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

Blood cell counts were performed on blood samples from 37 patients with imported malaria using three different blood analyzers (Coulter STKR, Coulter VCS and Technicon H1). Results were controlled by direct microscopic examination. Anemia, leukopenia, thrombocytopenia, or abnormalities of the leukocyte differential count were found in 32, 24, 30 and 92% of patients, respectively. The automatic analyzers gave alert messages for 70 to 75% of specimens, including specimens from ten patients with low parasitemias. These abnormalities should prompt careful analysis of blood smears when drug-resistance is suspected.
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PMID:[Hematologic features in imported malaria. Value for the diagnosis of forms with low parasitemia]. 201 36

In 1989 there were 71 cases of imported malaria admitted to the hospital in Bordeaux. This is 16.5% and 29% lower than in 1988 and 1987 respectively, thanks to the widespread use in Africa of mefloquine chemoprophylaxis. Sub-Saharan Africa is involved in 95% of cases, mainly West Africa (70% of cases), unlike the situation in 1987, and the first cases of paludism despite mefloquine chemoprophylaxis appeared during the second semester from the seasonal mid-summer recrudescence onwards, in travellers returning from this region. The most frequent species is still Plasmodium falciparum (80% of declared cases). This imported disease especially affects young adults despite regular prophylaxis in 59% of cases. It is therefore important to recommend rigorous protection against anopheles. Male predominance (sex ratio: 5.5) was greater in 1989 than in the previous two years, and French nationals represented 85% of the population. Falciparum malaria presents symptoms in 95% of cases before the end of the month following the patient's return to France, while for P. ovale the time for symptoms to appear is between 39 days and two years after return. Management of patients on their return poses a problem of information, since in 40% of cases diagnosis is made more than a week after the first symptoms. Attacks are mild in most cases (93%); among the serious cases death occurred in a 3-year-old child. Thrombopenia is the most frequent biological sign (22.5% of cases), followed to a lesser degree by anaemia and leukopenia. Mild attacks respond well to classical treatment (halofantrine, mefloquine, quinine, chloroquine), while two cases of more complicated symptoms required exchange transfusion.
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PMID:[Imported malaria in Bordeaux in 1989. Epidemiologic, clinical and therapeutic study of 71 cases]. 208 18

Recently introduced chloroquine resistant malaria has altered the clinical picture and complicated the overall management of malaria. 113 adults with proved malaria admitted at Harare Central Hospital, Zimbabwe, were evaluated to determine the incidence, nature, relationship to morbidity and mortality and response to treatment of the complications due to malaria. 47.7 pc (52 of 109) patients had relatively chloroquine resistant malaria. 87.4 pc (99 of 113) had complications whose percentage frequency of occurrence were: Anaemia 51.2 pc, diarrhoea and/or vomiting 42.2 pc, cerebral malaria +/- fits 39.2 pc, renal insufficiency +/- hyperkalaemia 26.4 pc, hypoglycaemia 15.6 pc, jaundice 15.2 pc, neuro-psychiatric 15.0 pc, shock 10.6 pc, concurrent sepsis 8.9 pc, pulmonary oedema 3.5 pc and hyperpyrexia 1.7 pc. Multiple complications in the same patient were common. The combination of cerebral malaria and renal insufficiency had the worst mortality (p less than 0.001). All patients dialysed, however, survived. Non-iron deficiency anaemia, 91.7 pc (51 of 55) and diarrhoea and/or vomiting, were common, worsened morbidity but not mortality (p = 0.555). A seriously-ill patient with malaria should be suspected of having complications and chloroquine resistance and should be referred promptly to a centre with facilities for dialysis. Anti-malaria drugs should be mixed in a dextrose solution and iron supplements should not be given routinely.
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PMID:Complications of seasonal adult malaria at a central hospital. 209 79

This study reflects the clinical pattern, diagnosis and management of cerebral malaria in 55 consecutive patients from Chittagong Hill Tracts. The predominant clinical features were: impaired consciousness with convulsion in a febrile patient with temporary residence in the endemic zone. Younger people were more prone to develop this condition. Thirty two patients (58.18%) were between 18-25 years. A high incidence of cerebral malaria was noted in blood group 'O' (37.5%) and group 'B' (33.33%). The malarial parasite count MPC was not proportional to the severity of the disease. Twenty four patients (43.63%) had malarial parasite count below 100% cumm. Anaemia (63.63%) and Jaundice (34.54%) were common, Splenomegaly (7.27%) was uncommon. Clinical features of cerebral oedema/raised intracranial pressure were not evident. CSF study was unremarkable except for raised pressure in 7 patients (12.65%). Response to intravenous quinine was satisfactory and yet the mortality was 11%.
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PMID:Cerebral malaria--an analysis of 55 cases. 209 10

The presence of intestinal parasitic infection, malaria and under-nutrition in relation to prevalence of anaemia was evaluated in a cluster of urban population in Hyderabad. Prevalence of anaemia was 25.7 per cent by clinical assessment from pallor as against 80.5 per cent by estimation of haemoglobin concentration. Presence of intestinal parasitic infection (48.4 per cent) and malaria infection (18.3 per cent) had no statistical significant association with anaemic state. Under-nutrition (31.9 per cent of anaemic individuals) and low per capita monthly income of Rs. 100 and below (60.9 per cent of enaemic individuals) had a statistically significant relationship to anaemia. Clinical assessment of anaemia from pallor had a low sensitivity (31.9 per cent) and a high false negative rate (54.9 per cent), though clinical pallor had a strong statistical association to the presence of anaemia. (p less than 10.01), (Q = 1.0).
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PMID:Relationship of intestinal parasitism, malaria and under-nutrition to prevalence of anaemia in an urban community. 209 9

A population segment was investigated in Kabinga, northern Zambia, in order to explore the use of biomedical ethnomedical health services and assess the knowledge of disease vectors. In this community schistosomiasis, malaria, anemia, and hookworm infestation was widespread. The population of 11 villages numbered 1097 people (545 males and 552 females) including 220 adults aged 15049. A WHO standardized questionnaire containing demographic and sociological questions was administered. The subjects were asked what action they would take when afflicted by malaria. The majority of 218 responders were women. The mean age for females was 35.2 years and for males it was 37.5 years. 4 responders did not know what to do if struck with malaria. Only .9% of both literate and illiterate adults indicated the use of African medicine in case of malaria. 62% of them went to the clinic or hospital for treatment during the last sickness episode. 29.2% of both genders did nothing, and only 2.4% of women turned to traditional medicine. 1 female could not recall what she did. 81% of the adult population attended either a clinic or a hospital for treatment during the previous 8 months. Most remembered using these facilities at least one (14 could not remember it). There was a significant correlation between refraining from the use of traditional medicine and utilization of the services of a clinic or hospital. Despite these findings, the answers were probably biased, because most women depend on their male counterparts for making decisions. Anthropologically oriented research methods could ensure reliability of data and reveal epidemiological problems in this community.
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PMID:The problems of a social survey in epidemiology: an experience from a Zambian rural community. 212 Sep 23

The science of blood rheology (study of the flow and deformability of blood) is of increasing practical importance to the investigation of blood disorders. In diagnostic laboratories, rheological tests such as the erythrocyte sedimentation rate, zeta sedimentation ratio, and plasma viscosity are used to monitor patients with an acute-phase response of greater than 24 h duration. In sickle-cell anemia, new methods for measuring erythrocyte deformability can be used to investigate the pathogenesis of vaso-occlusion, to test potential anti-sickling drugs, and to monitor drug efficacy in clinical trials. Genetic defects in the structure of the red cell membrane can have rheological consequences, monitoring of which may be useful for diagnosis. Rheological analysis of red cells infected by Plasmodium falciparum has indicated that their abnormal flow behavior may be an important pathological factor in malaria. Finally, the flow behavior of white blood cells, particularly neutrophils, is also important, as these cells, once activated, have the potential to occlude microvessels. The authors have reviewed the laboratory methodology and clinical applications that have led to recent advances in these aspects of blood rheology.
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PMID:Technological advances in blood rheology. 212 Nov 60

Anemia is the most common disorder in hospital patients in tropical Africa, and it is demonstrated in up to 70% of inpatients. Community studies indicate that as many as 40% of the children younger than 15 years of age, 63% of these being younger than 3 years, are anemic. Although the anemia is multifactorial in etiology, the interplay between malnutrition and infection is still the most important element in causing the morbidity and mortality attributed to childhood anemia in Africa. Although iron deficiency is the most common cause of nutritional anemia, P. falciparum malaria is the leading cause among the anemias of infectious origin. The role of other causative agents is highlighted in the discussion. The fact that effective treatment depends on accurate diagnosis is also emphasized.
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PMID:Malnutrition and infections as causes of childhood anemia in tropical Africa. 212 63

Erythroid precursors BFU-E and CFU-E and erythroblasts (ERB) were monitored in the marrow and spleen of mice during fatal or nonfatal malaria. Transient depletions of marrow CFU-E and ERB without modification of BFU-E or erythropoietin (Epo) levels were found as early events in fatal infections. Before anemia development, erythropoiesis was reduced in the bone marrow but increased in the spleen. During the anemic phase, for comparable levels of anemia, plasma Epo levels were elevated to a similar degree in fatal and nonfatal malaria. In the bone marrow, CFU-E increased twofold and BFU-E were usually reduced as expected in severe anemia. ERB populations increased but remained below or within normal values, suggesting an impairment of marrow erythropoiesis related to early events following infection. In contrast, in the spleen, ERB production was strongly simulated but amplification of ERB, CFU-E, and BFU-E populations was 2.5-fold lower in fatal than in nonfatal malaria. The results suggest that a defect in amplification of splenic erythropoiesis is a crucial determinant of the fatal outcome of malarial infection. This may have been mediated by a defective stem cell migration or multiplication. Some evidence obtained during recovery stages suggested that a factor(s) other than Epo may control splenic erythropoiesis during the anemia associated with malaria.
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PMID:Changes in hemopoietic and regulator levels in mice during fatal or nonfatal malarial infections. I. Erythropoietic populations. 214 41

Levels of mature lymphocytes, granulocytes, macrophages, platelets, their progenitor cells, and cytokines were monitored in the blood, marrow, and spleen during fatal or nonfatal murine malarial infections. In all four malaria models, before anemia developed, there was a lymphopenia, a rapid lymphocyte depletion in the marrow with a compensating rise in spleen lymphocytes, thrombocytopenia with increased megakaryocytic progenitor cell numbers, and monocyte increases in the bone marrow and later the spleen. The development of anemia was associated with a monocytosis and neutropenia, an increase in granulomonocytic progenitor cells in the spleen, and a reduction of spleen lymphocytes. Spleen granulocytes, monocytes, and their progenitor cells increased two- to threefold more in nonfatal than in fatal malaria and the spleen lymphocyte pool became severely depleted in fatal malaria. The data suggest that a defective effector cell response was of importance for the fatal outcome of the disease. Other than an early rise in serum macrophage colony stimulating factor levels in fatal infections, changes in levels of the regulators of these effector cells did not correlate well with the outcome of the infection.
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PMID:Changes in hemopoietic and regulator levels in mice during fatal or nonfatal malarial infections. II. Nonerythroid populations. 214 42


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