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

The children of 50 women positive for antibody to human immunodeficiency virus type 1 (HIV-1) and 42 children of antibody-negative mothers were examined for lymphadenopathy and hepatosplenomegaly at 3-month intervals during the 1st year of life. Lymphadenopathy was found to be significantly more frequent at 6 months (p less than 0.01), 9 months (p less than 0.001) and 12 months (p less than 0.01) in children who were subsequently shown to be infected with HIV-1. Hepatomegaly was seen more frequently (p less than 0.05) in the 1st year in HIV-1-infected children than in uninfected children. Splenomegaly was not more frequent in HIV-1-infected children in this area which is holoendemic for falciparum malaria.
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PMID:Lymphadenopathy and hepatosplenomegaly in the 1st year in children infected by HIV-1 in Zaire. 138 91

The "eradication of malaria" in Taiwan was announced by WHO in 1965. From 1966 to 1989, 919 malaria cases were detected in Taiwan. Of these cases, 803 were classified as imported malaria. During 1977 to 1989, our hospital collected 11 cases of imported malaria, 6 of Plasmodium falciparum (PF), including 1 suspicious case, 2 of Plasmodium vivax (PV), 1 of mixed infection (PF plus PV), and 2 unclassified. Most of the patients presented clinically with fever and chills. Hepatosplenomegaly was the most common abnormal finding during the physical examination. Jaundice and anemia occurred in the more severe cases. No cases had lymphadenopathy which is helpful in making a differential diagnosis. Six cases had thrombocytopenia which may be considered as an indirect sign in the diagnosis. The MCV levels were within normal limits in all of the cases. This may indirectly imply a potential protective effect against malaria infection in cases of congenital hemoglobinopathy such as thalassemia or G6PD deficiency. Initially, 10 cases were given "standard treatment", which consisted of chloroquine 450 mg qd for 2 days then 300 mg qd for 2 days and primaquine 15 mg qd for 2 weeks. Four cases of chloroquine resistance were encountered, all in cases with PF infection. Two cases were grade I delayed type resistance and were successfully treated with Fansidar, tetracycline and quinine. Two cases were grade II resistance and presented clinically as cerebral malaria. Intravenous quinine was given plus Fansidar and tetracycline. The cases were resolved without sequele or recurrence. None of the cases, except for 2, received chemoprophylaxis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Imported case of malaria in Taiwan: analysis of 11 cases]. 167 9

Identifying the incubation period of HIV infection is important for individual prognoses, for developing and testing intervention strategies, for determining the reproductive rate of the disease, and for prevalence of the disease. Mathematical modeling of HIV infection in Africa is necessitated because the disease is more widespread and the immune system is constantly active due to the exposure to diseases such as malaria and tuberculosis. The Markov model for this analysis was selected because parametric estimation is not based on the time a stage is entered, but on the duration between observations and the stages at the time of observation. The HIV infected female prostitutes in the Pumwani area of Nairobi, Kenya (a population primarily of Tanzanian origin) have been identified as a study population since 1985, and seen every 6 months in clinic, or as needed. Data are constricted by the movement out of the area in the end stage of disease, which is only partially solved by tracking with community health workers. The stages identified in incubation estimation are stage 1: seropositive but symptom free (CDC stage II); stage 2: generalized lymphadenopathy (CDC stage III); stage 3: symptomatic disease (CDC stage IV); and stage 4: death. Data reflect the movement back and forth between stage 1 and 2, between 2 and 3, so the model is not a pure Longini model but rather a timed homogeneous staged model with reversible stages called transition parameters computed in a numerical differentiation. The Fortran computer program for the analyses is available from the authors. The results suggest a quick transition between seroconversion and lymphadenopathy (2.4 months) and unlikely reversal, with the mean waiting time until passage to stage 3 is approximately 2.6 years and conversions are common. Since opportunistic infections are treatable, this makes sense. Assuming a correct model, the estimation of the transition time of 20 months of h34 value of .01 and .05, the mean passage time from stage 1, 2, 3 to 4 (death) is 9.1, 8.9, and 6.2 years 12.9, 12.7, and 10.1 years respectively. The implications are that 1) when infectiousness is hypothesized to be not uniform, peak infectivity occurs earlier in Africa than in the West at least among prostitutes, or 2) if infectivity is constant throughout the incubation period, then HIV transmission must be higher in Africa to explain the high rate of infection.
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PMID:Transition dynamics of HIV disease in a cohort of African prostitutes: a Markov model approach. 217 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

About 120,000 infants are born each year with sickle cell disease (SCD) in Africa. The majority have Hb SS, but Hb SC and Hb S/beta+ thalassaemia are common in west Africa. The development of Plasmodium falciparum and P. malariae is partially inhibited in the Hb SS red cells, but malaria precipitates both haemolytic and infarctive crises, and is the commonest and most important cause of morbidity and mortality. The pneumococcus is likely to be the second major infectious cause of sickness and death. In one rural community, there were less than 2% of the expected number of subjects with SCD surviving beyond 5 years of age. Genetic factors improving prognosis include (1) the Senegal beta chain haplotype, which is linked to a high level of Hb F, and (2) alpha+ thalassaemia. Of environmental factors improving prognosis, the family is of first importance. The commonest age of presentation is 1-3 years. Children present with anaemic crises (malaria, splenic sequestration, folate deficiency, and possibly aplastic), infarctive crises (hand-foot syndrome, bone-pain, pulmonary and abdominal) or acute infections (malaria, pneumonia, septicaemia, meningitis, osteomyelitis). Tragically, many patients in central Africa have been infected by the human immunodeficiency virus (HIV) through blood transfusions; they present with generalised lymphadenopathy and other features of the acquired immunodeficiency syndrome (AIDS). The principles of management are (1) to ensure freedom from malaria, (2) to continue folic acid supplements, (3) to give blood transfusions only when anaemia endangers life, (4) to control pain, (5) to restore hydration, and (6) to prescribe broad spectrum antibiotics in large dosage and without delay, but only when there are definite indications, such as fever (greater than 39 degrees C), acute pulmonary disease, meningitis, and acute osteomyelitis. The advent of HIV and AIDS makes the control of SCD of even greater importance. Principles of control are (1) early diagnosis through appropriate laboratory techniques and selective screening, (2) education of parents, patients, health professionals and public, and (3) the maintenance of health at sickle cell clinics; measures must include antimalarial prophylaxis. SCD programmes should be integrated with primary health care and AIDS control programmes.
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PMID:The presentation, management and prevention of crisis in sickle cell disease in Africa. 265 Jul 73

2 cases are reported from Nigeria of patients with illnesses compatible with a diagnosis of AIDS, but whose serum was HIV-negative. The 1st patient had Kaposi's sarcoma and cervical lymphadenopathy. The 2nd patient had lymph node tuberculosis and generalized lymphadenopathy. The 1st patient had had intramuscular injections for malaria at a local pharmacy, and the 2nd patient had received a blood transfusion after an appendectomy. They may have been infected with HIV-related but antigenically distinct retroviruses.
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PMID:Deaths from AIDS-like illnesses in west Africans. 323 78

Tuberculin tests were carried out on 400 adults with established tuberculosis and 200 apparently healthy adults. There was no significant difference in the tuberculin reactivity amongst those tuberculous patients who were clinically in a poor state and the control group. On the other hand the former reacted less than those tuberculous patients whose general physical state was normal and the difference was significant. Overall 23.75% of the tuberculous patients had negative reactions. Women were less reactive than men. The tuberculin allergy decreased with both age and the extent of tuberculous disease. There was no significant variation in the diameter of the skin test as a function of the number of Koch's bacilli. In tuberculous lymphadenopathy we noted a stronger allergy than in tuberculous disease of other parts of the body. There is a positive correlation between the tuberculin reaction and the Serum Albumin level. Associated morbidity (eg infestations, anaemia, malaria, intestinal schistosomiasis and malnutrition) reduce the tuberculin reaction. These observations reduce the diagnostic value of the intra-dermal tuberculin reaction in our environment.
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PMID:[Diagnostic value of the intradermal tuberculin reaction in the adult, in Zaire]. 372 66

6 Aotus trivirgatus monkeys, which had all spontaneously recovered from an experimentally induced Plasmodium falciparum infection, were included in a clinical study concentrating on possible adverse reactions caused by a vaccine using late schizonts and merozoites as an antigen a synthetic compound, CP-20,961, as an adjuvant. Two monkeys in the study were vaccinated once, 2 twice, 1 received adjuvant alone and 1 served as a saline control. Local and general inflammatory reactions as indicated by local oedema, induration, femoral lymphadenopathy, fever and leukocytosis, were observed in all vaccinated animals and in the one monkey after the second adjuvant injection. Serum albumin and transaminase enzyme levels increased in all animals whereas plasma fibrinogen, protamine sulfate and ethanol gelation titers rose only inthe vaccinated monkeys. A transient increase of alkaline phosphatase and erythrocyte sedimentation rate was noticed in half of them. We conclude that this type of malaria vaccine causes moderate adverse reactions in Aotus but they are transitory and seem not to lead to permanent damage.
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PMID:Plasmodium falciparum merozoite vaccination in Aotus monkeys recovered spontaneously from P. falciparum infection: a clinical study. 675 60

A 27-year old female from Nairobi was admitted to the medical wards of the Kenyatta National Hospital in May 1991. She presented with a 4-week history of productive cough, fever, weight loss, and night sweats. She acknowledged a history of contact with a patient known to have pulmonary tuberculosis. She has never received a blood transfusion. She was single and para 3 + 0. Examination revealed a sick patient, with moderate pallor, fever of 38 degrees Celsius, and who was wasted with moderate dehydration and oral thrush. There was no finger clubbing, lymphadenopathy, or pedal edema. Chest examination revealed bilateral basal pneumonia. The spleen was palpable 4 cm below the costal margin; the liver was not enlarged. The rest of the examination was normal. On admission, complete blood count showed a haemoglobin of 5.4 g/dl, total white cells were 12.5 x 10-9/L, with 82% polymorphonuclear cells and 18% lymphocytes, erythrocyte sedimentation rate (ESR) was 85 mm/hour, and platelet count was normal. The anemia was normocytic, normochromic, and no malaria parasites were seen. Urea and electrolytes and liver function tests were normal. Sputum showed no acid fast bacilli on Ziel-Neelson Stain. HIV-1 antibodies were positive by enzyme-linked immunosorbent assay (ELISA) and Western blot. Bone marrow aspirate revealed a hypercellular marrow with reversed M:E ration, dyserythropoesis, reticulum cell hyperplasia, plentiful golden yellow pigment, and clumps of Histoplasma capsulatum. Chest X-ray showed bilateral basal pneumonia. She was treated with antibiotics and intravenous fluids, but she remained febrile, her general condition progressively deteriorated, and she died a week after admission. Treatment for histoplasmosis had not been commenced, and no postmortem examination was carried out.
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PMID:Disseminated histoplasmosis in a patient with acquired immunodeficiency syndrome (AIDS): a case report. 851 33

A 30-year-old female entered the emergency room for medical advice because of progressive deterioration of general health with headache, arthralgias, myalgias and fever after a vacation of three weeks in Malaysia and Hong Kong. Because of persistent fever, lymphadenopathy, slight leuco- and thrombocytopenia and only insignificantly elevated humoral signs of an inflammatory process, the patient was treated symptomatically after exclusion of malaria. A viral disease was suspected. Two days later, an exanthema erupted suddenly on the trunk. Pinhead-sized livid, flat macules, increasing in size within hours and spreading to the extremities, were observed. Further investigations revealed a significantly elevated titer of IgG directed against rickettsia conorii, leading to the diagnosis of Mediterranean spotted fever. Under antibiotic treatment with tetracycline, the aforementioned findings regressed within few days, and the patient recovered completely.
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PMID:[Febrile status and exanthema following a trip to the jungle]. 869 32


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