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

Melioidosis is a long-known disease since 1912, but only quite recently we have obtained the knowledges about its actual clinical and epidemiological features. The disease is so unique in having a wide spectrum of disease course and clinical manifestation. The causative agent, P. pseudomallei, is free-living bacterium in the natural environments (soil and surface water) of tropical and subtropical areas. Just like legionnaires' disease, melioidosis is a good example of infectious disease in which pneumonia is produced by inhalation of contaminated soil dusts or water droplets. The infection becomes dormant for years, but with a chance of recrudescence under a variety of insults to the host resistance. The disease, may it be acute or chronic, will be symptomatically confused with malaria, typhoid fever, leptospirosis, septicemia caused by other gram-negative bacteria, tuberculosis and mycotic infections. Isolation of the causative agent from clinical specimens is the only reliable method for diagnosis. Because of the increasing clinical awareness and the development of diagnostic methods, the reported cases of melioidosis have numbered almost one thousand in Thailand during the past 20 years. This country has now the most ample clinical experiences on melioidosis. We have reviewed the history of melioidosis research from bacteriological, immunological, clinical and epidemiological viewpoints, especially including the recent reports in Thailand.
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PMID:Pseudomonas pseudomallei and melioidosis, with special reference to the status in Thailand. 307 4

The early history of the Federal involvement in Hansen's Disease reflects the history of the Public Health Service itself. As a young and aggressive institution, the Public Health Service sought out contagious, infectious diseases that threatened the public health. National resources and national coordination were needed to fight the likes of malaria, hookworm, or smallpox. The customary attack would consist of a field study, determination of the etiology, the method of transmission, and, then, perhaps, preventive measures. An eradication campaign would follow. Leprosy fit perfectly into the model--a disease of unknown etiology, an unknown method of transmission, thought to be highly contagious, and no known cure. The United States launched a major investigation in Hawaii, where the disease was prevalent and its victims conveniently segregated. The investigation failed. The Public Health Service then turned toward segregation and isolation as a way to fulfill its public health role. A bureaucracy was established around the idea that victims of leprosy must be incarcerated for the good of the public. The institutionalization of the Public Health Service and the philosophy upon which its treatment of leprosy was based proved difficult to change when researchers in the field made major scientific breakthroughs in the 1940s. The realization that the disease was only feebly contagious, activities of patient organizations, and pressure from the media and the Congress did not achieve as dramatic results as the sulfone drugs did. The Public Health Service moved, but slowly. What are the lessons in all of this?.
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PMID:The nationalization of a disease: a paradigm? 309 Jun 6

The shortcomings of the "seroepidemiology" approach as opposed to the traditional "clinical epidemiology" approach in answer to Africa's acquired immunodeficiency syndrome (AIDS) problem, are discussed. Investigators with a knowledge of tropical medicine have observe that recurrent malaria and other infectious diseases are associated with excessively high rates of false-positivity with H9/HTV-III, enzyme linked immunoabsorbent assay (ELISA), leading to a dichotomy between seroepidemiology and clinical epidemiology in tropical Africa. In addition, patients with alcoholic liver disease have a high incidence of false positive results on tests for HTLV-III antibodies, while acute malaria infections have produced false positivity even with the Western blot. When the conclusions of clinical epidemiology differ from those of seroepidemiology, clinicians should always believe the former. Serological work should be limited to assessing the specificity and sensitivity of the various kits under African conditions, screening all blood before transfusion, and serving as a back up procedure when clinical features are not clear cut. In his Krobo tribe, in southeastern Ghana, Dr. Konotey-Ahulu suggests that the bulk of any available funds should be resourcefully utilized in answering the questions: how, when, who, which, why and where?
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PMID:Clinical epidemiology, not seroepidemiology, is the answer to Africa's AIDS problem. 311 44

A non-immune, 31-year-old woman developed an acute infection with Plasmodium falciparum after travelling to Kenia. The parasites proved resistant to chloroquine and sulfadoxine/pyrimethamine. The course of the disease was complicated by acute renal failure, hepatocellular damage, disorders of blood coagulation, thrombocytopenia, hemolysis and cerebral involvement. Despite a very high level of parasitemia (50% parasitized erythrocytes) a rapid clinical improvement was achieved by plasmapheresis and hemodialysis. Our experience shows that plasmapheresis and hemodialysis are excellent additive methods which rapidly improve clinical symptoms and may reduce morbidity and mortality in severe malaria tropica.
Infection 1988
PMID:Successful treatment of malaria tropica with acute renal failure and cerebral involvement by plasmapheresis and hemodialysis. 322 May 82

The incidence of malarial infection in pregnant women at delivery, their corresponding infants and umbilical cords and a control group of non-pregnant women were investigated in the Madang region of Papua New Guinea. Anti-malarial antibody titres were measured in maternal and paired cord sera. Parasitaemia occurred in 18/73 (24.7%) of non-pregnant females compared with 15/51 (29.4%) of pregnant females. Malarial parasites were found in 7/48 (14.6%) cord blood samples and in 4/52 (7.7%) samples of the infant's peripheral blood, indicating transplacental transmission. Infection with Plasmodium falciparum was commoner in pregnant than non-pregnant females, and accounted for all the cord and infant infections. A significant correlation was found between anti-malarial IgG antibodies in paired maternal and cord bloods. There was an association between umbilical cord infection and low levels of cord antibody. Clinical malaria developed in at least one out of the 7 cases in which placental transfer of parasites was known to have occurred. This study suggests that transfer of parasites across the placenta is a common event in Papua New Guinea. Further consideration should be given to treatment with anti-malarial drugs of infants with cord or peripheral blood parasitaemia or, indeed, of all infants of mothers with parasitaemia.
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PMID:Congenital malaria in Papua New Guinea. 209 31

The analysis of human B cell responses at the clonal level (limiting dilution assay) is still technically difficult. In the present study we report on a culture system that leads to activation, proliferation and differentiation into antibody-secreting cells (ASC) of about 90% of B cells from peripheral blood or spleen. In this system, B cells are cultured in the presence of a mutant subclone of the mouse thymoma EL4 for B cell activation and human T cell plus macrophage supernatant as source of proliferation and differentiation factors. ASC precursors generating clonal responses of IgM only, IgM plus IgG, or IgG only occurred at a ratio of about 6:3:1. The mean clone size was 380 cytoplasmic Ig+ cells; the mean amount of Ig secreted per clone was 20 ng. Furthermore, it has been found using this system that a considerable proportion of peripheral blood B cells from individuals with a history of malaria infection could generate clones of anti-malaria (Plasmodium falciparum) ASC (range of 0.1 to 1%, n = 6). In a control group of blood donors the corresponding frequencies were 10 times lower (range of 0.01 to 0.1%, n = 9). These results show that the EL4 culture system can be applied to the investigation of the human B cell specificity repertoire and of priming effects such as result from infectious disease.
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PMID:Limiting dilution assay for human B cells based on their activation by mutant EL4 thymoma cells: total and antimalaria responder B cell frequencies. 329 36

To investigate the protective effects of beta-thalassemia against malaria, rodent malaria parasites were studied in C57BL/6J mice with beta-thalassemia, in mice in which the thalassemia had been transgenically corrected with the human beta A-globin gene, and in hematologically normal mice. In thalassemic mice, Plasmodium chabaudi adami infection was inhibited and peak parasitemia was variably delayed. In transgenically corrected mice, infection proceeded as in normal mice. Plasmodium berghei infection proceeded more rapidly in thalassemic mice, but survival was not different. Splenectomized normal mice displayed high-level parasitemia that peaked twice and persisted as a low-level parasitemia for more than 20 days after normal intact mice were free of all parasites. Splenectomized thalassemic mice showed a delay of 5 days in attaining peak parasitemia, but the parasitemia persisted as in normal splenectomized mice. Thus, for P. chabaudi, which displayed no preference for immature erythrocytes, beta-thalassemia offers enhanced resistance for the host. However, for P. berghei, which preferentially invades reticulocytes, thalassemia is not protective. The protective effects of the normal mouse spleen were observed, but the paradoxical facilitation of parasite growth by the thalassemic spleen is a new finding that will require further experimentation to explain. This new in vivo laboratory documentation of thalassemic protection against some rodent malaria parasites may serve as a useful model in further efforts to control this major infectious disease.
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PMID:Malaria in beta-thalassemic mice and the effects of the transgenic human beta-globin gene and splenectomy. 333 24

In 1984 a rare opportunity arose to document the effects of contact on a previously isolated population in Papua New Guinea. The Hagahai, a small group of hunter-horticulturalists, remained hidden from government and mission influence until the early 1980s. Prior to that time, indirect contact through trade with neighboring peoples facilitated the entry of introduced infectious diseases. In late 1983 the Hagahai sought medical aid at a mission station, an event which accelerated their contact with the common epidemic diseases of the highlands. A wide variety of genetic, linguistic, ethnographic and medical data have been collected which document the historical sequence of events contributing to the current rapid demographic decline among the Hagahai. Serological evidence demonstrates the endemicity of Bancroftian filariasis, malaria, C. diphtheriae, cytomegalovirus, HTLV-1, the Ross River arbovirus and several viruses associated with the common cold. Recent epidemics include mumps, influenza A, and hepatitis B. They have not yet been affected by TB or measles, among others. Infanticide contributes to an estimated infant mortality rate of 568/1000. With a crude birth rate of 38 and a crude mortality rate of 51, the Hagahai appear to be dying out. The provision of adequate health care to these people is extremely problematic and beyond the capacity of the existing system.
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PMID:Health in the early contact period: a contemporary example from Papua New Guinea. 339 25

Ethiopia is a country of 45 million people in northeast Africa. With a stagnant, agriculture-based economy and a per capita gross national product of $110 in 1984, it is one of the world's poorest nations. 70% of the children are mildly to severely malnourished, and 25.7% of children born alive die before the age of 5. Life expectancy is 41 years. The population is growing at the rate of 2.9%/year, but only 2% of the people use birth control. After the 1974 revolution, the socialist government nationalized land and created 20,000 peasant associations and kebeles (urban dwellers' associations), which are the units of local government. The government has set ambitious goals for development in all sectors, including health, but famine, near famine, forced resettlement programs, and civil war have prevented any real progress from being made. The government's approach to health care is based on an emphasis on primary health care and expansion of rural health services, but the Ministry of Health is allocated only 3.5% of the national budget. Ethiopia has 3 medical schools -- at Addis Ababa, Gondar, and the Jimma Institute of Health Sciences. Physicians are government employees but also engage in private practice. A major problem is that a large proportion of medical graduates emigrate. Ethiopia has 87 hospitals with 11,296 beds, which comes to 1 bed per 3734 people. There are 1949 health stations and 141 health centers, but many have no physician, and attrition among health workers is high due to lack of ministerial support. Health care is often dispensed legally or illegally by pharmacists. Overall, there is 1 physician for 57,876 people, but in the southwest and west central Ethiopia 1 physician serves between 200,000 and 300,000 people. In rural areas, where 90% of the population lives, 85% live at least 3 days by foot from a rural health unit. Immunization of 1-year olds against tuberculosis, diphtheria-pertussis-tetanus, poliomyelitis, and measles is 11, 6, 6, and 12% respectively. Infectious diseases dominate the medical scene in Ethiopia. In 1984, tuberculosis accounted for 11.2% of hospital admissions and 12.2% of deaths. The leading cause of childhood mortality in 1984 was diarrhea (45%). Malaria, trypanosomiasis, schistosomiasis, leishmaniasis, and meningococcal meningitis are endemic. Intestinal parasitism is rampant, and the nationwide prevalence of leprosy is 3/1000. Venereal diseases were the 9th most common cause of hospital outpatient visits in 1984, but AIDS is rare. The leading noninfectious diseases are rheumatic and syphilitic heart disease, hypertension, diabetes mellitus, hepatoma, and elephantiasis. Ethiopia has the highest number of cases of nonfilarial elephantiasis -- an estimated 350,000 cases -- in the world. Aside from a large influx of money, the most necessary changes to improve the health system are lowering the salaries of doctors and nurses, reorienting physician training toward primary health care, increasing the quality of existing health services, more efficient management, and better coordination between the Ministry of Health and the voluntary organizations.
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PMID:Health and medical care in Ethiopia. 271 Jan 85

General screening investigations with various antigens were carried out with a view to further specific investigations being carried out on the Cape Verde Islands concerning infectious diseases. Serological positive reactions were found in Mumps, Adeno, PLT, Cytomegaly, Herpes, Para-influenza 1, 2, 3, Influenza A and B, Mycoplasmosis, RS-Virus, Gonorrhoea, Hepatitis A and B, R. conori, Malaria, Syphilis, Brucella abortus, Brucella melitensis, Varicella, Legionella, Picornavirus, Measles, German Measles, Listeriosis, Toxoplasmosis and Amoebic dysentery.
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PMID:Serological screenings of various infectious diseases on the Cape Verde Islands (West Africa). 344 44


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