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)

Increased serum concentrations of soluble intercellular adhesion molecule-1 (sICAM-1), soluble endothelial leucocyte adhesion molecule-1 (sELAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were detected in Danish malaria patients infected with sequestering Plasmodium falciparum or non-sequestering P. vivax parasites, as well as in patients with sepsis or meningitis. Levels of soluble adhesion molecules remained elevated in the P. falciparum patients for several weeks after initiation of treatment. Plasma concentrations of sICAM-1, sVCAM-1 and sELAM-1 were higher in Gambian children with severe P. falciparum malaria than in children with mild malaria. Plasma levels of sVCAM-1 and sELAM-1 were significantly correlated. Plasma levels of sELAM-1 and sVCAM-1 may reflect endothelial inflammatory reactions and these reactions may be harmful for humans infected with malaria parasites.
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PMID:Increased plasma concentrations of sICAM-1, sVCAM-1 and sELAM-1 in patients with Plasmodium falciparum or P. vivax malaria and association with disease severity. 753 38

Because many Canadians are travelling to exotic destinations, family physicians may be asked for advice on immunization and health tips to prevent illnesses such as malaria, altitude disease, meningitis and schistosomiasis. A Toronto family physician who is on staff at a travel clinic says a few guiding principles and good resources can help family physicians ensure that their patients are healthy when they return from a trip.
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PMID:Resources available to help family physicians provide advice to travellers. 755 4

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

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

Between 1982 and 1986 in western Zaire, a pediatrician collected data on 206 children under 5 years old presenting at the Institute Medical Evangelique, a 400-bed mission hospital (60 pediatric beds), in Kimpese with persisting fever despite chloroquine therapy for falciparum malaria, a negative or scanty positive thick film for malaria, and no clear localizing signs of infections. The pediatrician suspected that these cases had an extraintestinal Salmonella infection and took blood, synovial fluid, and/or cerebrospinal fluid samples for diagnostic analyses. Salmonella serotypes other than Salmonella typhi (non-S. typhi) were responsible for most bacteremia cases (83%). The clinical features of non-S. typhi and S. typhi infections were basically the same. The case fatality rate for non-S. typhi and S. typhi an S. typhi infections were 22.7% and 29.4%, respectively. Infants under 6 months old had a significantly higher case fatality rate than older children (relative risk [RR] = 1.7; p .0005; e.g., 66% and 100% for infants under 3 months old). Meningitis was significantly associated with increased mortality, regardless of age (RR = 4.68). Jaundice was the only clinical sign significantly linked to increased mortality (RR = 2.35), especially among children who had S. typhi infection (80%). Mortality occurred significantly more often when children fell ill with Salmonella bacteremia in the late rainy season, coinciding with the peak of malnutrition, than in the dry season (RR = 2.62). Chloramphenicol-resistant non-S. typhi isolated were significantly associated with increased mortality (RR = 3.19). Hemoglobin levels below 6 g (i.e. severe anemia) has a strong link to increased mortality (RR = 1.77). Salmonella bacteremia will become more difficult to treat as antibiotic resistance and the prevalence of HIV infection increases in African countries.
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PMID:Salmonella bacteraemia among young children at a rural hospital in western Zaire. 768 45

In a 3-year prospective study of 9584 consecutive paediatric admissions to the Royal Victoria Hospital in Banjul, The Gambia, we examined the impact of seasonal variations in childhood diseases. The four principal diseases (falciparum malaria, pneumonia, gastro-enteritis and malnutrition) all peaked in September to October following the rainy season. The mortality rate was also higher in the rainy season than in the dry season. Of the 1525 children with cerebral malaria, 83% were admitted during the extended rainy season from July to December. With the emergence of chloroquine-resistant malaria over the 3 years, there was a 27% annual increase in severe anaemia owing to malaria. The median age of malarial anaemia (23 months) was significantly younger than that of cerebral malaria (42 months). Malnutrition peaked immediately following the annual rainy season epidemics of bacterial gastro-enteritis but was not associated with the cool dry season rotavirus outbreaks. Rainy season diarrhoea was also associated with more persistent diarrhoea, an older mean age and a higher mortality. Meningitis was caused by either pneumococcus or Haemophilus influenzae in 64% of cases, of whom 19% were 0-2 months of age. Causes of death in hospital showed good agreement with Gambian community studies. We conclude that analysis of hospital data in a developing country can give accurate information on childhood morbidity and mortality patterns which can be used to set priorities for health care interventions. Seasonal variation is a cardinal feature of paediatric diseases in this part of Africa, and accentuates the vulnerability of children in poor families.
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PMID:Seasonal variation of paediatric diseases in The Gambia, west Africa. 768 9

Physicians analyzed the hospital records of 62 sickle cell anemia (SCA) patients who were admitted to the pediatric wing of the University Teaching Hospital in Lusaka, Zambia, between January 1987 and December 1989 and who died. They examined the case fatality rate and the causes of death. During this period, SCA patients comprised 938 of the 31,843 pediatric admissions (2.95%). The case fatality rate of these 938 urban SCA patients was 6.61%, which is much lower than the 1970 rate of 18.57%. The researchers attributed the lower case fatality rate to the comprehensive health care provided by the hospital's sickle cell disease clinic, established in 1971. Sickle cell-related deaths during the study period made up 0.97% of all pediatric deaths. The case fatality rate was 20.17% for all pediatric admissions. SCA-related mortality peaked in the 1-5 year old age group (38.71%) followed by the 6-10 year old age group (20.97%). As for causes of death, the case records of only 44 sickle cell-related deaths were available. The pediatricians were not able to specify the exact clinical diagnosis in 18 case files (29.03%). The major categories of causes of death were infections (29.54%), vaso-occlusive crises (22.72%), and splenic sequestration crises (20.45%). The infections included 6 cases of bronchopneumonia, 4 cases of confirmed malaria, 1 case of pneumococcal meningitis, and 1 case of HIV infection with cardiomyopathy. The researchers were not sure whether the HIV infection or SCA caused cardiomyopathy. An earlier study at the hospital found HIV seroconversion in more and more SCA patients. This study's major obstacles were poor record keeping, poor communication channels, inability to conduct autopsies due to social and cultural reasons, procedural delays, and unavailability of pathologists. These obstacles must be addressed to improve knowledge on death in SCA patients.
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PMID:Clinical analysis of mortality in hospitalized Zambian children with sickle cell anaemia. 783 62

Thirty five children aged 5 months to 15 years suffering from stroke were studied from August 1984 to July 1990 from two hospitals in order to determine the incidence, the etiological factors and the short term outcome of the stroke. The average annual incidence was 1.85 per 1000 pediatric hospitalizations. There was a progressive rise in the number of cases from 1985, with a peak in 1990. Motor impairment of one half of the body was the commonest clinical feature seen in 97.1% of the cases. Other clinical signs were: facial paralysis (62.9%) and aphasia (28.6%). The main etiological factors were: homozygous sickle cell disease (31.4%), heart disease (17.1%), cerebral malaria (14.3%) and meningitis (14.3%). No causative factor was identified in 7 patients (20%). The mortality rate was low (2.9%) and all the children had neurological deficit after a mean hospital stay of 15 days. Laboratory investigations including lipid analysis, platelet count, and skull X-rays proved to be of no diagnostic value. However, computed tomography (CT) scan confirmed the diagnosis of ischemic stroke whenever it could be done.
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PMID:Stroke in children in Yaounde, Cameroon. 789 Mar 41

Between November, 1991, and March, 1993, in Accra, Ghana, physicians admitted 103 children, 2 months to 12 years old, to the Korle Bu Teaching Hospital with suspected bacterial meningitis. They constituted 1.04% of all children presenting at the emergency rooms. Late referral to the hospital was likely responsible for the high case fatality rate within the 1st 24 hours of admission (59.1% of all deaths). 42.7% of all cases presented more than 96 hours after the onset of symptoms. 7 children died immediately after admission, allowing physicians no time to begin antibiotic treatment. The overall case fatality rate was 21.4%. Streptococcus pneumonia was isolated from the cerebrospinal fluid (CSF) in 53.8% of the early deaths and 55% of all 73 mortality cases from which bacteria were isolated. Leading causative organisms were $. pneumoniae (47.9%), Neisseria meningitides (38.4%), and Hemophilus influenza (9.6%). All bacterial isolates were sensitive to ceftriaxone. 5-17% of all isolates were resistant to penicillin and chloramphenicol. No bacteria were isolated in the CSF of any children within 48 hours of antibiotic treatment. The leading complications and sequelae of the 81 survivors were mild diarrhea (33%), neurological complications (22%), and secondary fever (14.8%). Even though the chloramphenicol/penicillin treatment regimen had the highest survivor outcome results (43%), its results were not significantly different than those of ceftriaxone alone for 48 hours followed by chloramphenicol/penicillin and ceftriaxone alone (24% and 20%, respectively; p =.6). These results suggest that health workers at less than optimum health facilities should administer the 1st dose of ceftriaxone to children suspected of having meningitis before transferring them to a tertiary facility for further management. This should greatly reduce case fatalities and sequelae. Health workers worldwide, even those in malaria endemic areas, should consider meningitis as a significant cause of fever.
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PMID:Bacterial meningitis in children in southern Ghana. 792 39

Cryptococcal meningitis is an uncommon infection globally, including Nigeria. This systemic fungal infection often is associated with immunodeficiency. The most common causes of meningitis in Nigeria in the 2-3 year age group are the malaria parasites and bacteria. The concomitant infections of Cryptococcal neoformans and Plasmodium falciparum are uncommon. We present here the report of a case of fatal cryptococcal meningitis with malaria infection in a 2 year old child from Nigeria (one of the malaria endemic regions of the world). This case emphasizes the importance of doing a combination of fungal and bacterial cultures as well as looking for malarial parasites in the determination of etiological agents of meningitis in any hospital in Africa. We suggest that cerebrospinal fluid from meningitis cases must be cultured using Sabouraud dextrose agar and any growth on the agar must be examined using Indian ink.
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PMID:Cryptococcal meningitis with malaria. A case report. 793 35


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