.

BackgroundIntestinal parasitic infections (IPIs) among indigenous people have been widely documented in Malaysia, however, the prevalence of these infections remains high. In the past, most studies have focused on specific species of parasites but polyparasitism has received limited attention. In addition, epidemiology studies on indigenous people tend to consider them as a homogenous group, whereas in reality different sub-ethnic groups have different cultural and living practices. Variations in living habits such as personal hygiene practices may predispose different groups to different parasitic infections. To better understand prevalence and risk factors of intestinal parasitism among different sub-ethnic groups, the present study was conducted among two sub-ethnic groups of indigenous people (Temuan and Mah Meri) residing in Selangor state, Malaysia.MethodsA cross-sectional study that focused on two distinct sub-ethnic groups was carried out from February to September 2014. Faecal samples were collected from 186 participants and examined using the formalin-ether sedimentation technique. A molecular approach was adopted to conduct a genetic characterisation of the parasites. Additionally, questionnaires were administered to obtain information on the demographics, socio-economic backgrounds and behavioural risks relating to the participants, as well as information about their environments. Statistical analyses (i.e. binary and multivariate logistic regression analyses) were performed to measure risk factors.ResultsFor Temuan communities, trichuriasis (64.2 %) was the most common infection found, preceding hookworm infection (34 %), ascariasis (7.5 %), giardiasis (14.2 %) and amoebiasis (7.5 %). As for the Mah Meri communities, trichuriasis (77.5 %) prevailed over ascariasis (21.3 %), hookworm (15 %), giardiasis (7.5 %) and amoebiasis (3.8 %). Significant differences in proportions of trichuriasis, ascariasis and hookworm infections were observed between the Temuan and Mah Meri sub-ethnic groups. Polyparasitism was more common among the Temuan sub-ethnic group (41.5 %) compared to the Mah Meri sub-ethnic group (32.5 %), with the majority of participants harbouring two parasites concurrently (Temuan: 33 %, Mah Meri: 20 %). Trichuris trichiura and Ascaris lumbricoides co-infections were most prevalent (10 %) among the Mah Meri communities, while a co-infection of T. trichiura with hookworm (19.8 %) was most common among the Temuan communities. Multivariate analyses showed that being unemployed, having a large family and drinking unboiled water were found to be significantly associated with intestinal parasitism.ConclusionThe present study highlights substantial polyparasitism and risk factors for infections in the Temuan and Mah Meri sub-ethnic groups. The high prevalence of IPIs among these two sub-ethnic groups indicates that parasitic infections are important health issues in these communities. Hence, it is imperative to implement sound intervention strategies such as periodic preventive chemotherapy coupled w...

c 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. CASE REPORTO n 22 January 2014, a 23-year-old woman, who was in her second pregnancy and at 8 weeks of gestation, presented as an outpatient to the Emergency Department (ED) University of Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia. She was referred by a private general practitioner after complaining of vaginal bleeding for 3 days with small amount of spotting and staining on her undergarment associated with suprapubic pain for a day. The pain was described as sharp pricking, nonradiating, and progressively increasing in severity. She did not have any vaginal discharge or fever. The result of a urine pregnancy test carried out at the private clinic was positive. When she missed her menses in December 2013, no test was done to confirm pregnancy. Bowel and urinary habits were normal. She did not have any medical illnesses or previous surgeries. No known allergies were noted. She had a full-term vaginal delivery in 2009. She attained menarche at the age of 12 years and has a regular menstrual cycle and is free of menorrhagia, dysmenorrhea, dyspareunia, and postcoital bleeding. She is on a natural method of contraception, and a cervical smear test had never been done before.On physical examination, she appeared pale, with early signs of hypovolemia as evidenced by tachycardia with pulse rate of 110 to 120 beats per min and blood pressure ranging between 90 to 94 and 60 to 70 mm Hg. Fluid resuscitation was immediately started in the emergency department. Her vital signs were monitored continuously. Cardiorespiratory examination revealed no abnormalities. Her abdomen was mildly distended. There was presence of tenderness at the lower abdomen with guarding. Neither an abdominal scar nor organomegaly was noted. Vaginal examination revealed a normal vulvovaginal surface, and her cervix was tubular. The cervical excitation result was positive, with fullness in the Pouch of Douglas. Adnexal tenderness was elicited bilaterally.Transabdominal pelvic sonography revealed an empty uterus with a right irregular adnexal mass measuring 9 mm and a moderate level of free fluid that was 50 mm deep. Blood investigations revealed anemia, with hemoglobin at 6.7 g/dl and with a normal white blood cell count and platelet level. Preoperative diagnosis of a ruptured right ectopic pregnancy with hypovolemia was made. Informed consent for a laparotomy was provided by both the patient and her husband after they were counseled with respect to the working diagnosis and the intended procedure. She underwent laparotomy with right salp...