Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
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Taiwan's population has undergone rapid growth. From 3000000 in 1906. It had grown to 6000000 by 1941. By the end of 1996 the total population has reached 21500000. This large population is served by over 120000 health professionals. For every 10000 people there are 12.91 doctors (including 11.52 Western medical doctors and 1.39 Chinese medical doctors), 3.37 dentists and 9.36 pharmacists. There has been a huge change in causes of mortality. Under the Japanese occupation, the main causes of death were malaria, pneumonia, dysentery, enteritis, and pulmonary tuberculosis. After the return to Chinese control, the main causes were acute contagious diseases and digestive tract disease. At present, malignant tumors, cerebrovascular accident, heart disease, and diabetes are the main causes of death. With the development of the health-care system, infectious diseases have been controlled or eliminated. Malaria was eradicated from the island in 1956.
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PMID:Modern medicine in Taiwan (II). 1162 Apr 86

An intense process of epidemiological transition due to the change in mortality has superseded the eras of pestilence, pandemic disease, and chronic-degenerative diseases in Mexico. But the change has not been uniformly progressive, for instance, recurrence of malaria after its eradication indicates reverse transition. Enteritis, influenza, and pneumonia ranked among the primary causes of death between 1955 and 1957, whereas by 1980 heart disease became the leading cause followed by accidents, influenza, and enteritis. A polarized epidemiology can be observed in the post-transitional period: the poorest segment of the population continues to have high rates of infections and nutritional deficiencies. According to Mexican health service mortality data gathered in 1981 industrial workers had similar rates of infectious and chronic-degenerative diseases (11.7% and 12.0%, respectively), while agricultural workers had high rates of infectious and parasitic diseases (26.7%) and a low rate of chronic-degenerative diseases (5.6%). Illnesses of perinatal origin were also higher in agricultural workers than in industrial workers (26.1% vs. 13.7%), whereas circulatory diseases were more frequent among industrial workers (14.2% vs. 7.2%). It is the task of the health care system to meet the challenge of the complexity of this epidemiological mosaic.
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PMID:[The health transition in Mexico: a proper model]. 1215 27

During 1970-1973, a study was done on the Serer, a Senegalese tribe known to have difficulty in adapting to new situations. The study was done by the World Health Organization and the University in Dakar to determine the health differences, if any, of those still living in their rural environment and those residing in the city. 262 adults were surveyed in the rural area of Niakhar and 225 Serer natives living in the urban area of Dakir were also surveyed. Questionnaires were prepared dealing with sociodemographic, biomedical, mental health, housing and hygiene data. It was found that urban dwellers tended to be younger than their rural counterparts. There was also a greater percentage of Serer women who live in the city. Education was higher among those who lived in Dakar with male urban dwellers having a 13% higher ratio than women. Serer men who live in the city tend to socialize more with other groups while women mixed poorly saying that other cultures had "doubtful morality." Women who moved to Dakir trusted modern medicine, while urban dwelling men believed both in modern and folk medicine. 3 areas of medical concern were studied: precursors to heart disease, anemia, and infectious diseases. Little difference was observed between rural and urban populations for precursors to heart disease. Anemia was common in the rural area for both sexes. More malaria, intestinal parasites and tuberculosis were found in rural households. In regard to mental health, depression and anxiety are approximately the same for urban and rural dwellers while psychiatric syndrome, cerebral syndromes and personality disorders do appear more frequently in urban dwellers. The authors discuss the practical implications of their study and suggest further research that can be done to extend their analysis.
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PMID:Migrants' health and adjustment to urban life--Senegal. 1226 63

The Indian government's plan to introduce the new long-acting contraceptive Norplant in the National Family Planning Program under pressure from the US government is opposed because Norplant has not been adequately tested. The government has reduced the funding for the national program for eradication of malaria and tuberculosis, but it is proposing to finance a Norplant based population project for the State of Uttar Pradesh. The powers that can turn a deaf ear to the possible hazards of Norplant. Implanted in the arm of a woman, the chemical is released into the bloodstream providing contraception for 5 years. Severe adverse reactions include depression, heart disease thromboembolism, high blood pressure, and ovarian cysts. Many such long-acting contraceptives are being developed including injectables, vaccines, nasal sprays, and vaginal rings with potential permanent impairment to fertility. One of the major objectives of the Family Planning Program is the improvement of the health status of women, but the introduction of Norplant would harm healthy young women. Therefore, the group Saheli and others in the campaign demand: 1) that plans for introduction of Norplant in the Family Planning Program be halted immediately; 2) that the introduction of any other long acting invasive contraceptive such as Net-En, vaginal ring, nasal spray, and anti-fertility vaccine be banned, both on the grounds of inadequacy of the health services and loss of user controls; 3) that information on the safety aspects of Norplant and the basis on which the Drugs Controller has granted his approval be made public; 4) that each and every one of the hundreds of women who still have the implant should be located, and the implant removed; and 5) that all hormonal contraceptive preparations be banned in the social marketing program as their use involves extensive monitoring.
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PMID:Norplant campaign in India. 1228 26

South Africa's apartheid policies have had direct and indirect effects on morbidity and death that will likely remain for decades. Since 1964, the economy has largely been deteriorating, while the population has grown at 2.8%/year, both of which have hampered economic development and health. South Africa needs to supply water, sanitation, and housing to 75% of the population. Rural development is needed to stem malnutrition, soil erosion, and overgrazing. Urban development design and planning must include health. Schooling needs to improve educators can emphasize school health education. Electricity and better lighting are needed to reduce chest diseases and paraffin poisoning and to improve literacy and learning. Labor migration has contributed to a high rate of sexually transmitted diseases and HIV/AIDS in rural areas. In some cases, industry and the public sector have become partners to improve health. The alcohol industry sponsors drive safe campaigns. South Africans need to address inequalities in health status by race, region, and gender, and to follow a holistic development approach. Infant mortality is just 6.4/1000 for Whites, while it is 66.7/1000 for Blacks. It is 1.5 times lower in the best region than it is in the worst region. 2 of every 25 children die before their first birthday among Africans living in the poorest third of South Africa. 42% of Black men who live to 15 years die before their 60th birthday, while just 17.5% of like White women do. Black children less than 5 years old have an almost 9-fold excess in deaths over White children. The tuberculosis rate is among the highest in the world and is likely to increase as HIV/AIDS spreads. Many other preventable diseases occur among South Africans. 5-8% of the population suffer a disability. South Africa has the highest per capita violence mortality rate worldwide (59.2/100,000 vs. 9.6/100,000 in the US). South Africa is likely to face increases in lung cancer, chronic lung disease, heart disease, and malaria.
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PMID:Health status and its determinants in South Africa. 1234 7

Governments can override patents for legitimate purposes, including public health. But many small or poor countries hve no pharmaceutical industry to manufacture medicines themselves, and global trade rules being phased in will prevent others from exporting to them without the patent holder's permission. Negotiations to solve this problem broke down when the U.S. insisted that any agreement apply only to AIDS, tuberculosis, malaria, and similar major epidemics--excluding cancer, heart disease, and hundreds of other diseases.
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PMID:U.S. blocks trade agreement on generic drug access in poor countries. 1256 74

In this cross-sectional study, 8,481 women aged 15-49 who had at least one pregnancy outcome were considered. This study aimed to examine the characteristics of Filipino women having had a pregnancy loss, and to test the association between domestic violence and pregnancy loss. To control for the confounding effect of the number of pregnancies, the sample was divided into seven groups classified by the number of pregnancies. The risk factors considered were demographic characters (age and partner's age, marital status, and place of residence), socioeconomic status (education and partner's education, having a paid helper at home, having a say in how income was spent), domestic violence (physical abuse and forced sex), sexual behavior of partner, whether the pregnancy was wanted, and disease history (tuberculosis, diabetes, hypertension, malaria, hepatitis, kidney disease, heart disease, anemia, goiter and other medical problems). The major risk factors were found to be physical abuse, region, faithfulness of partners, hypertension, hepatitis, kidney disease, anemia, and the other medical problems, respectively. The risk of pregnancy loss for the women suffering domestic violence was 1.59 (95% CI 1.28-1.97) times higher than for the women who did not. Women aged 15-19 years had a much higher risk of pregnancy loss than the other age groups (OR = 1.49, 95% CI 1.22-1.82). There were similar risk for women aged 20-24 years (OR = 1.08, 95% CI 0.94-1.25) and 35-39 years (OR = 1.05, 95% CI 0.92-1.19). No association emerged with marital status, socioeconomic status, forced sex, the number of partners, unwanted pregnancy, tuberculosis, diabetes, malaria, heart disease, and goiter. Although women's age, partner's age, residence, women's education, partner's education, and paid helper at home were significantly associated with pregnancy loss, they were likely to be confounders rather than risk factors.
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PMID:Pregnancy loss in the Philippines. 1297 77

Chagas heart disease is endemic in 21 countries with approximately 100 million people at risk. It is the most common cause of myocarditis in the Americas and is recognized to have existed for more than 4000 years (isolated from mummies). Chagas disease was discovered during the search to find a cause for the overwhelming deaths occurring in Brazil in the late 18th century. Physician Carlos Chagas discovered Trypanosome minasense in 1908 while researching on malaria. Subsequently, the existence of the barbeiro triatomine (insects bites on the face), the isolation of the Trypanosome cruzi in the triatomine and the first human description of a disease in a 9-month-old child depicted the existence of a new human trypanosomiasis. Chagas named the trypanosome species after his colleague and mentor Oswaldo Cruz. In subsequent papers, Chagas described the morphology and evolutionary cycle of the trypanosome and the clinical features of the disease, including involvement of the heart. Never before or since one physician has fully characterized a disease from its grass roots to the clinical forms more or less all by himself.
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PMID:Early twentieth century descriptions of the Chagas heart disease. 1519 45

Constitutive nitric oxide (NO) is generated by constitutively expressed types of NO-synthase enzymes (NOS-I and -III), being involved in physiological processes such as nervous transmission and vasodilatation. Inducible NO, synthesized by the NO-synthase isoform NOS-II, is an anti-pathogen and tumoricidal agent. However, inducible NO production requires a tight control because of cytotoxic and immune-modulation activity. NO produced by human and canine macrophages has long been demonstrated to be involved in the intracellular killing of Leishmania. Mechanisms of parasite survival and persistence in the host have been throughly investigated, and include suppression of NOS-II and the parasite entry into NOS-II negative cells. Both intracellular and extracellular morphotypes of Trypanosoma cruzi are killed by NO in vitro and in vivo, although a role of NO in the pathogenesis of heart disease has been reported. Killing of extracellular protozoa such as Trichomonas vaginalis and Naegleria fowleri by activated macrophages is also mediated by NO. The main control of Plasmodium spp infection in human and murine hepatocytes, and in human monocytes is achieved by NO-mediated mechanisms. Protection from severe malaria in African children has been found associated with polymorphisms of the NOS-II promoter; however, a pathogenic role of endogenous NO has been documented in cerebral malaria. Although several macromolecules are putative NO targets, recent experimental work has shown that NO-releasing compounds inhibit cysteine proteases (CP) of P. falciparum, T. cruzi and L. infantum in a dose-dependent manner. CPs are present in a wide range of parasitic protozoa and appear to be relevant in several aspects of the life cycle and of the parasite-host relationships. Comparative analysis of 3-D amino acid sequence models of CPs from a broad range of living organisms, from viruses to mammals, suggests that the Sy atom of the Cys catalytic residue undergoes NO-dependent chemical modification (S-nytrosilation and disulfide bridge formation), with the concomitant loss of enzyme activity. The NO-donor S-nitroso-N-acetilpenicillamine (SNAP) was shown to kill T. cruzi epimastigotes and L. infantum promastigotes in culture, while a combination of nitrite plus acid organic salts was highly effective against L. major amastigotes in mouse macrophages. A parasitostatic effect--with both encystation and excystation inhibition--of S-nitrosoglutathione and spermine-NONOate was documented in trophozoite cultures of Giardia duodenalis. Recently, a novel formulation of metronidazole bearing a NO-releasing group was found to enhance significantly the in vitro killing of Entamoeba histolytica trophozoites, compared to metronidazole. So far, only two clinical studies were performed on human patients, suffering from cutaneous leishmaniasis. In one study, 16 Ecuadorean patients were treated with a SNAP cream administered on lesions for 10 days. All lesions were parasitologically cured and clinically healed by day 30. In the second study, a different NO-producing cream (basically nitrite in acidic environment) was employed to treat 40 Syrian patients. Only 28% of them showed improvement and 12% were cured by day 60. In conclusion, despite the wide evidence that NO can be regarded as a natural anti-protozoal weapon, little efforts have been made to develop and test NO-based drugs in human medicine. This is mainly due to the difficulty in designing suitable chemical carriers able to release the right amount of NO, in the right place and in the right time, to avoid toxic effects against non-target host cells.
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PMID:[Nitric oxide and anti-protozoan chemotherapy]. 1530 96

Parasitic diseases such as sleeping sickness, Chagas' heart disease, and malaria are major health problems in poverty-stricken areas. Antiparasitic drugs that are not only active but also affordable and readily available are urgently required. One approach to finding new drugs and rediscovering old ones is based on enzyme inhibitors that paralyze antioxidant systems in the pathogens. These antioxidant ensembles are essential to the parasites as they are attacked in the human host by strong oxidants such as peroxynitrite, hypochlorite, and H2O2. The pathogen-protecting system consists of some 20 thiol and dithiol proteins, which buffer the intraparasitic redox milieu at a potential of -250 mV. In trypanosomes and leishmania the network is centered around the unique dithiol trypanothione (N1,N8-bis(glutathionyl)spermidine). In contrast, malaria parasites have a more conservative dual antioxidative system based on glutathione and thioredoxin. Inhibitors of antioxidant enzymes such as trypanothione reductase are, indeed, parasiticidal but they can also delay or prevent resistance against a number of other antiparasitic drugs.
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PMID:Dithiol proteins as guardians of the intracellular redox milieu in parasites: old and new drug targets in trypanosomes and malaria-causing plasmodia. 1565 67


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