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

During the last years, imported diseases have become more frequent in Switzerland. This is easily explained by the enormous increase of tourism to tropical and subtropical countries. Immigration from these countries has equally seen an important augmentation. The principal imported diseases are still malaria and gastrointestinal infections. Viral infections are rarely diagnosed, with the exception of hepatitis and HIV infection. The prevalence of sexually transmitted diseases is most certainly underestimated. The differential diagnosis of imported skin diseases is still difficult. Rare tropical diseases will probably become more frequent in the coming years as travellers leave more and more the traditional tourist paths. Practitioners have to look out for such problems, and continuous training programmes for them will have to take these new problems into account. Referral centres of infectious diseases should be established in all regions of Switzerland. High priority should be given to the prevention of imported diseases.
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PMID:[Imported diseases in Switzerland: development and perspectives]. 226 17

The relation between Plasmodium falciparum malaria and symptomatic human immunodeficiency virus 1 (HIV-1) infection was investigated in paediatric and adult patients in Kampala, Uganda, from 1987 to 1989. Both infections contributed largely to hospital morbidity. Of 1527 clinically suspicious in-patients, 61% were positive for HIV-1 infection. 52% of patients with positive HIV-1 serology fulfilled the World Health Organization clinical case definition for acquired immune deficiency syndrome (AIDS) in Africa. No association could be found between HIV-1 infection and malaria either in paediatrics or in adults. P. falciparum parasitaemia was present in 18% of all patients and no differences in prevalence of malaria infection or in parasite density could be demonstrated between HIV-1 positive and HIV-1 negative patients. The comparison of clinical symptoms showed typical differences in AIDS-related morbidity but no difference in malaria-specific morbidity. Also, the response to malaria treatment was the same in HIV-1 positive and HIV-1 negative patients. P. falciparum malaria does not appear to act as an opportunistic agent in AIDS patients in Uganda.
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PMID:The clinical and parasitological presentation of Plasmodium falciparum malaria in Uganda is unaffected by HIV-1 infection. 226 Jan 60

Data of pediatric patients screened for HIV-1 infection between 1985 and 1989 were studied retrospectively in one of the major mission hospitals of Kampala (Uganda). Symptomatic HIV-1 infection was mainly acquired perinatally and was diagnosed in 87 per cent in children under 2 years of age. The mortality rate was 40 per cent in pediatric in-patients with symptomatic HIV-1 infection as compared to 12 per cent in overall pediatric inpatients. Symptoms included in the WHO clinical case definition for pediatric AIDS were mainly insensitive, unspecific and demonstrated a low positive predictive value. There was no difference in the prevalence of malaria and measles between HIV-1 positive and HIV-1 negative children.
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PMID:Pediatric HIV-1 disease in a Kampala Hospital. 228 Apr 34

The purpose of this study was to develop a strategy to reduce transfusion-related HIV transmission which went beyond the limits of routine HIV screening of blood donors. Current blood transfusion practices were assessed in 1044 patients for whom staff physicians had requested a transfusion between 5 September and 19 October, 1988. Children under 5 years of age with malaria, and pregnant women with acute anaemia requiring blood transfusion were the two highest risk groups. Many of the transfusions were given without an obvious medical indication; 22.7% (214 out of 955) of the recipients were transfused without prior laboratory tests [haemoglobin (Hb) or haematocrit (Hct)], 7.2% with Hb greater than 6g/100ml or Hct greater than 25% and 16.6% without clinical signs of severe anaemia (pulse less than 100/min without shortness of breath). The data of this study were used to organize a workshop for all the physicians responsible for blood transfusions in Kinshasa and two nearby health zones. A consensus statement on the indications for blood transfusion was developed. Subsequently, transfusion centres adopted this consensus statement instead of previous guidelines.
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PMID:Prevention of transfusion-associated HIV transmission in Kinshasa, Zaire: HIV screening is not enough. 238 19

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

T lymphocytes, in contrast to antibodies, appear to recognize primarily a limited number of antigenic sites on any given antigenic protein. We find that a single site can so dominate the T-cell repertoire that the presence or absence of a response to one immunodominant site can make the difference between a high responder and a low responder, even though low responders respond to other sites almost as well as high responders. Besides interaction with major histocompatibility complex (MHC) molecules, the mode by which the antigen is processed into fragments for T-cell recognition also determines which sites are seen. The products of natural processing of the protein appear to be larger than the synthetic peptides and contain structures which hinder binding to certain MHC molecules or to the T-cell receptor. A third factor in immunodominance is the intrinsic structure of the antigenic site. We have shown that amphipathic helices have a higher than random chance of being immunodominant, and have developed a computer program to locate such structures in protein amino acid sequences. We prospectively predicted sites in the malaria circumsporozoite protein and found that the four most widely recognized sites in an endemic area of West Africa were all predicted. Similarly, we identified two helper T-cell sites from the HIV (AIDS virus) envelope, and have now shown that immunization with these elicits enhanced antibody responses to the whole envelope when injected into monkeys. These sites are also recognized by human T cells from volunteers who had been immunized with a recombinant vaccinia virus expressing the HIV envelope. Also, because cytotoxic T lymphocytes (CTLS) may play a critical role in defence against AIDS, we have used a recombinant vaccinia virus and transfectants expressing the HIV envelope gene to induce specific CTLS against the HIV envelope. Using synthetic peptides, we were able to identify the first CTL recognition site in the AIDS virus. These results may contribute to the rational design of vaccines.
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PMID:Structural features of T-cell recognition: applications to vaccine design. 247 71

The registry of patients at the hospital of Kampene, Zaire, covering the period 1986-87 was examined to determine the hospital's rate of utilization and accessibility, to evaluate mortality, and to ascertain the prevalence of infectious diseases. The 1986 data of the hospital laboratory indicated a high incidence of infectious and parasitic diseases: ancylostomiasis (33.6%); ascariasis (22.9%); schistosomiasis (3.4%); multiple intestinal parasitic infections (10.9%); malaria (43%), often chloroquine-resistant; filariasis (70.8%); and alcohol-acid resistant tuberculosis bacilli (15%). Sexually-transmitted diseases such as vaginitis (80%) were caused by polygamy, prostitution, and promiscuity, HIV serodiagnosis could not be performed because of a lack of equipment. A high infant mortality rate was caused by neonatal tetanus, toxic gastroenteritis, measles (5.1% lethality: 2 died out of 39 cases), and epidemic cerebrospinal meningitis. Malnutrition caused kwashiorkor and avitaminosis. 792 births were registered at the maternity ward in 1986: 52.8% were male and 47.2% were female; 48 (6.1%) were stillborn or died in the following days; 104 (13.1%) were born prematurely; and 24 (3.1%) were twins. Cesarean section was performed in 43 cases (5.4%). There was a total of 15,099 outpatient visits during a 1-year period. The bed occupancy rate of the surgical ward ranged between .7 and .8 during 1987. Recovery and hospitalization days per doctor or health assistant were very high compared to Italian standards. The lethality of malaria was a high 1.8%, but malnutrition rated even higher: 21.4%. The utilization of the hospital was high, Maternal-child protection measures, especially in the area of nutrition, require the training of community health workers and traditional birth attendants; however, cost-benefit considerations limit resources and the implementation of primary health care is curtailed by economic and cultural factors.
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PMID:[Health care organization and health in a region of Zaire]. 248 74

Blood transfusions may lead to immunologic but also infectious problems. If bacterial pathogens are rarely involved, blood pathogens - especially malaria - and viruses are dominant. Non-a non-b hepatitis is the most frequently encountered viral infection, with a risk of 1% for each blood unit. Screening of SGPT and anti Hbc antibodies should diminish the transmission risk by 30-40%. Since August 1985, HIV antibody screening of blood donors has dramatically reduced the risk of blood transmission; however, patients Ag HIV+/Ac HIV (first weeks of infection, ...) imply that severe voluntary exclusion procedures are maintained for the donors; similar measures are also valid for malaria prevention.
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PMID:[Transmissible diseases through the intermediary of transfusions]. 250 50

Many viruses, bacteria or parasites can survive in stored blood for varying lengths of time. Recipients are therefore exposed to a risk which depends on the prevalence of pathogens in blood donor populations, the clinical and laboratory controls performed in blood transfusion centres and the efficiency of the patient's immune system. Beside the HIV and hepatitis viruses, transfusions may transmit the HTL virus in endemic areas or if the blood donor comes from one of these areas (e.g. the French West Indies), the CMV virus (but only in patients with weak immune defences) and some exotic viruses in specific regions. As regards bacterial agents, syphilis is prevented by blood storage at 4 degrees C for 72 hours and brucellosis remains a minor risk, but the very rare endotoxinic shock is severe and lethal in two-thirds of the cases. Infestation by parasites is common in certain areas, but it may occur in France after transfusion from blood donors coming from these areas; malaria transmitted by blood perfusion is a real problem. Drastic procedures of rejection of blood donors at risk, including examination and laboratory screening, must be applied and are effective in preventing these dangers. These procedures are well-known and are compulsory in France.
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PMID:[Transfusion and transmission of infectious and parasitic diseases excluding AIDS and viral hepatitis]. 255 83

We conducted a cross-sectional study to determine the serological response to malaria in an HIV-1 infected population and in a control population in a region of high malaria transmission. The study group consisted of 66 hospitalized patients with clinical acquired immunodeficiency syndrome (AIDS) and 70 trauma patients without clinical AIDS (controls). Mean optical densities of antibody produced against RESA-4, RESA-8, RESA-11, (PNAN)5 and (NAAG)5 synthetic peptides of Plasmodium falciparum were compared between HIV-1 seropositive and HIV-1 seronegative patients using non-parametric statistics. HIV-1 seropositive patients with clinical AIDS had significantly less antibody to the synthetic P. falciparum ring stage peptide, RESA-8 (P = 0.001), than a comparable group of seronegative patients. Antibody levels were also low for the other ring stage peptides, RESA-4 (P = 0.024) and RESA-11 (P = 0.024). Although not statistically significant, antibody levels among the HIV-1 seropositive trauma patients were higher than among the HIV-1 seronegative trauma patients. During HIV-1 infection, a polyclonal B cell activation may occur as noted in the HIV-1 seropositive trauma patients, but with increased immunosuppression in advanced clinical AIDS, B cell stimulation appears to be diminished. This results in decreased production of malaria antibody.
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PMID:Immunological effects of HIV-1 infection on the humoral response to malaria in an African population. 268 20


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