Gene/Protein Disease Symptom Drug Enzyme Compound
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Concurrently with the development of the general health services infrastructure in India, serveral special health programs were instituted at the national level to provide a massive and concentrated assault on the major public health problems of malaria, smallpox, cholera, trachoma, tuberculosis, leprosy, filariasis, and the rapid population growth. These vertical programs were expected to reduce the heavy morbidity and mortality within the shortest possible time to where they were no longer major public health problems. The impact was variable. Major steps toward providing integrated health care were taken during the first 5-year plan. Emphasis was on the provision of a packet of inttegrated health, family planning, and nutrition services to the vulnerable groups, i.e., children, pregnant women, and nursing mothers. To rectify past shortcomings ssuch as the failures of the national health programs, ineffective coordination in the nutrition programs, and slow rate of development as a result of interdependence of different sectors, it was necessary to improve the health infrastructure and to launch a frontal attack on poverty. The Multipurpose Health Workers Scheme was planned to rationalize the organization and use of available manpower to reduce the area and population covered by each of the field staff in order to reduce travel time and to make services more effective and more satisfactory. Each multipurpose health worker was entrusted with the task of providing comprehensive health care to about 5000 people. Communicable diseases were the main public health problems, and many specific control/eradication programs were launched. the immunization programs against common childhood diseases have not taken deep roots and coverage continues to be poor. The adoption of the Western model of medical services has resulted in emphasis on "cure" rather than on "care". Another problem is maldistribution of the facilities. Overemphasis on medical education has resulted in the relative neglect of development of health manpower for nursing, environmental engineering, and other technical and paramedical personnel. Community involvement and participation were at a minimum if they existed at all. The basic concern about primary health care for all continued unabated however. To realize the goal of health care for all, 3 programs will have to be pursued simultaneously during the next 2 decades: integrated overall development including family planning; improvement in nutrition, environment, and health education; and the provision of adequate health care services for all, particularly the poor and underprivileged. It is necessary to redefine the roles of the central and state governments in view of the large power powers delegated to local bodies at the district level and below. Voluntary agencies will have to function within the overall plan/aid down by the state.
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PMID:Primary health care in India. 704 59

A survey is given of the occurrence of communicable diseases in the Federal Republic of Germany including Berlin (West) in 1979. The epidemiological situation was dominated by salmonellosis, infectious hepatitis, scarlet fever, and meningitis. There was a striking increase in imported tropical diseases, such as malaria and leprosy. Poliomyelitis continued to decrease. There was an insignificant number of influenza cases in the winter 79/80. Due to the coming into force of the Amendment of the Federal Communicable Diseases Act on 1 January 1980 the obligation to notify communicable diseases has been changed in some respects. Moreover, the statistical data on communicable diseases have been collected and published only quarterly.
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PMID:[The epidemiologic situation of infectious disease in West Germany in 1979]. 721 10

Singapore, located in South-east Asia, enjoys a high standard of health care. However, certain diseases are still of major concern to the health authorities, who feel these could be more easily controlled if the public were more aware of their modes of transmission. A "Combat infectious diseases" campaign was therefore launched to educate the public on food-borne diseases (cholera, enteric fever), malaria, dengue/dengue haemmorrhagic fever, leprosy, tuberculosis, and sexually transmitted diseases (syphilis, gonorrhoea). Educational activities in the form of talks, film shows and exhibitions in schools, community centres and other institutions were carried out over a 15-month period. This paper analyzes some of the factors which affected the results of the campaign, as revealed by a health survey conducted in a selected lower-middle income urban community, where sub-groups of the adult population (aged above 15) were tested to assess their health knowledge. Findings indicate that educational level, age of respondents and language proficiency--four languages are used in Singapore--seem to be the three variables that affect the likelihood of the respondents' receptivity to campaign information.
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PMID:Factors influencing the outcome of health campaigns: a case study in Singapore. 746 67

Recent studies have identified genes involved in resistance to intracellular pathogens. Such genes include the murine MHC class I gene, Ld (toxoplasmosis), HLA-BW53, HLA DRB1* 1302-DQ B10s01 and TNF2 (malaria), murine Nramp (toxoplasmosis, leishmaniasis and tuberculosis), gene(s) modulating the T-helper type 1 and type 2 dichotomy (leishmaniasis, leprosy and HIV infection) and the natural killer cell complex (cytomegalovirus infection). There also have been other advances in immunogenetics that have led to a better understanding of resistance to intracellular pathogens. These include effector mechanisms of immune response genes and factors modulating genetic susceptibility. Identification of genes that determine resistance/susceptibility (and their effector mechanisms) has impacted on vaccine development. Immunogenetics has been important in characterizing roles of TCR genes, superantigens, and host genes that play a role in molecular mimicry in disease pathogenesis. In addition, recent work with gene knockout, recombinant inbred or congenic, mutant, consomic, and transgenic mice, positional cloning, mouse/human gene homologies to identify candidate human resistance genes, and the rapid expansion of the gene transcription maps of the human genome, have been important in analysis of resistance to intracellular pathogens.
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PMID:Immunogenetics in the analysis of resistance to intracellular pathogens. 749 19

The European-American exchange of infectious diseases was responsible for the demographic havoc of the native population in the New World after 1492. Prior to this date medical writers describe the presence in Spain of viral diseases like influenza, parotitis, smallpox, measles, poliomyelitis, and rabies; there were also rickettsiasis, diphtheria, salmonellosis, plague, tubercolosis, leprosy, malaria, scabies and tinea. In America, before European arrivals, there were no records of human viral diseases, though there were records of rickettsiasis, treponematosis--pinta, yaws and syphilis--leihsmaniasis, amibiasis and perhaps leprosy. With the discovery of America in 1492, Columbus's sailors were contaminated by yaws and spread this disease into Europe. In 1493 influenza, as a zoonosis, was introduced into Santo Domingo and was responsible for the annihilation of the natives of the Antilles in less than a quarter of a century; in 1518 smallpox was also introduced in Santo Domingo and then to the American continent by negro slaves: by the same means measles were introduced in 1531. The previous existence or introduction of other infectious diseases in America is also discussed.
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PMID:The European-American exchange. 752 30

Dapsone is used to treat several systemic inflammatory diseases, many of which have head and neck manifestations, such as leprosy, systemic lupus erythematosus, rhinosporidiosis, relapsing polychondritis, dermatitis herpetiformis, pemphigus vulgaris and bullous pemphigoid. It has also been recently used prophylactically alone or in combination against malaria and in AIDS patients against Pneumocystis carinii infections. This is significant to the otolaryngologist-head and neck surgeon since approximately 40% of AIDS patients will have head and neck manifestations. Thus, the likelihood that otolaryngologists will be treating patients who are taking dapsone regularly is significant. We present a case of a 16-year-old female who presented with a presumptive diagnosis of discoid lupus for biopsy confirmation of her disease. Induction of general anesthesia was complicated by methemoglobinemia, an uncommon side effect of dapsone. We will discuss recognition and prevention of this side effect, its potential anesthetic implications, complications and treatment.
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PMID:Dapsone-induced methemoglobinemia: an anesthetic risk. 755 44

Leishmaniasis is a spectrum of diseases ranging in severity from cutaneous (CL), post-kala-azar dermal (PKDL), and diffuse cutaneous (DCL) to mucocutaneous (MCL) and visceral (VL) infections that are endemic in 86 tropical and subtropical countries around the world, accounting for 75,000 deaths per year. Different forms of leishmaniases are generally caused by different distinct species of Leishmania having a digenetic life cycle alternating between an aflagellated amastigote form replicative within the macrophages of the host and a flagellated promastigote form that multiplies within the gut of the sandfly. VL, MCL, PKDL, DCL, and CL forms of the disease can be arranged on a priority basis in accordance with the humoral immune responses of host. Generally, the cell-mediated immunity, particularly the delayed-type hypersensitivity to leishmanial antigens, is associated with CL, MCL, PKDL, and cured VL cases. The serodiagnosis of leishmaniasis appears to be an alternative to parasite detection in biopsy samples either by the staining of amastigotes or by culturing the amastigotes, which transform to a promastigote form and replicate. A battery of immunological procedures have been developed or adapted to demonstrate either humoral or cell-mediated immune responses against Leishmania for diagnosis and epidemiological survey. The sensitivity and specificity of such diagnostic methods depend on the type, source, and purity of antigen employed, as some of the leishmanial antigens have common cross-reactive epitopes shared with other microorganisms, particularly Trypanosoma, Mycobacteria, Plasmodia, and Schistosoma. Serodiagnostic techniques for the detection of antileishmanial antibodies have been employed with about 72 to 100, 23 to 90, 83, and 33 to 100% success in VL, CL, MCL, and PKDL patients, respectively. The Leishmanin skin test (LST) is useful to detect MCL and CL, with about 100 and 84% success, respectively. In PKDL, the gradual fall of antileishmanial antibody titer to some extent and the rise of delayed hypersensitivity to the parasite antigen are the characteristic features associated with the chronicity of the disease. The use of whole promastigote as the source of antigens in the direct agglutination test (DAT) and immunofluorescent test (IFAT) gave cross-reactions with the sera of leprosy, tuberculosis, and African trypanosomiasis patients. Again, the use of cell-free extracts of promastigotes generally gave false positive results with the sera of normal human and Chagas' disease, leprosy, tuberculosis, and malaria patients in enzyme-linked immunosorbent assay (ELISA), dot ELISA, immunodiffusion, immunoelectrophoresis, and counter-current immunoelectrophoresis tests.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Serodiagnosis of leishmaniasis. 763 32

An easy, inexpensive and rapid indirect immunoperoxidase assay for serodiagnosis of Kala-azar (VL) has been tried using whole promastigotes of L. donovani in dried smear form as antigen. A total of 138 sera were tested including sera from parasite positive cases of VL (32), normal controls from endemic (20) and non-endemic (20) areas, cases of tuberculosis (10), leprosy (10), amoebic hepatitis (10), malaria (10) and tropical splenomegaly (26). All the positive control sera were positive in very high dilutions of serum ranging from 1/500 to 1/64,000. None of the sera with other diseases were positive by this method except 3 cases with tropical splenomegaly were positive in low titres. No other cause could be established in these cases for splenomegaly. Sensitivity and specificity of the test were found to be 100 and 95.3% respectively. Predictive values of the negative and positive tests were 100 and 86.5% respectively.
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PMID:An indirect immunoperoxidase assay for rapid serodiagnosis of visceral leishmaniasis. 789 12

The English-speaking Caribbean is in transition toward communicable disease health patterns seen in the more developed world. Structural adjustment policies in recent years have weakened control measures, such as water supply and sanitation, as illustrated by recent outbreaks of typhoid fever in Jamaica (1990-1991), increased malaria incidence in Suriname and Guyana (with temporary importation into southern Trinidad in 1991), an upswing in tuberculosis in some countries, and the occurrence of cholera outbreaks in Belize, Suriname, and Guyana. The emergence of epidemic cholera throughout most of Latin America in 1991, and Caribbean mainland countries in 1992, aroused concern. Deteriorating socioeconomic conditions and the consequent communicable disease risk underscored the absence of communicable disease control in the Caribbean Cooperation in Health (CCH) strategy which was adopted in 1986 by the countries of the Caribbean Community. The Caribbean Epidemiology Center (CAREC) offered the following analysis: At least four out of seven CCH priorities already directly address critical aspects of communicable disease control, and therefore the question arises whether communicable disease control should be recognized as an explicit CCH priority. Beyond cholera and the diseases already represented in the CCH strategy, there are only a few other communicable diseases that warrant specific attention at this time: tuberculosis; leprosy, which CAREC member countries may want to eradicate; and leptospirosis, a zoonosis (communicable disease of animals transmissible to humans) thought to be the most frequent disease of this type in the Caribbean. These three conditions are insufficient to justify a distinct communicable disease grouping within CCH. However, if all communicable diseases of public health importance were to be grouped together (AIDS/STD, vaccine-preventable diseases, food- and waterborne diseases, vector-borne diseases), such a group would be important enough to justify a distinct priority category, with several major subcategories.
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PMID:Communicable disease control as a Caribbean public health priority. 801 35

An immunological test based on indirect (plate) ELISA has been successfully standardized and modified using promastigote soluble antigen. The test carried out on 813 subjects from a kala-azar endemic area (including parasitologically confirmed patients, subjects presenting with clinical symptoms of visceral leishmaniasis and endemic controls) and a non-endemic area (with diseases other than kala-azar and apparently normal subjects) was found to detect, specifically, antileishmanial antibodies. The plate ELISA has been simplified to a more sensitive dot-ELISA where the results are read within 2-3 h. The antigen requirement is 250 ng per test. No cross-reactivity with sera from patients of malaria, tuberculosis, leprosy, amoebiasis and filariasis was observed. The follow up monitoring of antibodies in successfully treated kala-azar patients showed a decline of antibodies. A drop of blood taken on filter paper is sufficient to conduct the test. Dot ELISA therefore is a simple, inexpensive and stable test in serodiagnosis of visceral leishmaniasis.
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PMID:Evaluation of enzyme-linked immunosorbent assay in the diagnosis of kala-azar in Malda district (West Bengal). 814 6


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