Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The diagnosis of post-kala-azar dermal leishmaniasis (PKDL), a dermatosis that provides the only known reservoir for the parasite Leishmania donovani in India, remains a problem. Timely recognition and treatment of PKDL would contribute significantly to the control of kala-azar. We evaluated here the potential of the enzyme-linked immunosorbent assay (ELISA) as a diagnostic tool for PKDL. Antigen prepared from promastigotes and axenic amastigotes with parasite isolates that were derived from skin lesions of a PKDL patient gave sensitivities of 86.36 and 92%, respectively, in the 88 PKDL cases examined. The specificity of the ELISA test was examined by testing groups of patients with other skin disorders (leprosy and vitiligo) or coendemic infections (malaria and tuberculosis), as well as healthy controls from areas where this disease is endemic or is not endemic. A false-positive reaction was obtained in 14 of 144 (9.8%) of the controls with the promastigote antigen and in 14 of 145 (9.7%) of the controls with the amastigote antigen. Evaluation of the serodiagnostic potential of recombinant k39 by ELISA revealed a higher sensitivity (94.5%) and specificity (93.7%) compared to the other two antigens used. The data demonstrate that ELISA with crude or recombinant antigen k39 provides a relatively simple and less-invasive test for the reliable diagnosis of PKDL.
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PMID:Evaluation of enzyme-linked immunosorbent assay for diagnosis of post-kala-azar dermal leishmaniasis with crude or recombinant k39 antigen. 1187 80

The Proceedings here reviewed are those of the meeting held in Geneva in October, 1983, which led to the establishment of the World Health Organization's Program for the Accelerated Development of New Vaccines. These papers reflect the state of the art in the development of vaccines for cholera, leprosy, pertussis, salmonella, shigella, dengue, foot-and-mouth disease, hepatitis B, herpes simplex, influenza, poliomyelitis, Chagas' disease, malaria, and schistosomiasis. The identification and isolation of epitopes and other antigenic fragments is presented, as well as considerations of mucosal immunity, antigenic determinants and antigenic variations, antigen presentation and T-cell activation, the use of anti-idiotypes as antigens, the development of recombinant viruses for use in vaccines, and the use of circumsporozoite antigens in the preparation of a malaria vaccine.
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PMID:New approaches to vaccine development. Proceedings of a meeting organized by the World Health Organization. Book review. 1222 27

This study in the Institute's intensive field practice demonstration area in India attempted to determine if male health workers at the rate of 1/5000 population can carry out the various activities now being carried out by unipurpose health workers employed by the national malaria, smallpox, family planning, leprosy, and tuberculosis programs. 2 patterns were tried: 1) the workers to carry out all the activities of the various programs simultaneously through house visits at the rate of 40 a day for 6 working days a week, and 2) to do all activities except smallpox vaccination and family planning for 4 days a week with 1 day reserved for smallpox vaccination and 1 day for family planning activities. 23 workers were employed and trained. 9 were assigned to Plan 1, covering 40% of the population of 120,000; 14 under Plan 2 covered the remaining 60%. Survey design is detailed along with job descriptions. In the 1st round the multipurpose workers discovered as many fever cases as the single-purpose malaria workers and in the 2nd round, their performance improved. Performance was slightly better under Plan 2. Smallpox vaccination coverage was slightly better under Plan 1 but the time spent per worker was about double that of Plan 2 and wastage of lymph was nearly 3 times as great as when a separate day was set aside for vaccination. Family planning performance was much better under Plan 1 with 44.5% of high priority couples contacted on round 1 and 33.3% on round 2 compared with 28.2% and 36.4% under Plan 2. It was found that the worker gained effectiveness after he had developed rapport through other health services. There was demand for treatment of side effects and complications resulting from contraceptive use and for treatment of minor ailments among other household members. Quantities of Nirodh condoms distributed was higher under Plan 2. The multipurpose workers were not as effective as single-purpose workers in detecting tuberculosis or leprosy but they can refer suspected cases. It was pointed out that under Plan 2 group meetings could be held and more couples reached but that people were shy about attending group discussions and treatment of minor ailments helped in talking about family planning.
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PMID:Report on the pilot study of multi-purpose health workers (male) in Athoor Block, Madurai District. 1225 31

In order to accelerate welfare and nutrition programs for women and children in tribal, hilly, and backward areas of India, the government of India has accepted the National Program of Integrated Services. Delivery of these services is coordinated by the Integrated Child Development Services (ICDS). The package of services for prenatal women include physical and obstetrical exams; serial recording of weight, blood pressure, hemoglobin, and urinalysis; tetanus immunization; iron (60 mg) and folic acid (.5 mg) tablets; food supplements; identification and referral of high-risk mothers; and health education on antenatal care, breast feeding, child rearing, and family planning. Postnatal women received 2 home visits within 10 days of delivery and make 1 visit after 1 month of delivery. These visits cover general health, breast feeding, delivery records, infant health, and birth control measures. Food supplementation continues for nursing mothers. All women 15-44 years of age receive health and nutrition education. Specially organized courses, campaigns, home visits by anganwadi workers, cooking demonstrations, and mass media emphasize simple messages regarding health and nutrition. Areas that are covered include family welfare; antenatal, intranatal, and postnatal care; breast feeding; immunization; prevention of such common communicable diseases as malaria, tuberculosis, and leprosy; weaning and supplementary feeding; improvement of children's nutritional status; balanced diet; food storage, preparation, cooking, and serving; eye and ear care; personal and environmental hygiene; sanitation; management of acute respiratory infections; management of diarrhea; and control and treatment of internal parasites. The mobile food and extension units of the Department of Food are utilized. Pregnant and nursing mothers belonging to families of landless agricultural laborers, of marginal farmers, of the scheduled caste, of the scheduled tribe, and of poorer sections of the community are chosen for this program. Special care is given to pregnant women who: are pregnant for the 1st, 3rd, or 4th time; have gained less than 6 kg; are younger than 18 or older than 35; have had frequent or twin pregnancies; have a history of miscarriage or preterm delivery; are anemic; or have a history of edema, hypertension, or seizure. Personnel, who are monitored, receive training supplemented by reorientation and continuing education.
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PMID:Health and development of mothers through system of ICDS. 1228 36

The World Health Organization (WHO) estimates of AIDS cases in Africa are based on the results of trials using the two main HIV serodiagnostic tests: the ELISA and the Western Blot. Some AIDS specialists believe that these tests are not accurate enough to confirm HIV positivity. In fact, they may be most meaningless in Africa because the widespread ill-health there contributes to false positive reactions. Malnutrition and associated chronic diseases are the key causes of ill-health in Africa. The US Centers for Disease Control and Prevention considers the ELISA to be only a screening test to detect suspicious blood samples and not a confirmatory test. In the US, the Western Blot is used as a confirmatory test. False positives could be avoided if scientists could use a suitable gold standard (i.e., HIV isolation). Yet HIV has yet to be unequivocally isolated. In fact, according to Neville Hodgkinson, the entire HIV story might be a monumental error. In Africa, due to cost considerations, most people are diagnosed with HIV based on the findings of a single test. Yet many supposedly HIV-infected persons may actually be suffering from influenza, malaria, or malnutrition, all of which can produce positive HIV results. During the second half of the 1980s, there was no public acknowledgment of inadequacies in the HIV test. In 1994, a professor of public health at Harvard, scientists at the University of Kinshasa, and the health ministry in Zaire found that a supposed association with leprosy and HIV infection as detected by the ELISA was actually due to false positives. When they retested using the Western Blot and radioimmunoprecipitation analysis, the number of the 57 leprosy patients found to be HIV positive fell from 37-41 to 2 and the number of contacts found to be HIV positive fell from 9-12 to 0. An non-validated test (i.e., ELISA) has technical problems and pitfalls in interpretation and is vulnerable to shipping, climatic and storage conditions, and subject to unmeasured and immeasurable cross-reactivities, and may give false positive results.
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PMID:AIDS -- how false positives affect Africa. 1229 88

A UNDP/World Bank/WHO Special Program for Research and Training in Tropical Diseases (TDR) expert meeting has concluded that the means already exist with which to eliminate 4 of the 8 diseases which TDR originally identified as public health problems. Elimination in this case refers to reducing the number of cases of disease to a small and routinely manageable number. The diseases capable of being eliminated with existing tools are leprosy, onchocerciasis, lymphatic filariasis, and Chagas disease. Leprosy can be eliminated through the use of multidrug therapy, onchocerciasis through the administration of ivermectin, lymphatic filariasis through the use of DEC and ivermectin, and Chagas disease through the rational use of insecticides and the control of blood banks. Malaria, schistosomiasis, leishmaniasis, and African trypanosomiasis, however, must await better tools before their elimination can be attempted. TDR's role in identifying how to eliminate each of these diseases is described. Meeting attendees identified additional avenues of operational research upon which TDR should embark.
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PMID:Four TDR diseases can be "eliminated". 1229 16

This article presents an overview of the health situation in Bihar for the last 50 years. Although demographic improvements have been noted in the past years, the incidence of various diseases remains high and socioeconomic status low in Bihar. Protein-energy malnutrition, nutritional anemia and blindness are common. Safe drinking water and sanitary facilities are still not available to a large number of people. Furthermore, a number of communicable diseases are prevalent in the country. This is exemplified in the Kala-azar or visceral leishmaniasis epidemic in 1992, which reported 75,523 cases and 1417 deaths. Kala-azar cases have started rising again since 1996, and it is estimated that there might be another epidemic in the first decade of the 21st century if the situation is allowed to continue. Other infectious diseases, which threaten the health situation in Bihar, are malaria, tuberculosis, leprosy, and HIV/AIDS. Moreover, population and decadal growth rate have more than doubled over the last 40 years. Maternal mortality remains very high, but survival chances of children have increased due to immunization and other programs. In general, it was demonstrated that the present health situation in Bihar is a matter of grave concern, and requires an urgent solution.
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PMID:Health in Bihar -- an overview. 1229 96

About 53 million people (8% of the population) of India belong to various tribes in about 400 tribal communities. These groups live in different ecological geoclimatic conditions throughout India ranging from the Sub-Himalayas to the islands in the Bay of Bengal and in the Arabian Sea. They also differ in distinct biological traits and cultural and socioeconomic background. Due to cultural patterns which vary from tribe to tribe, they are all at different stages of social, cultural, and economic development. Since the tribes live in isolated and inaccessible areas, it is hard to implement health care and nutrition activities, elementary education, and preventive promotive health care. The government does plan to provide rural day care for 0-3 year old children. The Integrated Child Development Services (ICDS) Scheme reaches 2197 of 5143 tribal development blocks. ICDS activities include immunization of children and mothers, health education, and supplementary nutrition. The government also promotes primary health care in tribal areas. Despite these efforts, child welfare and development in tribal areas have not improved. Recently nongovernmental organizations have joined child welfare and development efforts in tribal areas. The Jigyansu Tribal Research Center has compiled a long list of recommendations to improve child welfare and development efforts in tribal areas including improving preventive activities especially those that target specific local diseases such as cerebral malaria and leprosy, introduction of traditional herbal medicines, and comprehensive data collection.
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PMID:Care and development of children in tribal areas. 1231 87

Since its establishment in 1979, the Kenya Medical Research Institute (KEMRI) has been one of the partner agencies working with the UN Development Program/World Bank/World Health Organization Special Program for Research and Training in Tropical Diseases (TDR). KEMRI consists of a secretariat and eight separate research centers devoted to alupe leprosy and skin diseases; biomedical, clinical, virus, microbiology, and medical research; vector biology and control; and traditional medicines and drugs. KEMRI also has a model clinic, an animal house, a library, a conference area, and a computer center serving 250 technical staff and 600 administrative staff. TDR has supported about 30 trainees, and KEMRI conducts research programs on all TDR diseases except trypanosomiasis, which is the responsibility of a sister institution. KEMRI's malaria research focuses on the vector, on control through the use of bednets impregnated with insecticide, and on clinical management. KEMRI is currently researching development of hard-wearing and cheaper bednets and alternatives to chloroquine. TDR has provided funding for KEMRI studies that focus on schistosomiasis treatment, prevention, and control; the distribution and impact of filariasis as well as treatment with ivermectin and anthelminthics; and control and treatment of leishmaniasis. Research into leprosy is seeking better drugs, better diagnostic tools, and ways to increase patient treatment compliance.
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PMID:In sickness or in health: TDR's partners. 8. Kenya Medical Research Institute (KEMRI). 1232 4

In this paper, the etiological factors affecting infertility among the Azande tribe of Central Africa are reviewed. Of those factors reviewed, including venereal disease, leprosy, sleeping sickness, endemic goitre, nutrition, voluntary contraception, and malaria none is sufficient to account for a lowering in the fertility rate. The data collected is estimated to be accurate but very limited. The author, however, concludes that there is 1) a low child/adult ratio; 2) a marked female preponderance; and 3) a high infant and child mortality rate. Finally, the people of the tribe are reproducing themselves, though not so prolifically as their former preponderance in this region, or comparison with fertility levels in neighboring tribes, would lead one to expect.
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PMID:Dearth of children among the Azande: preliminary report. 1233 86


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