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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

After languishing for decades in the scientific backwaters, malaria research is suddenly being swept into the mainstream. Money is beginning to pour in from international finance and aid organizations, giving researchers who have been doggedly pursuing an intractable foe with limited resources the means to follow new leads. But on the ground, the disease is unyielding, and the current weapons are losing their effectiveness. In a series of related stories, Science explores the World Health Organization's crusade that aims to cut malaria mortality in half over the next 10 years, conditions on the front lines of clinical research in Africa, the challenges that have slowed development of a so-far elusive vaccine, renewed interest in a Chinese herbal remedy that could aid in the fight against drug-resistant malaria, progress in attacking the Plasmodium parasite through its genome, and the dream of building a malaria-proof mosquito.
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PMID:Malaria. A renewed assault on an old and deadly foe. 1118 52

Sub-Saharan Africa has long suffered under the yoke of the Anopheles gambiae mosquito, but for northeast Brazil (figure 1) its arrival over 60 years ago was a new and horrifying experience. This African mosquito is an exceptionally effective malaria vector because it is well adapted to feeding upon people and to exploiting aquatic habitats associated with our daily activities. Anopheles gambiae sensu lato probably accounts for most of the world's malaria deaths and socioeconomic burden. Fortunately, the Brazilian experience had a happy ending. The prospect of A gambiae spreading across much of the Americas motivated a ruthlessly effective response that deserves a special and heroic place in the annals of public health. Building on the successes and infrastructure of the Yellow Fever Service for Aedes aegypti elimination, the Rockefeller Foundation and Brazilian government collaborated to form a new Malaria Service of the Northeast. This new entity rolled the invader back into oblivion with an aggressive eradication campaign, focusing primarily upon larviciding of all potential habitats. The driving force of this endeavour was an enigmatic man called Fred Soper whose sheer will and determination was a key element in this success, and a source of inspiration today (see Killeen GF, et al. Eradication of Anopheles gambiae from Brazil: lessons for malaria control in Africa? Lancet Infect Dis 2002; 2: 618-27). I recently took an opportunity to fulfil a long-held dream and follow in some of Soper's footsteps. Tired of gazing at yellowing maps like figure 1, I went to see the northeast of Brazil for myself.
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PMID:Following in Soper's footsteps: northeast Brazil 63 years after eradication of Anopheles gambiae. 1452 66

In real-estate agent's terms, the red blood cell is a renovator's dream. The mature human erythrocyte has no internal organelles, no protein synthesis machinery and no infrastructure for protein trafficking. The malaria parasite invades this empty shell and effectively converts the erythrocyte back into a fully functional eukaryotic cell. In this article, Michael Foley and Leann Tilley examine the Plasmodium falciparum proteins that interact with the membrane skeleton at different stages of the infection and speculate on the roles of these proteins in the remodelling process.
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PMID:Home improvements: malaria and the red blood cell. 1527 96

Each year, up to three million deaths due to malaria and close to five billion episodes of clinical illness possibly meriting antimalarial therapy occur throughout the world, with Africa having more than 90% of this burden. Almost 3% of disability adjusted life years are due to malaria mortality globally, 10% in Africa. New information is presented in this supplement on malaria-related perinatal mortality, occurrence of human immunodeficiency virus in pregnancy, undernutrition, and neurologic, cognitive, and developmental sequelae. The entomologic determinants of transmission and uses of modeling for program planning and disease prediction and prevention are discussed. New data are presented from the Democratic Republic of the Congo, Tanzania, Ethiopia, and Zimbabwe on the increasing urban malaria problem and on epidemic malaria. Between 6% and 28% of the malaria burden may occur in cities, which comprise less than 2% of the African surface. Macroeconomic projections show that the costs are far greater than the costs of individual cases, with a substantial deleterious impact of malaria on schooling of patients, external investments into endemic countries, and tourism. Poor populations are at greatest risk; 58% of the cases occur in the poorest 20% of the world's population and these patients receive the worst care and have catastrophic economic consequences from their illness. This social vulnerability requires better understanding for improving deployment, access, quality, and use of effective interventions. Studies from Ghana and elsewhere indicate that for every patient with febrile illness assumed to be malaria seen in health facilities, 4-5 episodes occur in the community. Effective actions for malaria control mandate rational public policies; market forces, which often drive sales and use of drugs and other interventions, are unlikely to guarantee their use. Artemisinin-based combination therapy (ACT) for malaria is rapidly gaining acceptance as an effective approach for countering the spread and intensity of Plasmodium falciparum resistance to chloroquine, sulfadoxine/pyrimethamine, and other antimalarial drugs. Although costly, ACT ($1.20-2.50 per adult treatment) becomes more cost-effective as resistance to alternative drugs increases; early use of ACT may delay development of resistance to these drugs and prevent the medical toll associated with use of ineffective drugs. The burden of malaria in one district in Tanzania has not decreased since the primary health care approach replaced the vertical malaria control efforts of the 1960s. Despite decentralization, this situation resulted, in part, from weak district management capacity, poor coordination, inadequate monitoring, and lack of training of key staff. Experience in the Solomon Islands showed that spraying with DDT, use of insecticide-treated bed nets (ITNs), and health education were all associated with disease reduction. The use of nets permitted a reduction in DDT spraying, but could not replace it without an increased malaria incidence. Baseline data and reliable monitoring of key outcome indicators are needed to measure whether the ambitious goals for the control of malaria and other diseases has occurred. Such systems are being used for evidence-based decision making in Tanzania and several other countries. Baseline cluster sampling surveys in several countries across Africa indicate that only 53% of the children with febrile illness in malarious areas are being treated; chloroquine (CQ) is used 84% of the time, even where the drug may be ineffective. Insecticide-treated bed nets were used only 2% of the time by children less than five years of age. Progress in malaria vaccine research has been substantial over the past five years; 35 candidate malaria vaccines are in development, many of which are in clinical trials. Development of new vaccines and drugs has been the result of increased investments and formation of public-private partnerships. Before malaria vaccine becomes deployed, consideration must be given to disease burden, cost-effectiveness, financing, delivery systems, and approval by regulatory agencies. Key to evaluation of vaccine effectiveness will be collection and prompt analysis of epidemiologic information. Training of persons in every aspect of malaria research and control is essential for programs to succeed. The Multilateral Initiative on Malaria (MIM) is actively promoting research capacity strengthening and has established networks of institutions and scientists throughout the African continent, most of whom are now linked by modern information-sharing networks. Evidence over the past century is that successful control malaria programs have been linked to strong research activities. To ensure effective coordination and cooperation between the growing number of research and control coalitions forming in support of malaria activities, an umbrella group is needed. With continued support for scientists and control workers globally, particularly in low-income malarious countries, the long-deferred dream of malaria elimination can become a reality.
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PMID:Conquering the intolerable burden of malaria: what's new, what's needed: a summary. 1533 14

A questionnaire-based study was conducted on 189 Traditional Birth Attendants (TBAs) on their knowledge and practices in prenatal services. Only 86 (45.5%) of them associated cessation of menstrual period with pregnancy while others use mystic power 46 (24.3%), early morning sickness, pallor of conjunctiva and reaction to herbs 56 (29.6%) to detect pregnancy. Fundal height n=76 (40.2%), palpation n=82 (43.4%), special soaps and soups n=52 (27.5%) and special devices n=8 (4.2%) are used to determine stages of pregnancy. Foetal health status is determined by regular foetal movements n=95 (50.3%), mystic power n=15 (8%), soap n=2 (1.1%), special concoction 9 (4.8%), health status of mother n=67 (35.4%) and foetal heart beat n=24 (12.7%). Ninety seven (51.3%) of them used herbal treatment, 77 (40.7%) used incantations, 189 (100%) used special soaps as their main methods of delivery, while only 18 (9.5%) of respondents refer difficult cases to hospitals. Instruments used for separating cord were blade 123 (65.1%) and scissors 40 (21.1%). Symptoms recognized by the TBAs as signs of complications in pregnancy were dizziness, swollen feet, pallor, tiredness, absent foetal movement, loss of appetite, heaviness, pain in back/stomach/side, weight loss, vomiting, bleeding, fever/malaria, head ache, bad dream, premature or delayed labour. Although some of them recognized some danger signs in pregnancy and labour, only very few would refer difficult cases for emergency obstetric interventions. Clear protocols for management and referral, which are necessary for improved maternal survival, should be provided through regular training of the TBAs.
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PMID:Knowledge and practices of traditional birth attendants in prenatal services in Lagos State, Nigeria. 1597 55

Mayotte is a little French island, located in the Indian ocean, between Madagascar and Mozambic. Officially there is a population of 150000 inhabitants, but in fact, there are probably about 200000 people, largely due to numerous illegal immigrants, especially coming from Anjouan the nearest Comorian island. There is only one hospital, with 252 beds. The malaria incidence reaches about 3000 cases per year; and treatments until august 2001 were generally haphazard. This is changing with the use of the Optimal rapid diagnostic test (DiaMed, Cressier Switzerland). More precise statistics should be available in the coming years. In 2000, 252 patients were hospitalised with malaria fever. Preventive measures were scarce. These have been reenforced this year, with the arrival of an entomologist, the use of reenforced pesticide pulverisation in high-risk areas, the distribution of impregnated bednets to pregnant women, and media based information campaigns. Common drugs resistance is becoming a real concern in Mayotte. First-line treatment was: chloroquine; second-line: sulfadoxine-pyrimethamine, and third-line: quinine. In vitro studies have shown high levels of resistance, therefore another antimalarial drug therapy will be introduced at the end of the year: first-line: artemether-lumefantrine, second-line: mefloquine or halofantrine, third-line: quinine. To conclude, solutions exist but a real policy from the decision makers is necessary to implement them. The eradication of malaria remains a dream, but we can expect "zero death" in Mayotte, considering that the fight against this disease may help to start a regional health program.
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PMID:[Malaria in Mayotte: epidemiology, diagnostic, prevention and treatment]. 1730 48

Giorgio de Chirico is one of the most admired and at the same time most discredited painters of the 20th century. As the 'inventor' of metaphysical painting, he has been considered as a precursor of Surrealism, while his later works have been harshly criticized as representative of the painter's decay. The mystery and dream-like atmosphere irradiating from his works has led to speculations that de Chirico may have taken his inspiration from migraine attacks or complex partial seizures. However, a careful study of his life and his own writings suggests that while de Chirico probably suffered from recurrent malaria, he had neither migraines nor epilepsy. De Chirico also denied that dreams were a major source of his inspiration, but he insisted on his fertile inner imagery, which allowed him to put in a new, poetic, often conflictual perspective, places and objects, which he had actually seen (Hofgarten arcades, Italian piazzas, statues, antique ruins, etc.) in Athens, Munich, Florence, Turin, Ferrare, and other towns. De Chirico was accused of self-plagiarism because he commonly used his former themes in new works, sometimes in what may look like servile copies of his early paintings. This 'replay syndrome' is quite unique in modern art, which has been dominated by the obligation, dogma and cult of newness and renewal. At odds with most of his contemporaries, Andy Warhol suggested that de Chirico made such recurrent series because 'he liked it'. Indeed, as a lifelong admirer of Nietzsche, de Chirico may just have applied the philosopher's concept of the 'eternal return', in which one is supposed to live and accomplish tasks that one would want to repeat forever. In that way, de Chirico's work should not be considered as that of a genius who fell into decadence, but may appear as a continuous, organized process to which organic brain dysfunction never contributed.
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PMID:The last myth of Giorgio De Chirico: neurological art. 2037 20

Eretz Israel medical history considers Dr. Sarah Ben Ami Solodar, a pioneer in the fight against malaria, as the first woman doctor in the moshavot (villages) of the Upper Galilee. In spite of her undisputed place in the historical account, information about her is extremely meager and the historical sources, surveying the development of medicine in Eretz Israel, ignore her achievements. This article portrays this fine doctor, a young educated woman, a fervent Zionist who had immigrated from Odessa, her dream being to fulfill her commitment to Zionism by working as a doctor in Eretz Israel. The article aims to tell the story of her exciting life and describes her medical-educational activities in the health services in the moshavot of the Upper Galilee during the period 1913 to 1919, against the background of life in the moshavot during the final years of the Ottoman period. She fought malaria in Yesod Hama'alah and in Mishmar Hayarden under the guidance of Dr. Hillel Yaffe. She deserves to be remembered as the first woman doctor working in the Upper Galilee moshavot and as a pioneer in her field, who contributed to the development of the medical system in the country and in particular in the Upper Galilee, during the first years of settlement in Eretz Israel.
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PMID:[Dr. Sarah Ben Ami Solodar: a pioneer in the fight against malaria in the moshavot in the Upper Galilee]. 2130 79

Despite the advancement of science, infectious diseases such as malaria remain an ongoing challenge globally. The main reason this disease still remains a menace in many countries around the world is the development of resistance to many of the currently available anti-malarial drugs. While developing new drugs is rather expensive and the prospect of a potent vaccine is still evading our dream of a malaria-free world, one of the feasible options is to package the older drugs in newer ways. For this, nano-sized drug delivery vehicles have been used and are proving to be promising prospects in the way malaria will be treated in the future. Since, monotherapy has given way to combination therapy in malaria treatment, nanotechnology-based delivery carriers enable to encapsulate various drug moieties in the same package, thus avoiding the complications involved in conjugation chemistry to produce hybrid drug molecules. Further, we envisage that using targeted delivery approaches, we may be able to achieve a much better radical cure and curb the side effects associated with the existing drug molecules. Thus, this review will focus on some of the nanotechnology-based combination and targeted therapies and will discuss the possibilities of better therapies that may be developed in the future.
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PMID:Combating malaria with nanotechnology-based targeted and combinatorial drug delivery strategies. 2706 12

India is highly endemic to malaria with prevalence of all five species of human malaria parasites of Plasmodium genus. India is set for malaria elimination by 2030. Since cases of mixed Plasmodium species infections remain usually undetected but cause huge disease burden, in order to understand the distributional prevalence of both monospecies infections and mixed species infections in India, we collated published data on the differential infection incidences of the five different malaria parasites based on PCR diagnostic assay. About 11% of total cases were due to mixed species infection. Among several interesting observations on both single and mixed parasitic infections, incidences of Plasmodium falciparum monoinfection were found to be significantly higher than P. vivax monoinfection. Also, P. malariae seems to be emerging as a potential malaria threat in India. Putting all the facts together, it appears that the dream of achieving malaria elimination in India will not be completely successful without dealing with mixed species infection.
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PMID:Can Mixed Parasite Infections Thwart Targeted Malaria Elimination Program in India? 2890 Jun 20


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