Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The "Health Transition" describes the medical consequences which accompany the demographic transition and development. In many Asian countries, as the infectious diseases of infancy decline, such as diarrhea, acute respiratory disease, measles and malaria, so too, do infant mortality rates. As a consequence of falling infant mortality rates and declines in fertility, the age pyramid has become more rectangular. No longer is nearly half of the population under the age of 15 years. Diseases of adults are beginning to become predominant: trauma, heart disease, cancer, stroke and diabetes. Life expectancy has increased along with costs of the health care system. As a fraction of per capita gross domestic product, health care is beginning to become a major national expense. It is ironic that the one vector-borne infectious disease likely to bridge the health transition in tropical countries is dengue. As evidenced by the experience of Singapore and Taiwan, modern housing and commercial development provide more, rather than fewer breeding places for Aedes aegypti. Greater affluence often means less compliance with mosquito control programs. Meanwhile, the dengue viruses, heeding some unknown genetic imperative, cause ever more severe disease. Modern Asian societies must count dengue as a real and enduring threat. To prevent costly hospitalizations and a sense of social disorder, effective measures must be adopted to achieve a significant reduction of Aedes aegypti populations. Sustained dengue control requires source reduction which, in turn depends upon imaginative leadership, skilled man power, legislative authority, an authentic national research program and intersectoral cooperation. A leadership role beckons for new actors in the control of Aedes aegypti: large municipalities, environmental agencies and the private sector.
 ...
PMID:Dengue in the health transition. 784 46

Immune response of infants vaccinated under Expanded Programme on Immunization (EPI) was evaluated for measles, poliomyelitis, and tuberculosis in Ifo/Otta area of Ogun State and Badagry area of Lagos State, Nigeria. In the prevaccination evaluation of measles antibody, 59 per cent were protected and 41 per cent were at risk in Ifo/Otta area, while 49 per cent were protected and 51 per cent were at risk in the Badagry area. After measles vaccination, 89 per cent of those evaluated seroconverted and 11 per cent did not in Ifo/Otta area, while in Badagry area, 86 per cent of those evaluated seroconverted and 14 per cent did not. For polio neutralizing antibody evaluated at post-immunization, 91 per cent seroconverted, while 9 per cent did not in Ifo/Otta area, while in Badagry area 66 per cent seroconverted and 34 per cent did not. Tuberculin test was used to evaluate the cellular response to BCG vaccination against tuberculosis. 64 per cent were found protected, while 18 per cent were at risk in both areas examined and 18 per cent dropped out. Using Gomez method to evaluate the nutritional status of the infants, 34 per cent were malnourished in Ifo/Otta area and are mostly immigrants. In Badagry area, 53 per cent were normal while 47 per cent were malnourished and most of the malnourished infants were plagued with diarrhoea, severe cough, high fever or malaria infection. Most of the malnourished in the two areas screened were between 9 and 18 months of age, which is the crucial period in the growing stage of the children.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Evaluation of immune response in infants with different nutritional status: vaccinated against tuberculosis, measles and poliomyelitis. 785 39

This paper opens by briefly tracing the development of vaccines from Edward Jenner's work in 1796 to the present. The proportion of deaths from communicable diseases in developed and developing countries is discussed, and it is noted that, in 1990, communicable diseases killed 575,000 people in industrialized countries and 16 million people in developing countries. In developed countries, there were no deaths from measles, malaria, tetanus, or pertussis, and only seven from diarrheal disease as compared to 1,006,000, 926,000, 505,000, 321,000, and 2,866,000, respectively, in developing countries. By the end of the century, AIDS will overshadow the communicable disease profile. Annual mortality figures from bites by rabid animals, snakes, insects, etc. are also grossly underreported. A look at the common biologicals used in developing countries shows that at least eight bacterial and eight viral vaccines are in common use globally. The origin and indications for each vaccine are tabulated. Data on anti-serum vaccines, plasma-derived preparations, and biological response modifiers (available in industrialized countries) are similarly tabulated. Consideration of the industrial production of immunogens in developing countries reveals that most production relies on outdated technology. Vaccines exhibit suboptimal performance in these settings either due to factors relating to individual vaccines or to community circumstances. Individual vaccines which exhibit inadequate potency in adverse circumstances include liquid vaccines and lyophilized vaccines and prophylactics. This situation is exacerbated by unsatisfactory vaccine administration practices, malnutrition, and cases of immunosuppression. Suboptimal performance at the community level is due to procurement procedure, the cost of vaccines, poverty, population growth, failures in the cold chain, lack of trained personnel, religion and gender bias, and political factors, such as war. A suitable remedial action plan requires integrated action at the international, national, and community levels. Such an effort would be aided by improved mortality data collection techniques and by multidisciplinary research to update indigenous manufacturing technology.
 ...
PMID:Human immunization in developing countries: practical and theoretical problems and prospects. 788 21

A proposed method is presented by which the cost-effectiveness of investing in the physical and human infrastructure of the health system can be evaluated. The role of health systems infrastructure in studies of cost-effectiveness analysis and health resource allocation is discussed, and previous health sector cost-effectiveness analyses are cited. Two substantial difficulties concerning the nature of health system costs and the policy choices are presented. First, the issue of health system infrastructure can be addressed by use of computer models such as the Health Resource Allocation Model (HRAM) developed at Harvard in the General Algebraic Modeling System (GAMS), which integrates cost-effectiveness and burden of disease data. It was found that a model which allows for expansion in health infrastructure yields nearly 40% more total disability-adjusted life years (DALYs) for a hypothetical Sub-Saharan African country with a population of 10 million and GDP per capita of $340, than a model which neglects infrastructure expansion. The most important interventions by expenditure are screening and treatment of acute respiratory infections, malaria, tuberculosis, measles as well as promotion of oral rehydration therapy, breast-feeding, tetanus, and hygiene. Widespread use of cost-effectiveness databases for resource allocations in the health sector will require that cost-effectiveness analyses shift from reporting costs to reporting production functions. Distinct policy questions can be addressed with cost-effectiveness analysis, each necessitating its own inputs and constraints: 1) allocations when given a fixed budget and health infrastructure, or 2) when given resources for marginal expansion, or 3) when given a politically constrained situation of expanding resources. The development of a consistent approach to using cost-effectiveness data for informing resource allocations precludes confusion concerning which question must be addressed. Finally, some implications for future cost-effectiveness studies are highlighted.
 ...
PMID:Cost-effectiveness analysis and policy choices: investing in health systems. 792 45

This study provides the age specific prevalence rates of diseases using data from 1152 infants by reviewing clinic records, which have been maintained from 1963 till 1984 (grouped according to households) at Kasangati Health Centre near Kampala, Uganda. On the average, each child reported 3 disease episodes per year. The conditions that brought a child to clinic for the first time were: respiratory infection 46.2%; clinical malaria 14.4%; skin infections 9.8%; diarrhoeal diseases 8.5% and, others 21.1%. The prevalence of diseases in infants at the age of less than one month old were, respiratory tract infection 78/1000, skin conditions 29/1000, clinical malaria/fever 18/1000, eye infection 15/1000, diarrhoea 5/1000 and others 67/1000. At the age of one month till the age of 18 months, four conditions consistently topped the disease prevalence list: respiratory tract infection with a range of 175/1000 to 29/1000, being higher in early childhood; clinical malaria/fever with a range of 79/1000 to 23/1000; diarrhoeal diseases with a range of 55/1000 to 10/1000 and skin conditions with a range of 42/1000 to 10/1000. Other disease conditions including urinary tract infection, burns/accidents, eye infections, ear infections, measles and tetanus had age specific prevalence of less than 10/1000 at each age. Most of the diseases showed decreasing level of prevalence as the age increased. Relatively more people used the clinic and at a higher rate in the 1970s compared to the 1960s, mirroring the general economic and political situation of the two periods. There were no sex specific differences in either the frequency of utilization of the clinic or in the prevalence of disease over time.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Record keeping on early childhood diseases in two decades, at the health centre level in Uganda. 795 70

Neither the use of DDT nor chemoprophylaxis has significantly reduced malaria morbidity and mortality, especially among children. Low-technology measures of reducing man/vector contact are gaining in popularity. Malaria control trials in various sub-Saharan African countries show the promise of permethrin-treated bed nets. Researchers have compared the effect of permethrin-treated bed net use with that of chemoprophylaxis (maloprim) in 17 villages in a primary health care scheme in a rural area of the Gambia. They also gave some children a placebo. 86% of adults in the study area already used bed nets, but only 28% realized mosquitoes caused malaria. The permethrin-treated bed nets had a protective efficacy for overall mortality and malaria-specific mortality of 63% and 70%, respectively, in children from intervention villages. These bed nets reduced malaria morbidity and mortality, even though not all bed nets were impregnated with the target dose of permethrin and 50% of bed nets were laundered at least once a month. The bed nets were effective when people were under them, but not when the people were outdoors. Chemoprophylaxis did not reduce clinical episodes of malaria, prevalence of enlarged spleen, or the presence of parasites. Village reporters and the verbal autopsy technique may have underestimated the actual malaria mortality, however. Bed net impregnation was very cost effective and was as effective as other public health interventions, e.g., measles vaccination. The results of trials in other sub-Saharan countries will provide information on the success of bed net impregnation in areas with more intense malaria transmission and whose mosquito control measures are different from those in the Gambia.
 ...
PMID:Malaria: keeping the mosquitoes at bay. 810 60

Despite improvements in infant mortality, 500,000 infants die every year in the Americas. In Costa Rica, child mortality dropped from 68/1000 live births in 1970 to 20/1000 in 1980 as a result of improved hygiene and nutrition, immunization, and treatment. In most other countries of the Americas, infant mortality rates have declined substantially mainly because of public health programs. Educational levels of mothers and per capita national product also exert a notable influence on infant mortality. Poverty inflicts health problems: 177 million children are malnourished, and 40% of children in developing countries are undernourished, a state of affairs responsible for almost 60% of infant deaths. Breast-feeding plays a vital role in the first year of life by providing high quality nutrition and immunological protection, and emotional bonding between the mother and the child. Unfortunately, breast-feeding prevalence and duration is on the decline in developing countries. Safe drinking water and good sanitation are crucial in preventing and reducing child mortality. Women who become pregnant at either extreme of the reproductive age are exposed to higher maternal and pediatric risks; so are multiparous women, and women with short birth intervals. Most child deaths between the ages of 1-4 are preventable by health intervention: the main causes are diarrheal and respiratory diseases, malnutrition, and vaccine-preventable infectious diseases. Intestinal infections cause almost 5 million child deaths a year, and oral rehydration therapy is the most effective preventive measure. Vaccination is the most effective means of preventing measles, polio, tetanus, diphtheria, tuberculosis, and pertussis. In many countries, malaria has resurfaced with some 250-300 million new cases every year. Children and pregnant women are especially vulnerable to suffer serious complications. There were a quarter million cases of cholera in the Americas between early 1991 and August, 1992. AIDS is also a threat to child health because of the rising numbers of infected mothers and pregnant women.
 ...
PMID:Children's health in the developing world: much remains to be done. 814 86

Verbal autopsies (VA) are widely used by population and health scientists to determine individual causes of death in areas where most deaths occur at home and well-documented clinical data on cause of death are usually unavailable. VA interviews are based upon key symptoms and signs recalled by relatives of the deceased. In order to assess the reliability of the technique, the accuracy with which mothers and normal guardians recognize and recalled specific symptoms and clinical signs over time was assessed in the cases of 491 children who died on the pediatric wards of 2 district hospitals in Ifakara, Tanzania, and Kilifi, Kenya. The bereaved were interviewed 3 days to 24 months after child death. Recall after 1 month was similar to recall after 6 months for most signs and symptoms except neonatal tetanus for which false positives reported by mothers increased with time after death. Kwashiorkor, measles, trauma, generalized convulsions, and neonatal tetanus were reported with a high degree of accuracy. Symptoms and signs commonly used to describe malaria, respiratory tract and diarrhea- related deaths, however, were reported by mothers to have been present during terminal illness in 43% of cases where the features were absent. Finally, recall abilities differed between the 2 communities studied.
 ...
PMID:Maternal recall of symptoms associated with childhood deaths in rural east Africa. 822 43

This brief editorial argues in favor of making acquired immunodeficiency syndrome (AIDS) a notifiable disease. According to the World Health Organization (WHO), AIDS will cause more deaths in sub-Saharan Africa than anywhere else in the world over the next 3 years. More children will die from AIDS than from malaria or from measles. The number of cases of tuberculosis, in association with human immunodeficiency virus (HIV), will also rise, creating an uncontrollable pandemic under present policies. The argument that notification requirements will drive AIDS underground (Dr. Prozesky of the Medical Research Council at the launch of the AIDS Bulletin) is indefensible. Patients who have contracted syphilis or gonorrhea, with regard to privacy and confidentiality, are questioned about sources of their infection; however, preventive action follows that protects public health. This cannot be left as a personal option (G Stewart, Nursing Times, 1993, Vol 89, No 26). Group rights collide with individual rights; however, groups as well as individuals have human rights. The greater responsibility is to public health, rather than to individual sensitivity.
 ...
PMID:Should AIDS be notifiable? 826 78

Six common health problems prevalent in two rural communities-Buoye and Kanyawegi Sublocations--of Kisumu District, in Western Kenya, were selected and the knowledge, attitudes and practices (KAP) of the communities investigated with special reference to human intestinal helminths (worms). The selected diseases were malaria, diarrhoea, human intestinal helminths, scabies, schistosomiasis, and measles. The selection of the six health problems was based on a previous more general KAP study of health and disease at household level in the two areas and information from the Medical Officer of Health in the area. The specific objective was to assess the perceived importance of intestinal worms vis-a-vis other common and known health problems in the community. The study included an analysis of responses to questions on human intestinal worms broken down by sex, age and education level of respondents as well as identification and perceived health effects of a set of vectors and parasites of common diseases in the area. Compared with the other five health problems, intestinal worms did not rank highly in people's minds as an important health problem, although very high proportions of respondents knew of the problem, notably the young and educated. This high proportion of respondents who knew of the problem could describe the symptoms with some accuracy and could correctly identify the vectors and parasite samples. But the full implications of intestinal worms were not fully appreciated. Both communities reflected relatively poor comprehension of causes, treatment and methods of prevention.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Knowledge, attitudes and practices (KAP) of human intestinal helminths (worms) in two rural communities in Nyanza Province, Western Kenya. 826 67


<< Previous 1 2 3 4 5 6 7 8 9 10