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 European-American exchange of infectious diseases was responsible for the demographic havoc of the native population in the New World after 1492. Prior to this date medical writers describe the presence in Spain of viral diseases like influenza, parotitis, smallpox, measles, poliomyelitis, and rabies; there were also rickettsiasis, diphtheria, salmonellosis, plague, tubercolosis, leprosy, malaria, scabies and tinea. In America, before European arrivals, there were no records of human viral diseases, though there were records of rickettsiasis, treponematosis--pinta, yaws and syphilis--leihsmaniasis, amibiasis and perhaps leprosy. With the discovery of America in 1492, Columbus's sailors were contaminated by yaws and spread this disease into Europe. In 1493 influenza, as a zoonosis, was introduced into Santo Domingo and was responsible for the annihilation of the natives of the Antilles in less than a quarter of a century; in 1518 smallpox was also introduced in Santo Domingo and then to the American continent by negro slaves: by the same means measles were introduced in 1531. The previous existence or introduction of other infectious diseases in America is also discussed.
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PMID:The European-American exchange. 752 30

The 1993 assassination of the President of the Republic of Burundi led to a bloodbath resulting in the killing of 700 000 people and 300 000 refugees in camps scattered throughout the country. After the emergency surgery phase, the French cooperation which was in charge of health care in the Gitega sector requested a humanitary mission. Two public health physicians, a polyvalent clinical physician, and two field nurses were sent. All were armed service personnel. From January to April 1994, after a preliminary assessment of the situation, this mission took charge of health services as well as administrative services for the population of the region including some 10 000 refugees. Epidemiologic surveillance was carefully organized. During the first quarter of the year, there were 2451 declared cases of bacterial dysentery, 6738 cases of malaria-like fever including 25% confirmed by paristological findings on a study of 60 consultants, 87 cases of measles, and 1306 cases of conjunctivitis. There were no cases of cholerea or meningoccoal meningitis. A food support program was started when it was noted that the overall rate of acute malnutrition among refugee children under the age of 5 years was 25% (weight/height ratio less than minus 2 standard deviations or observation of edema). At the present time the situation in the sector is back to normal and the health care system is operating satisfactorally. However the situation in neighboring Rwanda could have adverse effects on the political stability of Burundi.
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PMID:[Burundi: humanitarian mission (January-April 1994)]. 756 2

The impact of a combination of PHC intervention activities on child survival, growth, morbidity and mortality was assessed in three selected rural communities (Gomoa Fetteh, Gomoa Onyadze/Otsew Jukwa and Gomoa Mprumem) in the Central Region of Ghana from 1987 to 1990. EPI, provision of basic essential drugs and supplies for the treatment of common childhood diseases, treatment of the sick child, growth monitoring, health education, provision of antenatal services, family planning, training and supervision of Community Health Workers, disease surveillance and special studies were the major PHC strategies used to improve the health of the child and the pregnant woman in the three communities. These activities in their totality have had significant impact on morbidity and mortality in children under five and on maternal mortality in children under five and on maternal mortality over the study period 1987 to 1990. Although malaria, acute respiratory infections and diarrhoea diseases continue to be major causes of childhood morbidity, deaths due to these diseases have dramatically declined. Measles and other vaccine preventable diseases no longer contribute significantly to childhood morbidity and mortality. Infant and under five mortality have been reduced from 114.6/1000 and 155.6/1000 live births to 40.8/1000 and 61.2/1000 live births respectively. The crude birth rates however, remain almost the same over the five year period (43 to 48/1000 pop.) but crude death rates have declined (11 to 12.4/1000 pop.).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Impact of primary health care on child morbidity and mortality in rural Ghana: the Gomoa experience [corrected]. 762 99

Two Dutch researchers analyzed detailed standardized annual reports from 17 mission hospitals in Ghana, Kenya, Tanzania, and Zambia to determine what can be learned from hospital records on the volume of medical services provided as well as on the incidence and seriousness of major diseases and their patterns of change during 1975-90. These hospitals had more than 1.2 million patients (excluding deliveries, neonates, and premature births) and 67,534 deaths. The number of hospital admissions increased considerably (50-77%) in all countries except Ghana. Yet admission rates (per 1000 population/year) rose at a much lower rate (6-25%) in the three countries, suggesting that population growth accounted for a large part of the increase. During 1975-90, in Ghana, the admission rates decreased by 42% and the number of infectious disease admissions fell by 12%. More than 50% of all admissions were for infectious diseases in Kenya and Tanzania compared to 33% for Zambia and 35% for Ghana. Children aged under 15 years were more likely to be admitted for an infection or infection-related disease than adults (75% vs. 31%). The most common infectious disease responsible for admissions and a cause of death was malaria, probably due to a slowly rising resistance in the malaria parasite, resistance to insecticides in the mosquito, and the decreased immunity of the population due to uncontrolled use of antimalarials. In three countries (except Zambia for admissions and Ghana for causes of death), malaria has risen considerably (p 0.001). The case fatality rate for meningitis had also increased significantly during 1975-90 (p 0.001). Other significant causes of admissions and deaths included pneumonia, gastroenteritis, and tuberculosis. In all four countries, immunizable diseases and measles have declined greatly (p 0.001). Case fatality rates (CFRs) were highest for tetanus (36.7-68.8%) and meningitis (14.7-43%) and lowest for malaria (0.6-4.6%). CFRs for malaria, gastroenteritis, and pneumonia were much higher in adults than in children. These type of data are needed for planning and the operation of curative and preventive care.
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PMID:Analysis of hospital records in four African countries, 1975-1990, with emphasis on infectious diseases. 763 17

The author's conclusion in this article is that the problem of population displacement appears to be increasing and that the geographic impact is spreading. There is a need to predict complex emergencies (civilians affected by war or civil strike and population displacement) earlier. Effective intervention methods will require information on the quantity and content of relief commodities and analysis of the impact of relief on the health and nutrition of the affected population. International relief efforts must be more than a symbol of help. The goal should be to prevent excess mortality among the affected populations. The public health challenge is to improve the health status of populations caught in the cycle of war, intimidation, hunger, migration, and death. The direct health consequences of civil strife are identified as death, injury, disability, sexual assault, and psychological stress. The indirect health consequences are identified as mass migration, food shortages, hunger, and the collapse of health services. The numbers of people affected as dependent refugees under the care of UNHCR increased from 5 million in 1980 to almost 23 million in 1994. The total population of refugees and displaced persons is reported to have increased between 1990 and 1994 from 30 million to 48 million. The death rate of newly arrived refugees in Thailand, Somalia, and Sudan is estimated to be 30 times the death rate in the country of origin. Crude death rates (deaths/1000/month) during 1990-93 are reported as ranging from 3.5 to 12 times the rates in Ethiopia, Kenya, Nepal, Malawi, and Zimbabwe. The death rates of children aged under 5 years are estimated to be higher than adult rates. Causes of death are generally preventable. Common causes of death include measles, diarrhea, malaria, cholera and dysentery, and acute respiratory infections. Public health programs must target basic needs for shelter, food, water, and sanitation.
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PMID:Mass population displacement. A global public health challenge. 767 72

The results of a study of residents' knowledge about malaria and antimalarial drugs and of their treatment-seeking behavior in a rural area of western Kenya are reported. The investigation was conducted in 2 villages where malaria is holoendemic. Samples of 20-25 women were interviewed to discover their views about the main causes, symptoms, and treatments of malaria as well as measles, difficulty in breathing, and diarrhea. The study subjects were generally well-informed about the symptoms of the disease. Malaria was perceived as a relatively mild illness, much less severe than acquired immunodeficiency syndrome, measles, difficulty in breathing, and diarrhea. A total of 23 families completed an 8-week follow-up period, during which 230 separate illness episodes were reported. Only 23.1% of the patients who sought treatment did so at a health center, the remaining were treated at home. Most illnesses for which they sought treatment at a health center were self-diagnosed as malaria (82% vs. 60%; p 0.05). Self-treatment was extremely common: of 138 episodes of febrile illness, 60% were treated at home with herbal remedies or medicines purchased at local shops, and only 18% received treatment at a health center or hospital; no treatment was sought by the remainder. Commercially available chloroquine preparations were perceived as more effective than either antipyretics or herbal remedies for the treatment of malaria, and injections were regarded as more effective than oral medications. 4-aminoquinolines were used to treat 58% of febrile illnesses, but in only 12% of the cases was a curative dose of or= 25 mg/kg body weight employed. Even attendance at a health center did not ensure adequate treatment because of the common practice of sharing medication among family members. Increased attention should be paid to the role of home treatment of malaria when policies are being developed for the management of febrile illnesses in Sub-Saharan Africa.
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PMID:Self-treatment of malaria in a rural area of western Kenya. 774 95

At a global level, there is an urgent need for vaccines against major diseases which are not yet vaccine-preventable. This particularly includes bacterial and viral diarrhoeal diseases, acute respiratory infections, AIDS, malaria, schistosomiasis and meningococcal meningitis. There is also a need for more efficient vaccines against tuberculosis, for a new measles vaccine effective in the young child in the presence of residual maternal antibodies. Therefore, research aiming to define new ways to selectively induce protective responses which would fulfill the needs of immunization programmes, not only in terms of efficacy but also in terms of practicality, represents a real priority. Along this line, modern immunology should be a significant source of new tools to achieve the goal of developing a series of new vaccines which may potentially help to prevent millions of child deaths.
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PMID:Research priorities for vaccines to be used at a global level. 775 2

At the beginning of a longitudinal study to evaluate the use of Village Health Workers (VHW) to collect vital statistics at the grassroot, 100 out of a total of 342 house-hold heads were randomly selected and interviewed. Information on births, child deaths, attitude to registration, and some factors militating against successful registration of vital statistics at the grassroot were inquired into and is discussed. There were a total of 6 stillbirths and 100 deaths in children (aged 0-14 years) in the last 5 years following the training of VHW for the community. Only 4 (3.4%) of these deaths wee officially registered. The top 4 causes of death in the children were febrile convulsion, malaria fever, measles and acute respiratory tract infection (ARI). Thirty six percent of the household heads felt reporting of deaths in children was unnecessary and 63.1% of children had birth certificates. Only 14% of the respondents had marriage certificates and out of a cumulative total of 43 divorces, only 21 had divorce certificates. Ignorance, poverty, traditional beliefs, lack of motivation and reduced accessibility to registration centres are major hindrances to successful registration of vital statistics at the grassroot.
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PMID:The road to improved registration of vital statistics at community level. 775 92

Over an 18-month period, from October 1991 through early 1993, a study was carried out in two phases in the pediatric wards of the Eldoret District Hospital to document infant and child morbidity and mortality in the Uasin Gishu district and parts of several surrounding districts in western Kenya. Patient discharge summaries and ward registers were analyzed for age, sex, diagnosis, length of hospitalization, and outcome. There were a total 4720 pediatric admissions over the period. The most frequent 20 diseases were identified and their respective case fatalities were calculated. 74.5% of the admissions were due to only four diseases: malaria (33.0%), pneumonia (26.8%), gastroenteritis (10%), and measles (7.6%). Malaria was responsible for only 9 (9.1%) of all deaths. The disease specific mortality rate for malaria was 2.2%, 11th among the top 15 diseases. 20 (20.4%) out of a total of 98 deaths were due to pneumonia. Measles was becoming less important as a cause of morbidity because of immunization: in 1991, over 20 cases/per month were admitted, but by 1993 only 6.5 cases/month were admitted, a decrease of 68%. Neonatal tetanus was responsible for 43.2% of neonatal mortality during the 18 months. In addition, 47 infants and children had severe anemia (hemoglobin 4.0 gm%); 8 (17%) of these children died despite emergency blood transfusions. The overall mortality rate in the hospital during the study was 8.2%, which compares with 9.6% reported in Tanzania in 1987. 61 (64.9%) deaths occurred within 24 hours of hospitalization owing to delay in seeking medical care. In a 1988 study in Harare, 201 (43.7%) of 460 deaths occurred within the first 24 hours of admission. Furthermore, during February through June 1992, 29 of 57 children under 2 years of age admitted for gastroenteritis tested positive for HIV antibodies. A retrospective review of the ward register also showed that in 20% of the admissions the outcome was not recorded, in 25% the length of stay could not be determined, and for 8.3% the age of the patient was not recorded.
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PMID:Paediatric morbidity and mortality at the Eldoret District Hospital, Kenya. 779 68

A febrile convulsion is a generalized seizure occurring during a febrile illness whose cause is extracranial. Most scholars agree that strong evidence exists of familial predisposition to febrile seizures. The events are more common among men, with the pattern of such convulsions in Europe and North America apparently different from that in Africa. The authors report their findings from an examination of the pattern of febrile seizures at the Children's Emergency Room of the University of Benin Teaching Hospital in Benin City, Nigeria. 1046 children were admitted over the course of the study conducted January-September, 1988. Seven of the 202 patients with febrile convulsions died, five from aspiration pneumonia and two from tetanus following traditional treatment. 5% of patients with febrile convulsions were younger than 5 months or older than 5 years. The male:female ratio was 1.3:1. 140 children had a family history of febrile convulsion; in 55% the relative was a close family member. The authors point out that the number of families with a positive history of febrile convulsions may have been underreported because the average Nigerian family is loathe to admit that any member suffers from a socially stigmatized illness. These findings confirm the view that a strong familial predisposition exists for febrile seizures. Major causes of the rise in temperature in those studied included malaria, which accounted for 32.7%, followed by bronchopneumonia among 16.8%, measles at 15.4%, otitis media at 13.4%, and tonsillitis at 10.5%. Observed morbidity and mortality could be attributed to the sociocultural background of this community which practices modes of therapy which are often detrimental to patient health.
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PMID:Childhood febrile seizures (Benin City experience). 782 94


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