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

Malaria remains prevalent throughout tropical and subtropical regions and almost a third of the World's population is exposed to the risk of infection. There is currently a serious resurgence of the disease in Asia and Central America. The failure of global eradication measures based upon the use of insecticides and chemotherapy has resulted from difficulties of practical implementation compounded by the spread of insecticide and drug resistance. Repeated natural infection does not produce detectable resistance to the exo-erythrocytic cycle of malaria in man. Irradiated sporzoite vaccines do, however, induce stage specific immunity in murine malaria and in a proportion of human subjects. Vaccinated individuals remain susceptible to blood stage infection which causes clinical malaria. In addition the vaccine is unstable and must be administered by intravenous inoculation. Since neither sporogonic nor exo-erythrocytic parasite development is cyclical in human malarias, there is little prospect for vaccine production through cultivation of these stages. The inhabitants of hyperendaemic areas become increasingly resistant to malaria during childhood and adolescence, through the slow development of specific, acquired immunity to asexual blood stage parasites. Immunity is mediated by antibody, which blocks merozoite invasion of red cells, as well as by cell mediated mechanisms and non-specific cytotoxic agents. Vaccination with merozoites induces long lasting immunity of broad serological specificity active against the blood-stage of the parasite. Merozoite vaccines can be preserved by freeze drying and harvested from continuous cultures of blood stage parasites. The major problem in development of a human merozoite vaccine concerns the requirement for Freund's complete adjuvant which is not acceptable for man. The effective immunity induced by vaccination contrasts with the slow development of incomplete resistance which follows repeated natural infection. The latter is associated with the generation of immune suppressor cells, lymphoid cell mitogens and soluble antigens, and in some species by the occurrence of antigenic variation--all of which may favour parasite survival. It is probable that vaccination with non-viable antigen of appropriate composition, induces immune effector processes without activating mechanisms which allow parasites to escape the consequences of immunity. Many effective vaccines such as those against measles, poliomyelitis, tetanus and rabies are commercially available but barely used in the developing world. The affected nations cannot afford their purchase, nor do the means exist for their distribution. It follows that if a safe and effective malaria vaccine were to be developed, its bulk manufacture and administration would require massive international support and cooperation.
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PMID:Immunity to malaria. 3 57

Early referral for hospital delivery is important to reduce the risks during pregnancy and labor for 90% of the women in rural areas. Therefore, Tanzania has improved a record card for antenatal screening that would detect labor complications, indicate appropriate action, emphasize preventive treatment for pregnancy complications, and record labor outcome. A patient's obstetric history is obtained and the patient is examined with consideration given to height and limp or polio leg. Patients with raised blood pressure, signs of pre-eclamptic toxemia, or severe anemia are referred to the hospital and if breech, transverse lie, or twins are suspected, the patient is booked for a hospital delivery. Prevention of anemia, malaria, and neonatal tetanus are emphasized. Of 13,410 women screened, a height factor of 146 cm or less accounted for 41.6% of all risk factors, and 81% of all risk factors were detected from the patient's history and height measurement. By using the new antenatal cards there was a higher detection rate of risk cases an when used by different health workers, there was over 95% agreement in findings compared to 68% using the old cards.
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PMID:Use of an action-orientated record for antenatal screening. 30 47

The official notifications of the Department of Health pertaining to typhoid fever, tuberculosis, poliomyelitis and malaria are reviewed. Major findings of the epidemiological analysis of the data include the need for establishing the exact mode of transmission of typhoid, the need for assessing upper and lower limits of the expected case load in respect of tuberculosis over the next 5--10 years, the demonstration of the dramatic decline in the number of cases of poliomyelitis and the equally dramatic upsurge of malaria in 1977 and 1978. The need for an integrated, responsive and fully co-ordinated epidemiological service for the Republic of South Africa is emphasized.
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PMID:Trends in four major communicable diseases. 46 49

This article describes the major activities carried out since 1959 in the field of pediatrics and child care in Cuba. In particular, it notes the improvements made through establishment of a national health system and through the participation of community organizations (the Federation of Cuban Women, Committees for the Defense of the Revolution, associations of small farmers, and trade unions) and shows how perinatal, infant, and childhood mortality have been significantly reduced. As of 1973 perinatal mortality had fallen to 27.9 deaths per 1,000 live births, infant mortality to 27.4 deaths per 1,000 live births, preschool mortality to 1.2 per 1,000 children, and school-age mortality, to 0.4 per 1,000 children. This report also cites data on available physical and manpower resources, and outlines a large range of activities linked to a Comprehensive Child Care Program undertaken in 1967. This program, in which newborns are enrolled upon leaving the maternity, seeks to encourage breast-feeding, to promote the activities of well-baby clinics, to provide special examinations for malnourished infants, to provide health care for preschool and school-age children, to promote pediatric medical visits to the home, to assist with camps for asthmatic and diabetic children, to provide pediatric services at pioneer and other camps for schoolchildren, to carry out health education activities, and to combat communicable disease. In particular, activites to prevent communicable disease appear responsible for a good part of the progress achieved to date. As a result of these activities malaria and diphtheria have been eradicated, poliomyelitis has been overcome, and the incidences of tuberculosis, tuberculous meningitis, tetanus (among both newborns and children under 15), and acute diarrheal disease have been substantially reduced.
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PMID:Advances in pediatrics and child care in Cuba, 1959-1974. 77 91

Various workers, including T. D. Stewart, claim that the aboriginal Americas were relatively disease-free because of the bering Strait cold-screen, eliminating many pathogens, and the paucity of zoonotic infections because of few domestic animals. Evidence of varying validity suggests that precontact Americns had their own strains of treponemic infections, bacillary and amoebic dysenteries, influenza and viral penumonia and other respiratory diseases, salmonellosis and perhaps other food poisoning, various arthritides, some endoparasites such as the ascarids, and several geographically circumscribed diseases such as the rickettsial verruca (Carrion's disease) and New World leishmaniasis and trypanosomiasis. Questionably aboriginal are tuberculosis and typhus. Accordingly, virtually all the "crowd-type" ecopathogenic diseases such as smallpox, yellow fever, typhoid, malaria, measles, pertussis, polio, etc., appear to have been absent from the New World, and were only brought in by White conquerors and their Black slaves. My hypothesis is that native American medical care systems--especially in the more culturally advanced areas--were sufficiently sophisticated to deal with native disease entities with reasonable competence. But native medical systems could not cope with the "crowd-type" disease imports that struck Indian and Eskimos as "virgin-field" populations. Reanalysis of native population losses through a genocidal combination of diease, war, slavery and attendant cultural disruption by Dobyns, Cook and others strongly suggest that traditiona estimates underplayed the death toll by a factor of the general order of ten. This would make for an immediately pre-contact Indian population of some 90-111 million instead of the tradition 8-11 million. Evidence is growing that Indians may have been no more susceptible to new pathogens that are other "virgin soil" populations, and thus their immune systems need not be considered less effective than those in other people. Present-day high mortality rates in Indians of both continents from infectious disease imports may be more socioeconomic than anything else.
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PMID:Aboriginal new world epidemiolgy and medical care, and the impact of Old World disease imports. 79 20

Great streams of tourists flow every year from the Federal Republic to southern countries. The danger of infection with serious tropical diseases such as smallpox, cholera or leprosy is fairly small, statistically speaking. Even exotic parasitoses merit only individual medical interest in the majority of cases. Of greater importance are the cosmopolitan infectious diseases such as typhoid fever, paratyphoid, salmonella enteritis, poliomyelitis, viral hepatitides which are transmitted orally and altogether are imported in no small numbers. The alteration of the mode of living caused by the holiday and frequently a false confidence in the hygienic conditions favor the infection. Almost independent of the behavior of the tourists are the infections produced by insect bites, such as malaria or the leishmaniases, which often end fatally for lack of recognition. Here, a better enlightment of the travelers, the use of prophylactic agents and improvement of diagnosis must be instituted.
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PMID:[Tourism and risk of infection (author's transl)]. 82 9

This article is a transcript of the 58th Joseph Price Oration, delivered by Egon Diczfalusy (MD, PhD) at the 10th Annual Meeting of the American Gynecological and Obstetrical Society, held in Carlsbad, California on September 5-7, 1991. In his speech, Diczfalusy discussed the international community's moral obligation to promoting reproductive health, which hinges primarily on contraceptive prevalence. WHO figures indicate that 85% of the world's births, 95% of the world's infant deaths, and 99% of the world's maternal deaths take place in developing countries. While a women in a developed country has a 1 in 1750 chance of dying from pregnancy-related causes, the risk is 1 in 24 for a woman in Africa. The goals of reproductive health are well-known: reducing the unmet need for family planning, increasing family planning services and methods; lessening maternal, infant, and child mortality and morbidity; and reducing the prevalence of STDs. An investment of $2/capita would eliminate most maternal deaths in the developing world. An additional $2/capita spending increase in developing countries would also immunize all children, eradicate polio, and provide the drugs necessary to cure all cases of diarrheal disease, acute respiratory infection tuberculosis, malaria, schistosomiasis, and STDs. But the most important element with respect to reproductive health is increasing contraceptive prevalence. Over the next decade, yearly world population increments will approach 97 million. 94% of this growth will take place in developing countries. As Diczfalusy explains, the technology and resources to solve these problems exists. At bottom, the obstacle to overcoming the problems is the lack of political will.
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PMID:Contraceptive prevalence, reproductive health, and international morality. 156 58

The international community has launched the Children's Vaccine Initiative, which has created the most ambitious grouping of public and private sector interests ever to tackle a global health issue. Developed by WHO, UNICEF, UNDP, the World Bank, and the Rockefeller Foundation, the initiative is the result of decisions taken at the World Summit for Children, held in New York in September 1990. During that meeting, world leaders requested greater resources for the development of new or better vaccines. The Children's Vaccine Initiative, says WHO Director-General Dr. Hiroshi Nakajima, will not only yield specific benefits in improving vaccines, it will also establish a process of collaboration between the public and private sectors, which will have far-reaching benefits in other areas. The new initiative comes on the heels of another international effort, the successful Expanded Program on Immunization, which in 1990 achieved its goal of immunizing 80% of the world's children against 6 major childhood diseases: poliomyelitis, measles, tuberculosis, diphtheria, pertussis, and tetanus. The new initiative will strive to develop vaccines against a wider spectrum of viral, bacterial, and parasitic diseases which cause mortality in children. These diseases include rotavirus infection, hepatitis A and E, dengue, Japanese encephalitis, acute respiratory diseases, meningococcal meningitis, diarrheal diseases, pneumococcal pneumonia, and malaria. The new initiative will also seek to improve existing vaccines, making them easier to administer and less painful and costly.
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PMID:New children's vaccine initiative launched. 160 Apr 43

Mortality trends of missionary staff serving in sub-Saharan Africa were tracked for the period 1945-1985. For 1945-1970, when more complete incidence data were available, the missionary death rate was approximately 40% lower, after adjustment, than would be expected in a comparable US population. This trend persisted through 1985. Between 1945 and 1970, the largest number of fatalities was attributable to malignancy, atherosclerosis, accidents, and infectious disease, and the greatest mortality risks, compared with the US experience, were from homicides, the complications of pregnancy, and infections, notably malaria, hepatitis, and polio. Beginning in the late 1950s, motor vehicle accidents became the leading cause of death. Since the 1960s, accidental causes of death have been approximately 50% higher than in the US, and homicides have been four times higher. During this same period, the infectious disease death rate decreased to approximately that within the US. Currently, the leading causes of mortality are motor vehicle accidents, malignancy, and atherosclerosis, followed by other accidental causes, notably aircraft mishaps and drownings. Viral hepatitis is presently the leading infectious disease cause of death. Other contemporary lethal infections include malaria, rabies, typhoid, Lassa fever, and retroviral infection. It was concluded that missionaries in sub-Saharan Africa had a death rate approximately half that expected in a comparable domestic control population. Preventive strategies, particularly relative to accident and infectious disease prevention, could effectively reduce mortality risk further.
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PMID:Mortality trends of American missionaries in Africa, 1945-1985. 162 93

New vaccine developments will reflect achievements of the World Health Organization's (WHO) Expanded Programme on Immunization (EPI), as well as resistance from the public toward increasing numbers of vaccines. WHO's EPI program has concentrated on tuberculosis, diphtheria, tetanus, whooping cough, polio, and measles. 35 countries are attempting to control hepatitis B with universal vaccination. Now some countries are also recommending vaccination against Haemophilus influenza, mumps, and rubella. The complexity of multiple injections has prompted new research on acellular vaccines for pertussis, hepatitis A and B, varicella, and malaria. Combined vaccines and new adjuvants are also targets of intense research. Vaccines are a priority, because they are among the most cost-effective of medical interventions.
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PMID:New developments in vaccinology. 163 65


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