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)

A community-based malaria control programme was initiated in Saradidi, Kenya. One factor determining the utilization of treatment would be the symptoms felt to be diagnostic of malaria. The 12 most common diseases and 29 most common symptoms were identified by community members. Thirty-six randomly selected women were interviewed to determine association of the common diseases and symptoms; nine women were aged 15 to 29 years, nine women were 30 to 40 years, nine were 45 to 59 years and nine were 60 years or more. Women 60 years and older recognized a higher proportion of the diseases (P less than 0.0005) when compared with the other women of other ages. More than 90% of the women associated headache, fever, vomiting, joint pain, loss of appetite, tiredness and death with malaria. Measles and influenza were distinguished from malaria by rash and mouth ulcer for measles and by 'runny nose' and 'sneezing' for influenza. Analysis by average linkage hierarchical clusters revealed that malaria, influenza and measles were distinguished readily. The results suggest that if people in Saradidi do not obtain treatment from community health workers, it is not because they do not recognize the clinical symptoms of malaria.
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PMID:Symptoms associated with common diseases in Saradidi, Kenya. 368 33

Mortality and fertility rates were measured from 1981 to 1983 by prospective registration of vital events as part of a community-based malaria control and health development programme in Saradidi, Kenya. There was no obvious effect of providing chloroquine phosphate for treatment of malaria in each village on mortality or fertility rates. Crude death rates were 13.1 in the year before intervention (1 May 1981 to 30 April 1982) and 12.3 after intervention (1 September 1982 to 31 August 1983). Neonatal mortality increased from 36.8 per 1000 live births pre-intervention to 49.1 during intervention. There was a slight decline in post-neonatal (one to 12 months) mortality (72.8 to 67.0) and a significant drop in early childhood mortality (25.2 to 18.2). The change in mortality rates in these two age groups were fully explained by a high rate of measles mortality in the pre-intervention period. Measles accounted for 35.7% of 284 reported deaths in infants one to 12 months of age and for 40.9% of 230 deaths in children one to four years old. There was little change in reported malaria-specific mortality rates in infants and young children most likely because of a high level of chloroquine use for treatment of presumptive illness. Perinatal mortality by area ranged between 60.4 and 81.3 pre-intervention to 79.5 to 97.2 after the control programme was instituted. Crude birth rates by area remained stable at about 40 and general fertility rates were about 200. Both pre-intervention and during intervention infants were significantly more likely to have died without medical consultation than children one to four years. However, 79.2% of 284 infants and 90.7% of 193 children died in spite of having consulted a health worker prior to death. The data suggest that a measles vaccine programme would significantly reduce mortality rates in infants and young children. The fact that the majority of infants and young children died in spite of receiving medical attention indicates both the inadequacy of curative medical services in this high mortality setting as well as the necessity for promoting preventive health measures.
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PMID:Impact on mortality and fertility of a community-based malaria control programme in Saradidi, Kenya. 368 36

An analysis is presented of data on all 30 129 inpatient admissions to a mission hospital in the West Nile District of Uganda in the 27 year period from July 1951 to August 1978. For most of this period the hospital was staffed by the same two doctors. For each patient admitted, a record was made of their age (adult or child), sex, place of residence, duration of stay in hospital, diagnosis and vital status at discharge. The annual number of admissions increased steadily from around 300 in 1952 to over 1600 in 1966 and subsequently declined to about 900 in 1977. Sixty-five per cent of admissions were medical, 12% surgical, 11% obstetric and 9% gynaecological. Thirty per cent of admissions were children (aged 0-9 years). Forty-five per cent of admissions were from those resident in the same county as the hospital and another 20% were from an immediately adjacent county. Infective and parasitic conditions (including respiratory diseases) accounted for over 60% of admissions among children and over 38% of admissions among adults (excluding obstetric patients). The six most common causes of admission were: uncomplicated delivery (2308 admissions), pneumonia (2020), hookworm (1999), malaria (1806), schistosomiasis (1742) and diarrhoea (1041). In total 1960 deaths were recorded (6.5% of all admissions). High case fatality rates were observed for tetanus (61%), immaturity (54%), meningitis (38%), kwashiorkor (21%), other malnutrition (19%) and anaemia (19%). A striking increase in the number of admissions for measles was observed in the period 1976 to 1978. Admission rates for schistosomiasis (S. mansoni) appeared to be highest from counties adjacent to the Nile and 104 deaths were recorded among the 1742 patients with this as the primary diagnosis. Admissions for diabetes, as a percentage of all admissions increased from 0.2% in 1951-54 to 1.5% at the end of the study period. Marked seasonal variations in admission patterns were found for diarrhoea, measles, meningitis and respiratory infections, the last two, but not diarrhoea, being most common in the wettest months. Admissions for malaria showed no strong seasonal associations. Despite the limitations of hospital-based data, it is argued that the data analysed provide a reasonable indication of the important causes of severe morbidity and mortality in the district. Furthermore, some of the changes in admission patterns over time are likely to represent true changes in disease rates rather than artefacts of diagnosis or referral. The analyses presented indicate the value of simple record systems, carefully maintained.
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PMID:Admissions to a rural hospital in the West Nile District of Uganda over a 27 year period. 378 13

85 cases of measles with complications have been reported in Agades (Niger) from September 1983 to March 1985. The patients were all adults more than 15 years of age. Such complications are more frequent during winter season. The disease is superposable to the one observed in children: same course, same types of complications (superinfection, undernutrition, dehydration, broken compensation of a parasitosis, encephalitis). Mortality rate is next to the one observed in child (18.2%). Death occurs mainly in women (15 women/1 man). The more often fatal complications are: laryngitis, subcutaneous, emphysema, encephalitis, pernicious malaria, pregnancy complications. It appears highly desirable to extend to adults not yet diseased the immunisation campaign carried out for children.
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PMID:[Complications of measles in adult Africans. Apropos of 95 cases]. 380 54

The immune response of 198 young Nigerian children protected against malaria by chemoprophylaxis with chloroquine to immunization with triple, poliomyelitis, measles, typhoid, meningococcal and BCG vaccines was compared with the immune response to vaccination of 185 control children. Good responses to triple, measles and BCG vaccines were shown by children in both groups; poorer responses were obtained to poliomyelitis, typhoid and meningococcal vaccines. The response to immunization of protected children was similar to that observed among control children for all the vaccines tested except for meningococcal polysaccharide vaccine. Protected children showed a significantly greater antibody response to both group A and group C meningococcal polysaccharides than control children. This finding supports the results of previous studies which have shown that the immune response to meningococcal polysaccharide vaccines is adversely affected both by acute malaria and by asymptomatic malaria parasitaemia.
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PMID:Malaria chemoprophylaxis with chloroquine in young Nigerian children. II. Effect on the immune response to vaccination. 383 41

A survey aiming at assessing the effectiveness of anti-measles vaccination was carried out in a rural Upper-Volta population. The haemagglutination inhibition technique was used for detection of anti-measles antibodies; a reciprocal antibody titer of 20 or more was considered as a positive one and the subject considered as immunized. In the age group of 1-3 years old studied here, malaria does not seem to be a factor that modulates the ability of vaccinated subjects of producing anti-measles antibodies. Thus the immunodepressive properties of the Plasmodium is not observed in this immunizing system which effectiveness has been further improved by the development of thermostable vaccines.
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PMID:[Measles vaccination in the Sudan-Sahel region of Africa. Absence of the immunodepressive effect of malaria]. 389 51

In the tropics and sub-tropics, poliomyelitis is characterized by a high non-seasonal case-rate, very young victims and a predominance of leg paralysis following injections. It is proposes that this could be caused by infection of immunosuppressed infants with poliovirus of low virulence following mal-nutrition, infections with malaria and measles and treatment by injections. Vaccination policies are briefly reviewed and the complete safety of inactivated and oral poliovaccines in the tropics is queried on theoretical grounds. Even if injections are coincident with and not causal of paralysis, it may be difficult to persuade parents of this .
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PMID:Is poliomyelitis in the tropics provoked by injections? 628 92

Insights gained by a group of American maternal and child helath (MCH) care nurses during a 1983 exchange tour to Kenya, sponsored by Professional Seminar Counsultants, are decribed. Kenya is a poor, predominantly rural country. The annual population growth rate is 4.1%, and 60% of the population is under the age of 16. The government's annual per capita health expenditure is only US$4, there is little emphasis on pediatrics as a speciality, and the linguistic diversity of the population complicates the delivery of health care services. As a result of these factors, the MCH care system in Kenya differed markedly from the systems observed in previous exchange tours to China and the USSR. Kenya's population is served by a variety of government, private, and missionary hospitals and by government health centers. The health centers are staffed by 2 nurses and 2 assistants who provide maternity, family planning, and immunization services. The staff also diagnoses and treats common illnesses. Service are provided free for patients under the age of 16, and minimal fees are collected from older patients. The largest hospital in the country is the 1600 bed, Joma Kenyatta National hospital which employs 900 nurses and serves as a refereal hospital for complicated cases and as a teaching and research center. 42% of the hospital staff nurses are registered nurses and 58% are enrolled nurses. Disease patterns in Kenya and the US are markedly different. In Kenya, infectious diseases are more common than chronic diseases, and amony children the major causes of death are starvation, measles, whooping cough, malaria, tubercluosis, and diarrhea. Marasmus and protein calorie deficiency are the 2 major types of childhood malnutrition found in Kenya. Nurses frequently provide health education services and even teach mothers how to grow nutritious foods for their children. Rh incompatibility is rare in Kenya, but ABO incompatibility is common. Othr common diseases, raraly found in temperate climates, include Burkitt's lymphoma, leprosy, and tropical ataxic neuropathies. The visiting nurses were at 1st shocked by some of the practices and customs they observed; however, as they learned more about the rationall behind these practices, shock gave way to appreciation. Children's wards lacked playthings, the walls were devoid of pictures, and the rooms were sparsely furnished. The lack of material items, however, was more than compensated for by the rich stimuli provided family members and friends, who not only visited the chilren, but performed a variety of nursing tasks. The family centered approach also provided a sense of security for the patients. A Masai paramedic explained how the custom of polygamy ensures adherence to the 2-year postpartum sexual taboo which, in turn, facilitates prolonged breast feeding. The nurses also became acquainted with the social value of adolescent circumcision rites. These rites are illegal but still performed in many rural areas. The rites are physically painful, but they provide a mechanism for easing the transition from adolescent to adult status. The rites help young people assume measningful roles in the society and provide them with clearly specified identities. As a result, adolescent suicide is rara among the rural villagers.
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PMID:Health care in Africa. 646 42

For 228 of 425 deaths (54%) occurring among 26 100 people of known age in the Malumfashi area of northern Nigeria, data were collected on symptoms present prior to death. Information was obtained on monthly registration visits, as part of demographic investigations, and data for the period November 1977-October 1978 have been analysed. Enumerators used a carefully prepared list of 25 symptoms to elicit information from relatives of the deceased. Pyrexia, diarrhoea and measles accounted for 77% of all deaths. Epidemiological determinants were responsible for all cases of meningococcal infections in the dry season and most cases of diarrhoea in the wet season. Most deaths attributed to measles occurred in the late dry season and early wet season. Epidemics of measles seemed to be localized at any one time in certain villages and the micro-epidemiology of this feature is considered. Malaria does not appear to be responsible for all deaths from pyrexia in the nought to four age group.
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PMID:Malumfashi Endemic Diseases Research Project, XXI. Pointers to causes of death in the Malumfashi area, northern Nigeria. 648 32

The child in Nigeria is loved and pampered but food may be scarce or inadequate in nutrients, and he/she has overcrowding and poor sanitation to deal with as well as a maze of conflicting and hybrid values and way of life. Statistics show that in black Africa 1 child out of 5 will survive up to his 5th birthday. The infant mortality rate is high primarily because of inadequate nutrition and communicable diseases. The 10 most common diseases in Africa from 4 sample countries, i.e., Ethiopia, Nigeria, Uganda, and Kenya are: malaria; gastroenteritis, measles; respiratory tract infections; malnutrition; intestinal worm, anemias; tetanus; meningitis; and tuberuclosis. All these diseases are preventable, but prevention is more difficult because there are few health workers and inadequate facilities. 80 pediatricians and a few unrecognized pediatric trained nurses look after about 40 million children in Nigeria. Nutrition plays a prominent role in both growth and development. Local food may be plentiful but some families are unable to balance their diets. There is malnutrition or undernutrition because of ignorance, poverty, and feeding habits. In Africa the effect of malnutrition is most marked during weaning. In a traditional African society a child does not lack for love and affection. There are no unwanted pregnancies, no motherless children, no unmarried women, for the extended family system absorbs many of these shocks. The circumstances of the family are related to the incidence of child abuse, which is increasing. Children are used as cheap labor by both parents and guardians. In the current 5-year development plan, the government is making a bold step in health care. Some of the major goals of this 4th 5-year development plan in health care delivery include: rapid expansion of facilities to achieve 100% primary health care coverage by the year 2000; emphasizing preventive care; decentralization so that the local government areas are implementation units; modification of the health care system to suit local conditions and resources; and crash training programs for various health personnel. Suggestions of this author include the following: the full implementation of the health plan; education; school health service; the provision of school children with 1 balanced meal per school day; the preparation of inexpensive baby foods with local foodstuff demonstrated to mothers' groups; and the development of day care centers.
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PMID:Nigeria: child health. 655 Mar 10


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