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

Fifty blood culture positive patients of typhoid fever were studied during the current outbreak of the disease for their clinical profile. In 39 (78%) cases the isolates of S. typhi were resistant to conventional drugs. Children below 2 years of age constituted 20% of the total cases and belonged exclusively to the group with multidrug resistant typhoid fever (MRTF). The clinical presentation seemed to mimic malaria, bronchopneumonia, meningitis, etc. Typhoid hepatitis was diagnosed in 2 cases with MRTF. Life threatening complications were seen in 28.2% patients and were observed exclusively in MRTF group.
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PMID:A clinical profile of multidrug resistant typhoid fever. 179 69

Various pernicious syndromes in Plasmodium falciparum infection are being reported with increasing frequency from tropical countries. A rare case of fatal pancytopenia associated with falciparum malaria is described. The patient developed fulminant aspiration bronchopneumonia which was unresponsive to antibiotic therapy and contributed to the development of adult respiratory distress syndrome. He also had severe uncontrolled gastrointestinal bleeding and possibly an intracerebral haemorrhage. Anaemia and thrombocytopenia are well known in malaria but severe leucopenia is very rare and pancytopenia has not been reported.
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PMID:Fatal pancytopenia in falciparum malaria. 269 48

A longitudinal survey of child health in Juba was done to secure data on which preventive schemes could be based. 223 pregnant women were identified in a systematic search of a district. 5 infants were stillborn and 10 were born prematurely. The mothers of 5 of 10 premature infants had had acute malaria at or immediately preceding delivery. 2 of these premature babies later died from causes attributable to prematurity and therefore indirectly to the preventable maternal malaria. The causes of neonatal mortality included tetanus caused by cutting the cord with a blade of grass. Between months 1-6, 5 infants died of infective enteritis, 1 of bronchopneumonia, and 1 of pyrexia of undetermined origin associated with convulsions. Growth was much impaired by diarrhea, which caused 85 attacks among 63 babies, and by lower respiratory infections, of which there were 119 among 74 of the babies. Skin and eye infections were also common. Removal of the unerupted canine teeth, believed to cure or prevent illness, caused much distress and some aspiration bronchopneumonia. Health education and improved hygiene and water supplies would greatly reduce the extent of morbidity and mortality.
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PMID:Infants in Juba, Southern Sudan: the first six months of life. 613 86

Childhood hyperpyrexia is associated with serious infections particularly bronchopneumonia, infective diarrhoea, meningitis, measles, urinary tract infections, otitis media, septicemia and sickle cell crisis Hyperpyrexia was found most in children aged 6-12 months followed by children aged 12-18 months. Hyperpyrexia occurred least in children aged 2-6 months. Febrile convulsion was associated with 38% of the cases. Malaria was a cause of convulsion in 27% of children with fever. This appears to contrast earlier reports by Lennox (1953) and Familusi (1971). The study confirms the rarity of hyperpyrexia in children aged 3 months and under. Deaths recorded were in children brought at the late stages of their ill health. Intensive health education is recommended to obviate unnecessary death of children through ignorance and poor knowledge of simple first aid measures.
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PMID:Childhood hyperpyrexia in Benin City, Nigeria. 709 25

Severe anemia has remained a major cause of morbidity and mortality in children of Southern Ghana since the early 1960s. Cases of anemia and anemia-associated mortality in the Korle Bu Teaching Hospital (KBTH), Accra, that occurred from January to December 1991 were reviewed. Data on hemoglobin levels, hypochromia, and malaria parasitemia of children referred from January to December 1991 were collected and analyzed to determine the prevalence of moderate/severe malaria parasitemia, anemia, and severe anemia. 10,989 (71.1%) of 15,450 children attending KBTH referred to the laboratory for hematological studies had hemoglobin (Hb) levels below 11.0 g/dl; while 3049 children (27.7%) of anemic patients had Hb levels below 7.0 g/dl. Of these 3049 children with severe anemia, 2185 (71.7%) had Hb levels below 5.0 g/dl, thus requiring urgent blood transfusion. Though the Department of Child Health alone utilized 32.2% of total blood processed by the National Blood Transfusion Service at KBTH, as many as 259 (58.1%) of the 554 deaths (306 male and 248 female) in the emergency room in children beyond the neonatal period were related to severe anemia. The main causes were nutritional anemia (n = 135), anemia associated with severe malaria (n = 56), anemia associated with sickle cell disease (n = 28), anemia associated with protein-energy malnutrition (n = 22), and 18 cases of anemia complicating gastroenteritis, pneumonia, meningitis, and convulsions. 108 (19.5%) deaths occurred because of neonatal sepsis, severe neonatal hyperbilirubinemia, meningitis and bronchopneumonia, severe anemia secondary to hemorrhage of the newborn, and faulty cord ligation. A significant decline occurred in the prevalence of childhood anemia in the developed world following improved counseling in nutrition, fortification of foods with iron, and iron supplementation to infants and schoolchildren with the attendant improvement in growth velocity and intellectual performance. A planned national anemia survey and early consideration of iron supplementation to older infants and preschool children at risk are recommended.
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PMID:Childhood deaths from anaemia in Accra, Ghana. 749 16

A febrile convulsion is a generalized seizure occurring during a febrile illness whose cause is extracranial. Most scholars agree that strong evidence exists of familial predisposition to febrile seizures. The events are more common among men, with the pattern of such convulsions in Europe and North America apparently different from that in Africa. The authors report their findings from an examination of the pattern of febrile seizures at the Children's Emergency Room of the University of Benin Teaching Hospital in Benin City, Nigeria. 1046 children were admitted over the course of the study conducted January-September, 1988. Seven of the 202 patients with febrile convulsions died, five from aspiration pneumonia and two from tetanus following traditional treatment. 5% of patients with febrile convulsions were younger than 5 months or older than 5 years. The male:female ratio was 1.3:1. 140 children had a family history of febrile convulsion; in 55% the relative was a close family member. The authors point out that the number of families with a positive history of febrile convulsions may have been underreported because the average Nigerian family is loathe to admit that any member suffers from a socially stigmatized illness. These findings confirm the view that a strong familial predisposition exists for febrile seizures. Major causes of the rise in temperature in those studied included malaria, which accounted for 32.7%, followed by bronchopneumonia among 16.8%, measles at 15.4%, otitis media at 13.4%, and tonsillitis at 10.5%. Observed morbidity and mortality could be attributed to the sociocultural background of this community which practices modes of therapy which are often detrimental to patient health.
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PMID:Childhood febrile seizures (Benin City experience). 782 94

Physicians analyzed the hospital records of 62 sickle cell anemia (SCA) patients who were admitted to the pediatric wing of the University Teaching Hospital in Lusaka, Zambia, between January 1987 and December 1989 and who died. They examined the case fatality rate and the causes of death. During this period, SCA patients comprised 938 of the 31,843 pediatric admissions (2.95%). The case fatality rate of these 938 urban SCA patients was 6.61%, which is much lower than the 1970 rate of 18.57%. The researchers attributed the lower case fatality rate to the comprehensive health care provided by the hospital's sickle cell disease clinic, established in 1971. Sickle cell-related deaths during the study period made up 0.97% of all pediatric deaths. The case fatality rate was 20.17% for all pediatric admissions. SCA-related mortality peaked in the 1-5 year old age group (38.71%) followed by the 6-10 year old age group (20.97%). As for causes of death, the case records of only 44 sickle cell-related deaths were available. The pediatricians were not able to specify the exact clinical diagnosis in 18 case files (29.03%). The major categories of causes of death were infections (29.54%), vaso-occlusive crises (22.72%), and splenic sequestration crises (20.45%). The infections included 6 cases of bronchopneumonia, 4 cases of confirmed malaria, 1 case of pneumococcal meningitis, and 1 case of HIV infection with cardiomyopathy. The researchers were not sure whether the HIV infection or SCA caused cardiomyopathy. An earlier study at the hospital found HIV seroconversion in more and more SCA patients. This study's major obstacles were poor record keeping, poor communication channels, inability to conduct autopsies due to social and cultural reasons, procedural delays, and unavailability of pathologists. These obstacles must be addressed to improve knowledge on death in SCA patients.
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PMID:Clinical analysis of mortality in hospitalized Zambian children with sickle cell anaemia. 783 62

Infections are the leading cause of childhood morbidity and mortality in developing countries. Bronchopneumonia, meningitis and gastroenteritis are the commonest fatal infections encountered in Ibadan. Tuberculous lymphadenitis, bronchopneumonia and meningitis are other frequent causes of death. The predominant sequela of measles is respiratory tract infection. Another important cause of childhood mortality is cerebral malaria. In half of the cases of tetanus no obvious portal of entry can be found. It is advocated that the implementation of immunization schedules should be vigorously pursued to curtail childhood mortality resulting from infection.
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PMID:Childhood infections in Nigeria: an autopsy study. 834 43

Today ARDS is more frequently recognized and managed in tropical countries, although published data from most locations is meager. The spectrum of disorders causing ARDS in tropical countries includes virtually all conditions encountered in the West. Additionally, tropical infections and other disorders are seen far more commonly. In particular, malaria and TB are important infections that predispose patients to ARDS in the tropics. Both of these illnesses give lead to severe forms of disease, such as falciparum malaria, acute miliary TB or TB bronchopneumonia, and may cause ARDS. Awareness of the complications helps in early recognition and differential diagnosis from several similar manifestations. Although earlier reports painted a gloomy picture of the outcome of these patients in general--mainly due to financial and logistic constraints--the scenario is improving quickly with better and wider availability of newer diagnostic and management tools.
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PMID:Adult respiratory distress syndrome in the tropics. 1209 38

Malnutrition is the fourth commonest reason for hospital admission to the paediatric department of the Central Hospital, Maputo and has the second highest death rate (20 per cent). A study from 1995 into mortality at this paediatric department, suggested an increase in severe malnutrition. Recent studies have shown that the global burden of undernutrition in the world is declining; however, data for Eastern Africa shows a deterioration. The current study was aimed at describing and comparing the patients on the malnutrition ward, in 2001 and 1983. The study gathered indices of nutritional status and secondary diagnoses from the notes of all children (aged between 6 months and 5 years) discharged from the malnutrition ward for a period of l year (January-December 2001), and from data (collected in January-December 1983) for the malnutrition ward. Data was entered and analysed using Epi-Info 6 and SPSS statistics package. The ethics committee of the hospital approved the study. Data was collected for 558 children in 2001 and 833 in 1983. There was no gender difference, average age was 21.7 months in 2001 and 23.8 months in 1983 and the average hospital stay was 13.1 and 14.3 days, respectively. In 2001, 33 per cent had kwashiorkor, 26 per cent marasmus, and 28 per cent marasmic kwashiorkor. Three hundred and twenty children (82 per cent) were <2 Z-scores below the median weight-for-age and 252 children (65 per cent) were <3 Z-scores. Forty per cent had malaria, 65 per cent anaemia, 53 per cent bronchopneumonia, 14 per cent TB, 36 per cent diarrhoea, and 12 per cent HIV/AIDS. In 1983, 49 per cent had kwashiorkor, 17 per cent marasmus, and 11 per cent had marasmic kwashiorkor. A total of 494 children (81 per cent) were <2 Z-scores below the median weight-for-age and 335 children (55 per cent) were <3 Z-scores. Eighteen per cent had malaria, 37 per cent anaemia, 28 per cent bronchopneumonia, 6 per cent TB, 8 per cent diarrhoea, and 4.4 per cent measles/post-measles. A comparison between the clinical status of 1983 with that of 2001 shows little difference in age, gender or length of stay. There were fewer admissions in 2001, although a higher percentage of severely underweight children and the 2001 group had more secondary infections, especially malaria, bronchopneumonia and anaemia. Clinical malnutrition at a referral hospital level, in spite of the remarkable Mozambican economic growth, shows signs of following the depressing pattern for much of Eastern Africa. A prospective study including HIV tests and anthropometric data for this and the city's other hospitals is warranted. Discussion needs to be prompted on a local level about malnutrition and the use of guidelines.
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PMID:Nutritional and clinical status of children admitted to the malnutrition ward, Maputo central hospital: a comparison of data from 2001 and 1983. 1567 69


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