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

The causes of disqualification in a volunteer blood donor population for a period of two years were analyzed. Of 138,436 prospective volunteer blood donors, 24,327 (17.6%) donors were disqualified. Phlebotomy was unsuccesful in 721 (0.5%) donors and blood was drawn from 113,388 (81.9%) eligible donors. The majority of rejections were due to medical history findings (61.0% of all rejections). The ten leading causes of disqualification were: low hemoglobin/hematocrit, medication, allergies, signs and symptoms, high blood pressure, illness in last month, hepatitis and hepatitis exposure, malaria and travel overseas, atypical antibodies, and high serum bilirubin. Hepatitis B surface antigen was detected in 82 donors out of 114.746 donors tested (0.07%).
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PMID:Causes of disqualification in a volunteer blood donor population. 59 14

Aflatoxin-albumin adduct levels were measured in serum samples obtained from a group of Gambian children. The relationships between exposure to aflatoxin and the prevalence of malaria, between exposure and humoral and cellular responses in vitro to defined malaria antigens and, amongst children with evidence of exposure to hepatitis B infection, between aflatoxin and carriage of the hepatitis B surface antigen (HBsAg), were assessed. Aflatoxin-albumin adduct was found in nearly all serum samples collected during a survey performed at the end of the dry season and levels of adduct were generally high (up to 720 pg aflatoxin-lysine equivalent/mg albumin). Higher levels of aflatoxin-albumin adduct were detected in Wollof children than in children of other ethnic groups and marked variation in mean adduct levels between villages was observed. Aflatoxin-albumin adduct levels were higher in children who were HbsAg positive and in children with Plasmodium falciparum parasitaemia than in controls. However, levels of adduct had no consistent effect on either malaria-specific antibody responses, lymphoproliferative responses in vitro, or morbidity from malaria during the subsequent rainy season. Much lower levels of aflatoxin-albumin adduct were detected in repeat samples obtained at the end of the rainy season. There was poor correlation between dry and rainy season levels of adduct in individual children. We have shown that Gambian children are exposed to high levels of aflatoxin. The seasonal variation of aflatoxin-albumin adduct and marked fluctuation of adduct with time in individual children need to be considered in the future planning of epidemiological studies using this marker of exposure.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Aflatoxin exposure, malaria and hepatitis B infection in rural Gambian children. 144 Aug 26

New vaccine developments will reflect achievements of the World Health Organization's (WHO) Expanded Programme on Immunization (EPI), as well as resistance from the public toward increasing numbers of vaccines. WHO's EPI program has concentrated on tuberculosis, diphtheria, tetanus, whooping cough, polio, and measles. 35 countries are attempting to control hepatitis B with universal vaccination. Now some countries are also recommending vaccination against Haemophilus influenza, mumps, and rubella. The complexity of multiple injections has prompted new research on acellular vaccines for pertussis, hepatitis A and B, varicella, and malaria. Combined vaccines and new adjuvants are also targets of intense research. Vaccines are a priority, because they are among the most cost-effective of medical interventions.
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PMID:New developments in vaccinology. 163 65

The development of recombinant subunit vaccines against pathogenic organisms requires not only the identification of epitopes eliciting a protective immune response but also suitable carriers with adjuvant function. B- and T-cell epitopes of the malaria vaccine candidate gp190 were selected on the basis of a systematic search along the gp190 molecule and by computer prediction based on the amino acid sequence. Using some of the epitopes identified, we have redesigned the surface of the hepatitis B surface antigen lipoprotein particles by replacing the major antigenic determinants with malaria-specific sequences of up to 61 amino acids in length. Upon expression via vaccinia virus the hybrid particles elicit an anti-gp190 immune response in animals. Monoclonal antibodies derived from such infections recognize the native parasite.
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PMID:Epitopes of the human malaria parasite P. falciparum carried on the surface of HBsAg particles elicit an immune response against the parasite. 171 8

Glucocorticosteroids are the most commonly used immunosuppressive agents. In the following review important mechanisms of action of glucocorticoids on the immunological network are summarized, the relationship between duration of therapy, daily dose and incidence of infections is analysed, and evidence is presented that in some infectious diseases glucocorticoids may even be beneficial. The association between corticosteroid therapy and subsequent infections was calculated by pooling the data from 73 controlled clinical trials (meta-analysis). The rate of infectious complications was not increased in patients given a daily dose of less than 10 mg or a cumulative dose of less than 700 mg prednisone. With increasing doses the occurrence rate of infectious complications increased in patients given corticosteroids as well as in patients given placebo, a finding which suggests that not only the corticosteroid but also the underlying disease state accounts for the steroid-associated infectious complications observed in clinical practice. To analyze the effect of glucocorticoids prescribed as adjuvants in patients with infectious diseases, an analysis of the controlled trials was performed. Some patients with pulmonary tuberculosis or constrictive pericarditis have a better outcome when they are given prednisone. On the other hand, there is no evidence that patients with septic shock or ARDS derive advantage from glucocorticoid therapy. At present there is controversy as to whether patients with bacterial meningitis should be treated with glucocorticosteroids. Patients with hepatitis B should not be treated with glucocorticoids, whereas elderly patients less frequently show postherpetic neuralgia when given glucocorticosteroids. Patients with cerebral malaria should not be given glucocorticosteroids. Aids patients with pneumocystis carinii pneumonia have a higher survival rate when treated with glucocorticosteroids than with placebo.
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PMID:[Glucocorticoids and infection]. 173 19

R16HBsAg is an experimental recombinant malaria vaccine consisting of 16 repeats of a four amino acid sequence (Asn-Ala-Asn-Pro or NANP) of the circumsporozoite (CS) protein of Plasmodium falciparum expressed as a fusion protein with the recombinant hepatitis B virus surface antigen (HBsAg) produced by yeast cells. Twenty male volunteers were experimentally vaccinated with the product, as well as with two doses of the commercial recombinant HBsAg vaccine Engerix B (Smith Kline Beecham Biologicals, Rixensart, Belgium) at intervals during a period of 18 months. No serious side effects were observed. Circulating antibodies to recombinant CS antigen (R32tet32) developed in all volunteers and persisted in most cases over ten months. Anti-HBs antibody production was poor initially, but a single dose of the commercial hepatitis B vaccine was sufficient to elevate these titers to high levels in all but two volunteers.
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PMID:Phase I clinical trial of a recombinant malaria vaccine consisting of the circumsporozoite repeat region of Plasmodium falciparum coupled to hepatitis B surface antigen. 183 11

Diarrhea, malaria, and viral hepatitis are among the preventable diseases of travellers. In Switzerland, almost all serious cases of malaria are introduced from tropical Africa; therefore, we recommend protection with 250 mg of mefloquin per week for this destination. Elsewhere, protection against mosquitoes, in combination with Fansimef for self-treatment, may be enough. For travellers' diarrhea, we prefer immediate treatment with ciprofloxacin or cotrimoxazol to prophylaxis. Administration of immune globulin against hepatitis A may be recommended for all non-immune tourists, whereas protection against hepatitis B is necessary for health workers and sex tourists.
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PMID:[Prevention of infectious diseases in traveling]. 185 66

A prospective study of US Peace Corps volunteers (PCVs) serving in Zaire, central Africa, was undertaken to determine the risk of human immunodeficiency virus (HIV) and hepatitis B virus infection in an acquired immunodeficiency syndrome-aware expatriate population living in an area of high endemicity for both diseases. Of the 338 PCVs who served in Zaire between October 1985 and May 1988, 282 (83%) were enrolled, representing 7776 volunteer-months of service. Analyses of serum samples for HIV and hepatitis B virus were performed on enrollment and at completion of service. All PCVs received extensive education and counseling regarding HIV and acquired immunodeficiency syndrome throughout their stay in Zaire. There were no documented seroconversions to HIV among 282 PCVs who lived in Zaire for periods ranging from 1 to 81 months, with a mean length of stay of 27.4 months. Of the 14 (6.2%) of 226 PCVs tested who had at least one positive serologic marker for infection with hepatitis B virus, none was documented to have seroconverted during service. During the study period, the rate of all sexually transmitted diseases among PCVs in Africa decreased from 131 to 68 per 1000 study population per year, and there were 52 cases of confirmed malaria among volunteers in Zaire. These data suggest that the risk of acquiring infection with HIV or hepatitis B virus in PCVs in Zaire is very low, and there is no evidence for unusual modes of transmission.
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PMID:Human immunodeficiency virus infection among Peace Corps volunteers in Zaire. No evidence for unusual modes of transmission. 153 61

The high prevalence of hepatitis B markers in the Sudan (up to 80% of those surveyed) suggests the potential for a rapid spread of human immunodeficiency virus (HIV) since both viruses are transmitted in similar ways. Although clinical cases of acquired immunodeficiency syndrome (AIDS) have not been reported from Port Sudan, southern Sudan borders on several countries with a high prevalence of HIV infection. Sudan's National AIDS Committee plans a series of surveys to determine the prevalence of HIV infection in high risk groups and the general population in several geographic regions. The 1st such survey was conducted in Port Sudan in 1987 among 593 high-risk individuals (203 prostitutes, 103 lorry drivers, 118 prisoners, and 169 in mixed occupations). The study population included 330 males and 263 females. About half of the participants were married and in the 21-30-year age group. Over 75% had been exposed to hepatitis B and 76% had been treated for malaria, largely through injection. Overall, the incidence of non-sex-related risk factors for HIV infection among Port Sudan subjects was: injection, 48%; scarification, 40%; and tatoos, 38%. 32% reported a prior history of a sexually transmitted disease. 71% of the males had used prostitutes. Surprisingly, no study participants were positive for HIV infection. This finding presumably reflects Port Sudan's geographic isolation from other Central and East African countries with large numbers of HIV-positive individuals. On the other hand, Port Sudan is the site of importation of all goods by sea into the country and many people from other African and Arab countries are associated with the seaport. Thus, once the HIV virus is introduced by infected persons from other areas, the risk factors suggest the potential for rapid transmission.
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PMID:Serosurvey of prevalence of human immunodeficiency virus amongst high risk groups in Port Sudan, Sudan. 225 74

This review describes the transmission, clinical picture and immunological abnormalities of HIV infection in children in general, and the special problems of AIDS in African children. The review begins with a thorough introduction to the epidemiology of AIDS. Transmission to children generally involves vertical transmission by placental transfer or transmission of HIV via transfusion of blood and blood products, or by contaminated needles. Casual transfer is unknown, and only a few cases of transmission via breast milk are known. The clinical picture of HIV infection in infants and children differs from that in adults in 3 important aspects: earlier onset, different clinical presentation and existence of AIDS embryopathy. The average onset was 5 months of age. The most common symptoms in young children are chronic interstitial pneumonitis without demonstrable etiology, hepatomegaly, failure to thrive, adenopathy, diarrhea, oral or perineal thrush, eczema and thrombocytopenia. The common opportunistic infections are pneumocystis carinii pneumonia, cytomegalovirus, Epstein-Barr virus, Cryptosporidium diarrhea, pyogenic infections of the middle ear and gram-negative septicemia. Several infections seen in adult AIDS cases are rare in children: mycobacterium avium-intracellulare, toxoplasma gondii, hepatitis B, as well as Kaposi's sarcoma, malignant lymphoma and cardiac abnormalities. The AIDS embryopathy or HIV dysmorphic syndrome is characterized by immunological abnormalities, growth failure, and craniofacial dysmorphism, particularly microcephaly, prominent box-like forehead, hypertelorism, flattened nasal bridge, obliquity of the eyes, blue sclerae and patulous lips. AIDS in African children is extremely difficult to diagnose because of similarities between the presenting symptoms and those commonly seen in sick children there, many of whom are also immune compromised. Where serotesting is available, the picture is complicated by cross reaction between the test agents and some factor found in sera from malaria patients. Seropositivity in some areas is high, increased by the prevalence of transfusion and injection treatments. Diagnosis is made more difficult by lack of laboratory facilities and difficulties in follow-up for pediatric patients. The CDC definitions of AIDS and ARC, and the WHO/CDC definitions of AIDS are appended.
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PMID:Human immunodeficiency virus infection in childhood. 245 15


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