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

From 28 October 1991 to 30 December 1992, in Jima Hospital, a teaching hospital serving a predominantly rural population in southwestern Ethiopia, there were 841 deliveries and 573 abortions with 22 maternal deaths, a maternal mortality rate of 26 per thousand live births. Direct obstetric causes accounted for 19 of the 22 deaths. The non-obstetric causes were one case each of intestinal obstruction, cerebral malaria and pneumonia. The most frequent causes of death were illegal abortion in nine, ruptured uterus in six and post partum haemorrhage (PPH) in three. Half of the deaths occurred within 24 hours of admission. The causes of maternal death are analyzed and possible preventive measures are suggested.
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PMID:Analysis of maternal deaths in Jima Hospital southwestern Ethiopia. 803 78

The causes and clinical course of 136 cases of acute renal failure (ARF) consecutively treated in the Renal Unit of Tikur Anbessa Hospital, Addis Abeba, Ethiopia, between January 1989 and December 1992 are described. There were 106 women and 30 men with mean age of 26.9 +/- 7.2 and 40.7 +/- 14.9 years respectively. Septic abortion is still the leading cause of ARF (71 patients) followed by falciparum malaria (29 patients) and nephrotoxic agents (12 patients). One-hundred-seventeen patients (86%) required dialysis. The overall case fatality rate was 33.8%, with similar mortality rates in septic abortion (36.6%) and falciparum malaria infection (37.9%), but a much lower rate (16.7%) in acute renal failure secondary to nephrotoxic agents. Septicaemia and pneumonia were leading causes of death. Derangement of liver function was associated with higher mortality rates in patients with septic abortion and malaria, whereas leukocytosis was found to be a poor prognostic finding in the latter. Non-oliguric ARF was seen in 33.8% of cases and was found commonly in patients with malaria (75.9%) or in nephrotoxin-induced ARF (83.8%). Mean duration of oliguria was 18.9 +/- 11 days. Compared to the previous report from the same centre, this larger series identified important clinical settings other than septic abortion which predispose to ARF. As renal function tests are not performed routinely in many Ethiopian hospitals and as many patients have non-oliguric ARF, cases may be being missed. Measures to prevent septic abortion and malaria, and the judicious use of nephrotoxic agents, may decrease the incidence of ARF.
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PMID:Acute renal failure in Addis Abeba, Ethiopia: a prospective study of 136 patients. 803 81

Two thousand eight hundred ninety-eight children younger than 5 years old were investigated during a 2-year period in a rural area of The Gambia for possible pneumonia, meningitis or septicemia. After clinical examination and appropriate investigations, 1014 children were diagnosed as having pneumonia, 31 as having meningitis and 100 as having septicemia. Nine hundred seven children had a final diagnosis of malaria including 702 who satisfied the World Health Organization criteria for a diagnosis of pneumonia. A bacterial etiology was established in 115 (11%) patients with a final diagnosis of pneumonia, in 25 (81%) with meningitis and in 29 (29%) with suspected septicemia. Overall the pneumococcus was the leading pathogen identified among children with pneumonia and meningitis and ranked third among those with septicemia. However, during the wet season, when malaria transmission was highest, 50% of blood culture isolates obtained from children satisfying the World Health Organization criteria for a diagnosis of pneumonia were Salmonella or coliform species, and the pneumococcus and Haemophilus influenzae type b accounted for only 43% of isolates. Thus enteric bacteria may be as important as those bacteria more usually associated with respiratory disease among children presenting with a clinical picture of pneumonia during the wet season. This finding has important implications for case management and surveillance for antibiotic resistance.
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PMID:Importance of enteric bacteria as a cause of pneumonia, meningitis and septicemia among children in a rural community in The Gambia, West Africa. 819 May 37

Pneumonia and malaria are common causes of childhood morbidity and mortality in many developing countries and simple guidelines have been proposed to facilitate their diagnosis by relatively unskilled health workers. We have studied children in The Gambia attending out-patient and under-five clinics with clinically suspected pneumonia (cough or difficulty in breathing and a raised respiratory rate) during periods of high or low malaria transmission. During a period of high malaria transmission, 33% of these children had radiological evidence of pneumonia (with or without malaria parasitaemia) compared to 38% who had malaria parasitaemia, no radiological evidence of pneumonia and no other obvious cause of fever. Corresponding figures during a period of low malaria transmission were 48% and 6% respectively. The clinical overlap between pneumonia and malaria has important implications for case management strategies and evaluation of disease-specific interventions in regions in which both pneumonia and malaria are prevalent.
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PMID:Overlap in the clinical features of pneumonia and malaria in African children. 829 67

A 32-year-old woman in the 26th week of pregnancy became ill, 6 days after returning from a trip to Indonesia, with a fever up to 42 degrees C, haemolytic anaemia (haemoglobin 7.6 g/dl) and thrombocytopenia (7,000/microliters). She had not been on any malaria prophylaxis. Chloroquine, quinine and pyrimethamine, administered after macrogametocytes of Plasmodium falciparum had been found in the blood smear, eliminated the parasites from the peripheral blood, but respiratory failure and treatment-resistant pneumonia occurred, leading to the adult respiratory distress syndrome (Morel stage 4). Because of threatened intrauterine death (resulting from premature placental separation during artificial ventilation) the child was delivered by an emergency section. Despite extensive conventional therapeutic measures the mother's respiratory state progressively deteriorated so that extracorporeal membrane CO2 elimination was instituted on the 17th day. First signs of improvement in respiratory functions were noted after six days. The extracorporeal CO2 elimination was discontinued after twelve days, because artificial ventilation could now be adequately controlled. The woman was gradually weaned from the ventilator and discharged home without symptoms after a total of 11 weeks in hospital. Her child has not shown any neurological symptoms.
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PMID:[Acute respiratory failure in tropical malaria during pregnancy. Successful treatment using extracorporeal CO2 elimination]. 818 19

A 64-year-old woman developed a relapse of Plasmodium vivax malaria followed by a rapidly progressive diffuse patchy pulmonary process. Open lung biopsy specimen showed bronchiolitis obliterans organizing pneumonia (BOOP). After corticosteroid therapy was initiated, there was both clinical and radiographic improvement. This is believed to be the first reported association of BOOP with malaria.
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PMID:Bronchiolitis obliterans organizing pneumonia caused by Plasmodium vivax malaria. 840 17

In a study of the disease pattern of the elderly in Rwanda, all patients aged 60 or more, hospitalized in a one-year period at the Medical Department, University Hospital, Butare, were examined prospectively. One hundred and ninety-two patients were included; most were subsistence farmers having a mainly vegetarian diet and living in large families. Infections (37.5% of the patients) and liver cirrhosis (31.8%) were the problems most frequently encountered. Primary hepatocellular cancer was diagnosed in 5.7% of the patients and was the most frequent malignancy. The hospitalized elderly occupied 17.5% of the available beds in the Medical Department. Their disease pattern was different from that of younger patients, making heavier demands on the medical resources. Malaria and upper intestinal inflammation were less frequent in the elderly; liver cirrhosis, primary hepatocellular cancer, pneumonia, prostatic cancer, cardiovascular pathology, chronic renal pathology and chronic lung disease were more prevalent. Several age-related conditions frequently observed in industrialized countries (e.g. coronary heart disease, stroke, gallstones, renal cysts, dementia) were rare. The study thus illustrates the concept of 'secondary aging': to the primary changes induced by the aging process, additional alterations are added which depend upon the environment and the lifestyle, resulting in a varying disease pattern. Health policies thus must take into account that the demographic transition in developing countries may result in a pattern of diseases different from that seen in industrialized countries; care must be taken when transposing data obtained from elderly populations in industrialized countries.
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PMID:The disease pattern of elderly medical patients in Rwanda, central Africa. 841 4

In the unique environment of Australia's tropical north there are endemic diseases inherited from Gondwana, others introduced from the north and from Europe, and a wide range of particularly venomous animals. There is continuing disparity in morbidity and mortality between Aboriginal people and other Australians in tropical areas and elsewhere. This is being addressed by the National Aboriginal Health Strategy, which emphasises social, environmental and economic issues, as well as control and coordination of services by Aboriginal and Torres Strait Islander communities. While the re-introduction of malaria remains a potential threat, together with other infections, current diseases in tropical Australia are being better elucidated; melioidosis is now recognised as the commonest cause of fatal [corrected] community-acquired pneumonia in the Top End of the Northern Territory, and a new focus of scrub typhus has been found. Sexually transmitted diseases are an urgent issue, especially for Aboriginal communities, given the potential impact of the human immunodeficiency virus.
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PMID:Medicine in tropical Australia. 841 5

Following the establishment of university departments of pediatrics after World War II, national pediatric associations were formed in several countries (in Korea in 1945 and in Nepal in 1981). In Papua New Guinea, the Papuan Medical College began in 1959, and a university department of pediatrics was established in 1974. The population of Papua New Guinea is growing at a rate of 2.3% a year, and less than 70% of women receive prenatal care. Only 40% of deliveries are done under medical supervision. Most of child health problems are associated with malnutrition, pneumonia, gastroenteritis, malaria, meningitis, and tuberculosis. Nonetheless, the infant mortality rate (IMR) dropped from 134/1000 in 1971 to 72/1000 in 1980, and to 60/1000 in 1991. In Nepal, improved child health is a national priority, because the IMR is 129/1000 live births, the under-five mortality rate is 200/1000 live births, life expectancy is 52 years, and adult literacy rates are 39% for males and 12% for females. Nurses receive graduate pediatric training, and there is a postgraduate Diploma in Child Health. In Thailand, supervision of births increased from 33.7% in 1980 to 64.8% in 1988; the IMR dropped from 54.8/1000 live births in 1980 to 42/1000 in 1988; and malnutrition in under-fives dropped from 35.6% in 1980 to 28.5% in 1988. However, 85% of children live in rural communities, and rapid urbanization has resulted in overcrowding, with infectious and parasitic diseases, and high maternal malnutrition. Industrialization profoundly affected child health indices. In Korea the IMR was only 12.5/1000 in 1987, life expectancy was 67 years for males and 75 years for females. In Japan, the IMR dropped from 124/1000 in 1930 to 5.2/1000 in 1986; and maternal mortality declined from 176/100,000 live births in 1950 to 10.8 in 1989. Life expectancy increased from 59.6 years for males and 63 years for females in 1950 to 75.5 years and 81.3 years in 1988, respectively. In Australia, children's hospitals mostly treat asthma, congenital anomalies, and leukemia. Pediatric postgraduate education programs had been developed by the 1980's in most countries. The 7th Asian Congress of Pediatrics was held in Perth, Australia, in May 1991, focusing on priorities of child health.
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PMID:Paediatrics in the Asia-Pacific region. 848 6

A raised respiratory rate is a useful sign in the diagnosis of pneumonia in children. It was observed that children with malaria and other febrile illnesses may also present with a raised respiratory rate. To determine the extent to which increased body temperature contributes to the raised respiratory rate observed in these children the effect of change in body temperature on respiratory rate was measured in 186 sick Gambian children with a raised respiratory rate, including those with pneumonia or malaria. A temperature dependent effect on respiratory rate of 3.7 breaths per minute per degree centigrade was demonstrated for the whole study cohort, with no significant difference between children with pneumonia or malaria. Twenty three per cent of children with pneumonia whose temperature fell had a final respiratory rate below that currently recommended by the World Health Organisation for the diagnosis of pneumonia. It is concluded that respiratory rate is to some extent dependent on body temperature in children with febrile illnesses such as pneumonia and malaria, but that this does not alone account for the raised respiratory rate seen in these children. The effect of reduction in body temperature on respiratory rate does not help to distinguish children with pneumonia from those with malaria. A history of recent use of an antipyretic or other measures to control fever is important when evaluating children for possible pneumonia.
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PMID:The effect of temperature reduction on respiratory rate in febrile illnesses. 850 74


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