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

We reported a rare case of Plasmodium vivax malaria who showed findings of disseminated intravascular coagulation (DIC). A 50-year-old Japanese male was sent to our hospital with the diagnosis of Plasmodium vivax malaria on the 26th of April, 1990. He had stayed in the Solomon Islands from Oct. 1987 to Dec. 1989, and had febrile episodes during his stay in the island. On April 18, 1990, he complained of a high fever with chills, and showed the same episodes on the 20th, 22th and was diagnosed as malaria. He was treated successfully with the sulfadoxine 500 mg and pyrimethamine 25mg (Fansidar), following the normal temperature on the 4th day and disappearance of malarial parasites in the peripheral blood smear on the 6th day. Interestingly, he had thrombocytopenia and a high titer serum level of fibrin degradation product (FDP) supporting the questionable diagnosis of DIC. Even on the 12th day after improved thrombocytopenia by treatment with Gabexate (FOY), the serum level of FDP, D-dimer and thrombin-nati-thrombin (TAT)III complex still remained at high titer levels. One month later he was readmitted for a relapse of Plasmodium vivax malaria, when he showed thrombocytopenia but the serum level of FDP, D-dimer, TAT III complex and PM.alpha 2 PI complex were normal levels. We concluded that the thrombocytopenia and the high titer of FDP at his first admission was a manifestation of DIC.
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PMID:[A case of Plasmodium vivax malaria with findings of DIC]. 207 64

We have reviewed 114 episodes of malaria in 110 patients who were admitted to the Infectious Diseases Unit in Leicester during the 5 year period from February 1983-January 1988. There were 71 episodes of vivax malaria (62%), 33 episodes of falciparum malaria (29%), four patients with mixed infection and six patients with negative blood films who were diagnosed on clinical suspicion alone. Most patients presented in the summer months, 68% were aged under 40 years, 39% were born in the Indian subcontinent, 23% in East Africa and 23% in Britain. Eighty-two per cent of patients with falciparum malaria had recently returned from Africa whereas 82% with vivax malaria had visited Asia. Thirty six per cent had been given antimalarial chemoprophylaxis but only half of these took medication correctly. Seventy five per cent of episodes of falciparum malaria presented within 2 weeks of arrival in Britain, however vivax malaria could present at any time and 49% of cases occurred over 3 months after exposure. Presenting symptoms and signs were often non-specific. Twenty nine per cent of patients had been treated with antibiotics and 11% received antimalarials prior to admission. Vivax malaria was generally a mild infection but falciparum malaria was often severe with 39% of patients experiencing complications including one death. Although Plasmodium vivax and P. falciparum are morphologically similar the diseases caused by the two species of parasite are quite distinct. Physicians must ensure that malaria is excluded in anyone who has travelled to an endemic area.
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PMID:Malaria in Leicester 1983-1988: a review of 114 cases. 218 Oct 23

Parasitological and entomological parameters of malaria transmission were monitored for 17 months in 3,625 residents in a Plasmodium vivax malaria endemic region in southern Sri Lanka; the study area consisted of 7 contiguous villages where routine national malaria control operations were being conducted. Malaria was monitored in every resident; fever patients were screened and 4 periodical mass blood surveys were conducted. An annual malaria incidence rate of 23.1% was reported during the period: 9.3% was due to P. vivax and 13.8% was due to P. falciparum; there had been a recent epidemic of the latter in this region, whereas the P. falciparum incidence rate in the previous 10 years had been negligible. There was a wide seasonal fluctuation in the malaria incidence, with the peak incidence closely following the monsoon rains. The prevalence of malaria due to both species detected at the 4 mass blood surveys ranged from 0.98% (at low transmission) to 2.35% (at peak transmission periods). Adults and children developed acute clinical manifestations of malaria. Entomological measurements confirmed a low degree of endemicity with estimated inoculation rates of 0.0029 and 0.0109 (infectious bites/man/night) for P. vivax and P. falciparum, respectively. Several anopheline species contributed to the transmission, and the overall man biting rates (MBR) showed a marked seasonal variation. Malaria at Kataragama, typical of endemic areas of Sri Lanka, thus presents characteristics of "unstable" transmission. Malaria was clustered in the population. There was a low clinical tolerance to P. falciparum malaria, to which most had only been at risk, compared to P. vivax, to which most had had a life-long exposure.
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PMID:Characteristics of malaria transmission in Kataragama, Sri Lanka: a focus for immuno-epidemiological studies. 218 88

Two soldiers continued weekly prophylaxis with 300 mg chloroquine base on their return to Australia from Papua New Guinea but were not protected against Plasmodium vivax malaria. Both had symptoms and parasitaemia although plasma concentrations of chloroquine were considerably higher than those regarded as adequate for suppression of vivax malaria. Parasitaemia did not clear after one of the patients was treated with 600 mg chloroquine base. The results suggest the emergence of strains of P vivax with a reduced susceptibility to chloroquine.
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PMID:Plasmodium vivax resistance to chloroquine? 257 3

Phenotypic heterogeneity in the repetitive portion of a human malaria circumsporozoite (CS) protein, a major target of candidate vaccines, has been found. Over 14% of clinical cases of uncomplicated Plasmodium vivax malaria at two sites in western Thailand produced sporozoites immunologically distinct from previously characterized examples of the species. Monoclonal antibodies to the CS protein of other P. vivax isolates and to other species of human and simian malarias did not bind to these nonreactive sporozoites, nor did antibodies from monkeys immunized with a candidate vaccine made from the repeat portion of a New World CS protein. The section of the CS protein gene between the conserved regions I and II of a nonreactive isolate contained a nonapeptide repeat, Ala-Asn-Gly-Ala-Gly-Asn-Gln-Pro-Gly, identical at only three amino acid positions with published nonapeptide sequences. This heterogeneity implies that a P. vivax vaccine based on the CS protein repeat of one isolate will not be universally protective.
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PMID:Circumsporozoite protein heterogeneity in the human malaria parasite Plasmodium vivax. 267 36

Two randomised double-blind trials were conducted to examine the activity and tolerability of mefloquine alone and in combination with sulfadoxine/pyrimethamine (MSP). In one trial mefloquine was compared with chloroquine in 40 patients with Plasmodium vivax malaria and in the other one mefloquine was compared with MSP in 40 patients with P falciparum malaria. The former trial showed that both a single oral dose of 250 mg mefloquine and a single oral dose of 450 mg chloroquine (base) were highly effective in relieving symptoms of malaria and in clearing P vivax parasitaemia. No side-effects and no changes in laboratory variables attributable to the test drugs were observed. The other trial showed that a single oral dose of 750 mg mefloquine and a single oral dose of MSP (750 mg mefloquine plus 3 tablets of 'Fansidar', were equally effective in the treatment of falciparum malaria. 2/4 treatment failures in the mefloquine group and 2/3 treatment failures in the MSP group were due to low plasma drug levels resulting from vomiting soon after ingestion of the tablets. Gametocytes of P falciparum were unaffected by either mefloquine or MSP. 5 patients in each group had side-effects such as vomiting, skin rash, diarrhoea, and transient mental confusion. Mefloquine was well tolerated by patients with glucose-6-phosphate dehydrogenase deficiency or heterozygous haemoglobin E.
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PMID:Trials of mefloquine in vivax and of mefloquine plus 'fansidar' in falciparum malaria. 285 43

Immunity to malarial infections in human populations is known to affect the development of the asexual blood stages of the parasites in the human host and to be capable of conferring significant protection against morbidity and mortality due to the disease. In this study we show that during acute infection with Plasmodium vivax malaria, one of the two main malarial pathogens of humans, most individuals also develop immunity that suppresses the infectivity of the sexual stages of the parasite to mosquitoes. The immunity is antibody mediated and is directed against the parasites in the mosquito midgut shortly after ingestion of blood by a mosquito. This immunity could be expected to have significant effects on the natural transmission of P. vivax malaria.
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PMID:Malaria transmission-blocking immunity induced by natural infections of Plasmodium vivax in humans. 287 93

Natural Plasmodium vivax malaria infections in man evoke anti-gamete transmission blocking antibodies which influence the infectivity of malaria patients to the vector mosquito. In this study, entomological, immunological and parasitological data obtained through the monitoring of an epidemic of human vivax malaria in Sri Lanka were used in a mathematical simulation to assess the effect of naturally induced transmission blocking immunity on malaria transmission. A mathematical model to describe malaria transmission accounting for transmission blocking immunity was developed from the basic differential equations originally stated by R. Ross and the epidemic was simulated using the available data. An attempt was made to predict the monthly malaria incidence by means of the mathematical simulation, with and without accounting for transmission blocking immunity. A plausible mathematical solution of the epidemic could be obtained when transmission blocking immunity was accounted for, and it was not possible to obtain such a plausible solution in the absence of immunity. Thus, the postulated occurrence of transmission blocking immunity was essential to describe adequately this malaria epidemic, indicating that, at least in epidemic situations, naturally occurring transmission blocking immunity has a controlling influence on malaria incidence.
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PMID:Modulation of human malaria transmission by anti-gamete transmission blocking immunity. 307 11

Human neutrophil elastase (HNE) has been well-studied with respect to its role in pathologic states, but less is known about the physiologic functions of this important granulocyte enzyme. In the present study, we show that HNE can degrade the major circumsporozoite protein of the infective (sporozoite) stage of Plasmodium vivax malaria, and that this enzyme can also interfere with the cytoadherence of human E infected with Plasmodium falciparum (strain K+ FMG-FCR3) (IE). Cytoadherence reactions are not only blocked by treatment of IE with as little as 10 fg HNE/IE, but already adherent IE are also removed by the enzyme. Normal E surface Ag are not extensively destroyed by these doses of HNE. This suggests that the effect of HNE on cytoadherence is selective and probably due to degradation of the malarial Ag exported to the IE surface and responsible for the formation of "recognition knobs" upon which the cytoadherence reaction depends. This conclusion, in turn, was supported by the results of Western blot analysis showing that HNE degrades a high m.w. Ag found exclusively in membrane extracts of IE. Our results suggest that one physiologic role of HNE may be degradation of parasitic antigens during host defense against malaria.
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PMID:Degradation of plasmodial antigens by human neutrophil elastase. 329 93

An analysis of records of 494 malaria patients admitted to the General Hospital in Colombo (the capital of Sri Lanka where malaria transmission is not known to occur) from 1981 to 1984 is presented and compared with national malaria data from the entire country. The incidence of predominantly Plasmodium vivax malaria rose sharply over the 3 years; its species distribution and seasonal variation in patients in the General Hospital, Colombo (GHC) generally reflected the disease pattern in the country as a whole. The disease had spread from mainly the endemic dry zone to the non-endemic wet zone. Malaria patients at the GHC were mainly residents of Colombo who had acquired malaria during brief visits to endemic areas, and we have demonstrated how information from them can be used as a sampling method to obtain almost immediate epidemiological information from the whole country. Based on the histories of selected patients we deduced the incubation periods and possible relapse patterns of P. vivax infections in Sri Lanka. This study also provided an insight to the epidemiology of the disease in the city.
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PMID:A metropolitan hospital in a non-endemic area provides a sampling pool for epidemiological studies on vivax malaria in Sri Lanka. 331 15


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