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

Malaria remains prevalent throughout tropical and subtropical regions and almost a third of the World's population is exposed to the risk of infection. There is currently a serious resurgence of the disease in Asia and Central America. The failure of global eradication measures based upon the use of insecticides and chemotherapy has resulted from difficulties of practical implementation compounded by the spread of insecticide and drug resistance. Repeated natural infection does not produce detectable resistance to the exo-erythrocytic cycle of malaria in man. Irradiated sporzoite vaccines do, however, induce stage specific immunity in murine malaria and in a proportion of human subjects. Vaccinated individuals remain susceptible to blood stage infection which causes clinical malaria. In addition the vaccine is unstable and must be administered by intravenous inoculation. Since neither sporogonic nor exo-erythrocytic parasite development is cyclical in human malarias, there is little prospect for vaccine production through cultivation of these stages. The inhabitants of hyperendaemic areas become increasingly resistant to malaria during childhood and adolescence, through the slow development of specific, acquired immunity to asexual blood stage parasites. Immunity is mediated by antibody, which blocks merozoite invasion of red cells, as well as by cell mediated mechanisms and non-specific cytotoxic agents. Vaccination with merozoites induces long lasting immunity of broad serological specificity active against the blood-stage of the parasite. Merozoite vaccines can be preserved by freeze drying and harvested from continuous cultures of blood stage parasites. The major problem in development of a human merozoite vaccine concerns the requirement for Freund's complete adjuvant which is not acceptable for man. The effective immunity induced by vaccination contrasts with the slow development of incomplete resistance which follows repeated natural infection. The latter is associated with the generation of immune suppressor cells, lymphoid cell mitogens and soluble antigens, and in some species by the occurrence of antigenic variation--all of which may favour parasite survival. It is probable that vaccination with non-viable antigen of appropriate composition, induces immune effector processes without activating mechanisms which allow parasites to escape the consequences of immunity. Many effective vaccines such as those against measles, poliomyelitis, tetanus and rabies are commercially available but barely used in the developing world. The affected nations cannot afford their purchase, nor do the means exist for their distribution. It follows that if a safe and effective malaria vaccine were to be developed, its bulk manufacture and administration would require massive international support and cooperation.
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PMID:Immunity to malaria. 3 57

For major diseases for which control measures are inadequate, research is an inexpensive approach on the basis of cost per infected person per year. Priorities among the infectious diseases affecting the 3 billion people in the less developed world have been based on prevalence, morbidity, mortality and feasibility of control. With these priorities in mind, a program of selective primary health care is compared with other approaches and suggested as the most cost-effective form of medical intervention in the least developed countries. A flexible program delivered by either fixed or mobile units might include measles and diptheria-pertussis-tetanus vaccination, treatment for febrile malaria and oral rehydration for diarrhea in children, and tetanus toxoid and encouragement of breast feeding in mothers. Other interventions might be added on the basis of regional needs and new developments. Aiming services at the most important diseases is the only rational approach to absolute proverty and unsanitary conditions. The goal is to help the greatest number of people in the cost effective method possible.
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PMID:Selective primary health care: an interim strategy for disease control in developing countries. 11 30

The frequency of infectious diseases in 6543 children hospitalised in the year 1974-75 in Arthur Davidson Hospital is analysed. Airborne infections including pneumonias and bronchopneumonias were found in 53.7% of the children and in 79.4% of those who died. Measles was found in 1112 children with a mortality rate of 15.6%. Measles and Malaria were among the top five killer diseases in Arthur Davidson Hospital. Of the airborne infections, measles, tuberculosis, laryngotracheobronchitis and pyogenic meningitis are the worst. Some problems concerning prevention and diagnosis are stressed. Improvement in the diagnosis of infectious diseases will depend on improvement in laboratory facilities.
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PMID:Analysis of admissions to the Arthur Davidson Children's Hospital, Ndola. 72 49

Various workers, including T. D. Stewart, claim that the aboriginal Americas were relatively disease-free because of the bering Strait cold-screen, eliminating many pathogens, and the paucity of zoonotic infections because of few domestic animals. Evidence of varying validity suggests that precontact Americns had their own strains of treponemic infections, bacillary and amoebic dysenteries, influenza and viral penumonia and other respiratory diseases, salmonellosis and perhaps other food poisoning, various arthritides, some endoparasites such as the ascarids, and several geographically circumscribed diseases such as the rickettsial verruca (Carrion's disease) and New World leishmaniasis and trypanosomiasis. Questionably aboriginal are tuberculosis and typhus. Accordingly, virtually all the "crowd-type" ecopathogenic diseases such as smallpox, yellow fever, typhoid, malaria, measles, pertussis, polio, etc., appear to have been absent from the New World, and were only brought in by White conquerors and their Black slaves. My hypothesis is that native American medical care systems--especially in the more culturally advanced areas--were sufficiently sophisticated to deal with native disease entities with reasonable competence. But native medical systems could not cope with the "crowd-type" disease imports that struck Indian and Eskimos as "virgin-field" populations. Reanalysis of native population losses through a genocidal combination of diease, war, slavery and attendant cultural disruption by Dobyns, Cook and others strongly suggest that traditiona estimates underplayed the death toll by a factor of the general order of ten. This would make for an immediately pre-contact Indian population of some 90-111 million instead of the tradition 8-11 million. Evidence is growing that Indians may have been no more susceptible to new pathogens that are other "virgin soil" populations, and thus their immune systems need not be considered less effective than those in other people. Present-day high mortality rates in Indians of both continents from infectious disease imports may be more socioeconomic than anything else.
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PMID:Aboriginal new world epidemiolgy and medical care, and the impact of Old World disease imports. 79 20

The US Centers for Disease Control has published recommendations for and information on public health concerns of populations displaced for disasters, such as civil strife and famine. Most recent relief programs use the sustainable primary health care approach of preventive medicine and refugee involvement. This report lists leading, intermediate, and trailing indicators of famine (e.g. low acreage under cultivation, crop failure, and increased malnutrition rates, respectively). Mortality rates are the best reflection of the health status of displaced and refugee populations. The leading causes of death in these populations are the same leading causes as those in nondisplaced populations in developing countries: malnutrition, diarrhea diseases (even cholera), measles, acute respiratory diseases, and malaria. Much of the excess mortality in refugee and displaced populations is due to synergism between high malnutrition prevalence and increased incidence of communicable diseases. Public health practitioners should be prepared for sudden population displacement by targeting the most important public health problems identified in earlier emergencies that cause considerable mortality. Response preparedness should be an integral component of existing health programs in developing countries. A health information system (HIS), diarrheal disease control, immunization, basic curative care, endemic disease control and epidemic preparedness, and maternal and child health care should be the first programs to be established after an emergency. This report provides detailed program-specific recommendations for rapid health assessment, HIS, nutrition, control of vaccine-preventable diseases, control of diarrheal diseases, malaria control, tuberculosis control, and epidemic investigations. For rapid health assessment, for instance, it has a checklist addressing preparation, field assessment, health information, nutritional status, mortality, morbidity, environmental conditions, and resources available. It provides a sample weekly surveillance reporting form.
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PMID:Famine-affected, refugee, and displaced populations: recommendations for public health issues. 132 13

The verbal autopsy (VA) is an epidemiological tool that is widely used to ascribe causes of death by interviewing bereaved relatives of children who were not under medical supervision at the time of death. This technique was assessed by comparison with a prospective survey of 303 childhood deaths at a district hospital in Kenya where medically confirmed diagnoses were available. Common causes of death were detected by VA with specificities greater than 80%. Sensitivity of the VA technique was greater than 75% for measles, neonatal tetanus, malnutrition, and trauma-related deaths; however, malaria, anaemia, acute respiratory-tract infection, gastroenteritis, and meningitis were detected with sensitivities of less than 50%. There may have been unwarranted optimism in the ability of VAs to detect some of the major causes of death, such as malaria, in African children. VA used in malaria-specific intervention trials should be interpreted with caution and only in the light of known sensitivities and specificities.
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PMID:Childhood deaths in Africa: uses and limitations of verbal autopsies. 135 14

The study, which is based on data from a household level health survey conducted in 1990 in Freetown, Sierra Leone, examines the coverage of an Expanded Program on Immunization (EPI), infant mortality, and infant morbidity among children in Greater Freetown, capital of Sierra Leone. The results of the study indicate that there was a decline in infant mortality in the recent period of the survey, 1988-89, compared to earlier periods. This decline seemed to have been the result of immunization coverage, which considerably increased by 1989-90, reaching above 70% of the children under age 5. The study further reveals that the increased immunization coverage of children and their mothers might have considerably reduced the incidence of tetanus. While reduction of tetanus might have played the leading role in the latest reduction in infant mortality, the incidence of diarrhea, measles, and malaria continued to be high, suggesting that the increase in the quality and quantity of basic immunizations, oral therapy for diarrheal disease, and provision of chloroquine and improved drugs for malaria disease could further reduce most of the deaths from these prevailing diseases among children under age 5.
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PMID:Immunization coverage, infant morbidity and infant mortality in Freetown, Sierra Leone. 141 85

An investigation of child mortality in a semi-urban community, Bandim II, in the capital of Guinea Bissau was carried out from April 1987 to March 1990. 153 deaths were recorded among 1426 live-born children who were followed for 2753 child-years. The under-five mortality risk was 215 per 1000 children (95% confidence interval [CI] 176-264), infant mortality 94 per 1000 (95% CI 73-115), and perinatal mortality 52 per 1000 (95% CI 41-63). By prospective registration of morbidity, post-mortem interviews, and examination of available hospital records, a presumptive cause of death was established in 86% of the deaths. Persistent and acute diarrhoea were the most frequent causes of death, accounting for 43 and 31 deaths per 1000 children, respectively. Fever deaths (possibly malaria), neonatal deaths, acute respiratory infections, and measles were other frequent causes. The access to health services was relatively easy: 75% of the children who died had attended for treatment at a hospital or a health centre. It is important to find ways of preventing and managing persistent diarrhoea, the major cause of death, and to improve the control of acute diarrhoea by a targeted approach.
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PMID:Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau. 144 Jul 94

In tropical countries, concomitant infections are a continuous problem. In the Rufiji Delta, an area of Tanzania that is holoendemic for malaria, there were outbreaks of influenza A, measles, and pertussis in 1986 and 1987. Significantly lower parasitic prevalences and mean densities of malaria parasites were found in children up to nine years of age who had measles or influenza than in asymptomatic control children. In contrast, children with pertussis had a higher prevalence and mean density than controls. The clinical courses of measles, influenza, or pertussis infections did not appear to be significantly affected by concomitant malaria infections. The reasons for the suppression of Plasmodium falciparum parasitemia during these viral infections are unclear. This effect could not be explained by the presence of fever.
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PMID:Suppression of Plasmodium falciparum infections during concomitant measles or influenza but not during pertussis. 144 8

The American population developed, during thousands of years, free of epidemics that had been attacking Europe, Asia and Africa. The European and African migrations, after Columbus's first trip, produced an epidemic invasion of influenza, smallpox, measles, yellow fever, malaria, diphtheria, typhus, and other diseases that attacked the immunologically virgin populations and produced a very high mortality, with a diminution of the indigenous population of more than 90% in many places. According to historical evidence, the first epidemic was influenza, produced by swine strain of virus, immediately followed by smallpox. The Spaniards mated freely with the Indians producing a mixed race called the Mestizo, who were immunologically more capable of defending themselves against various viruses, bacteria, and parasites brought over from the Old World. Marriage between the races also was sanctioned by Queen Isabella (1503) and Fernando I (1515). With these new genetic immunologic defenses against infections, the Mestizo eventually made up the majority of the population of Indians in the New World.
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PMID:Epidemic hecatomb in the New World. 148 72


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