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)

Researchers analyzed data on 2627 Australian tourists returning from Kenya, Sri Lanka, Thailand, and the Maldives (November 1988-March 1989 and October 1989-January 1990) to examine tourist behavior regarding prophylaxis measures. 94.1% sought health information. 1st time tourists were more likely to get this information than those who had already made at least 1 visit (98.1% vs. 92%; p.05). Many tourists relied on travel agencies (37.5%) and friends (20.2%) for this information. Experienced tourists were not as likely to depend on travel agencies and friends as were 1st time tourists (p.05), however. 92% of those who sought information took at least 1 precautionary measure. 96.3% of tourists to Kenya carried out a prophylactic measure compared with 79.6% of those to the Maldives (p.05). Tourists tended to obtain immunoglobulin prophylaxis against hepatitis A (75.1-84.8%), yet not obtain vaccinations for typhoid fever (55.7-68.1%), tetanus (43.3-56.7%), and polio (25.9-38.7%). They appeared to be aware of dietary risks (86.1%), but not about sexually transmitted disease risk such as AIDS (41.7%) or taking a medical travel kit (50.5%). After a mass media campaign, these figures increased to 93.1% (not significant), 64.7% (p.01), and 68.2% (p.05). The Maldives was free of malaria, but 31.9% still took malaria prophylaxis. Most travelers to Thailand (88.35) also took malaria prophylaxis, yet 81.8% of them went to malaria-free areas. Tourists to Kenya had better compliance than those to Sri Lanka (94.2% vs. 82.7%, p.05). Moreover only 74.7% of travelers to Kenya took mefloquine, the recommended choice for short-term travelers. Compliance was greater among those who took mefloquine than it was for those taking chloroquine (74.1% vs. 90.3%, p .01). The most important finding was the considerable misinformation about and noncompliance with malaria prophylaxis. For example, the more complex the intake instructions the more likely noncompliance occurs.
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PMID:Compliance of Austrian tourists with prophylactic measures. 164 43

We report a prospective study of travel-associated illnesses observed after their return in 109 French travellers, including 86 tourists. Sixty-three were returning from Africa and 84 percent had been abroad for less than 4 weeks. The percentages of travellers immunized against tetanus, poliomyelitis and typhoid fever were 70, 63 and 36 percent respectively. Malaria prophylaxis was well adjusted to current recommendations in only 19 patients; for 9 patients it was a routine visit. One hundred patients reported 105 diseases. The diagnosis was undetermined in 31 patients, including 19 with diarrhoea and 8 with fever, and it was determined in 74 patients who were found to have malaria (14), cutaneous myiasis (12) or bacterial skin infections (12).
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PMID:[Diseases observed after return from travels outside Europe. 109 cases]. 171 19

The results of medical examinations carried out on 212 missionary personnel from one missionary society returning on leave to the UK are presented. The great majority of missionaries worked in developing countries. They served in 27 countries altogether and for a total of 488 person years. The commonest illnesses reported overseas were malaria (87.3 per 1000 person years at risk), diarrhoea (63.5), anxiety (63.5), depression (41.0) and giardiasis (38.9). More illnesses were reported from West Africa (698 per 1000 person years at risk) than from any other region. Ten people (4.7%) were repatriated for health reasons and 10 relatives also returned as a consequence. Sixty per cent of those returning did so because of psychiatric illness. The highest rates of immunization achieved were for yellow fever (100% of those travelling to affected countries), tetanus (93%), polio (85%), typhoid (71%) and tuberculosis (53%). The results of urinalysis (100% of adults), full blood counts (78% of adults) and stool tests (74% of all people) are reported. The study shows that the history and psychiatric examination are an important part of the medical examination of people returning from overseas. Physical examination and urinalysis did not contribute much information, although the full blood count and absolute eosinophil count were useful tests.
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PMID:A survey of the health of British missionaries. 185 37

It is estimated that five million Americans will travel to the developing world over the next year. This study examines the demographic profile, past medical and immunization history, itinerary, and reason for travel of 2, 445 travelers to the developing world seen at a travel medicine service from 1984 through 1989. The travelers age ranged from three months to 85 years (mean age 43). A chronic medical condition was reported by 654 (27%). Four percent of all travelers were intolerant of sulfonamides, and 9% had contraindications to mefloquine for malaria prophylaxis. Many travelers were due to receive the primary series or updatings of routinely recommended immunizations: 43% for tetanus/diphtheria, 55% of those born after 1956 for measles, and 70% for polio if their travel itinerary included a polio risk. Most travel (71%) was for vacations, 13% was for teaching or study, 11% for business, and 5% for missionary activities. The median duration of travel was 21 days; 5% traveled for more than one year. While over 150 countries were visited, 52% of all travel was to 10 countries in East Africa, the Indian subcontinent, the Far East, and South America. Information about the epidemiology of travel to the developing world can help physicians and travel medicine services develop more effective preventive measures for travelers.
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PMID:Pre-travel health, immunization status, and demographics of travel to the developing world for individuals visiting a travel medicine service. 187 22

The health situation in Nigeria is typical of tropical Africa. It is characterised by high childhood and maternal mortality and a relatively short life expectancy. Mortality in childhood in due mainly to diseases like malaria, measles, poliomyelitis, tetanus, diarrhoea and acute respiratory tract infections. Diseases like filariasis, schistosomiasis and leprosy which are now readily controlled by drugs cause considerable morbidity in later life. Although the technology and tools (particularly vaccines and drugs) for the control of most of these diseases are now available, it has not been possible to make optimal use of them in Nigeria and other tropical African countries because of unfavourable social and economic conditions. The non-availability of drugs most needed for healthcare and disease control has been found to be due not only to insufficient funds but also to the use of the limited funds on expensive drugs that have little bearing on the disease pattern. The Essential Drug Programme initiated by the World Health Organisation, now adopted by Nigeria and about 100 other countries mostly in the Third World, aims to correct this unsatisfactory drug supply situation by ensuring that the available funds are used to provide those drugs needed by the large majority of the people and are made available at all times at prices that most people can afford. The Bamako Initiative in the African Region of the World Health Organization is also designed to ensure regular availability of drugs particularly to primary healthcare facilities. Seed drugs are provided to the health institutions either by the National Government or through external aid. These are sold to patients at a small profit margin. The proceeds are then used to replenish stocks and the small profit used to improve services in the health centre. The introduction of these programmes in Nigeria has improved drug availability considerably in the past couple of years and should soon start yielding further dividend in the form of measurable improvement in the health situation.
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PMID:Drug supply in Nigeria. 204 36

Researchers interviewed 194 mothers of children 1-2 years old in Port Moresby, New Guinea to determine why childhood immunizations are not completed. They also looked at the baby clinic books to see if the children received the completed doses of vaccines. 87% did not know why children should be immunized. Moreover only 13% believed immunizations could prevent disease. Further 86.6% could not list any of the diseases that immunizations target. 11.9% did correctly report measles, tuberculosis, polio, and pertussis, however. On the other hand, 3 (1.5%) mothers incorrectly believed immunizations protect against malaria, diarrhea, and malnutrition. The relationship between lack of knowledge and noncompletion of immunization was not significant, however (p=.07). 76.8% reported very rude behavior on the part of the health staff. 15.5% went so far to say that the health staff often reacted aggressively towards them. Only 7.7% reported kind of behavior. Mothers who perceived health staff attitudes as negative tended not to return to the clinic with their children for the 3rd dose (p=.002). DPT and polio vaccine coverage declined consistently from 94% (1st dose) to 79% (3rd dose). Nevertheless 3rd dose coverage was considered rather high. Since hospital delivery was almost universal in Port Moresby and hospital staff routinely administer the BCG vaccination prior to discharge, BCG coverage was high (96%), however. Emphasis in the national immunization program should be on changing health staff attitudes leading to improvements in the social interaction between patients and health staff.
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PMID:Possible reasons for non-completion of immunization in an urban settlement of Papua New Guinea. 205 99

A total of 740 consecutive children aged between 6 months and 12 years who presented with acute encephalopathic illnesses during a three year period were assessed both clinically and by laboratory investigations. Cerebrospinal fluid was examined for the presence of cells or other abnormal substances, and any organisms were cultured. Blood examination included white cell count and estimations of haemoglobin, urea, glucose, and electrolyte concentrations and serum alanine aminotransferase and aspartate aminotransferase. A firm diagnosis was established in 278 patients (38%). Pyogenic meningitis (n = 134), measles encephalopathy (n = 38), and electrolyte imbalance (n = 23) were important causes in this group, cerebral malaria (n = 4) was uncommon and there were no cases of Reye's syndrome. The diagnoses of the remaining 462 were combined under the heading 'acute unexplained encephalopathy'. Altogether 394 of the 462 patients underwent virological investigations for arboviruses and 92 (23%) had one or more indicators of Japanese encephalitis. No other arboviruses could be isolated. Throat swabs from 187 patients with acute unexplained encephalopathy were studied on monkey kidney tissue cell lines of which 14 were positive (8%). These were identified as adenovirus, parainfluenza, influenza, poliomyelitis, Coxsackie, and echovirus; in two cases the virus was untypable. Japanese encephalitis is an important cause of acute childhood encephalopathy in this region. Clinical features of the illness may be mimicked by several disorders which require specific treatment. Thirty four of the 92 died (37%).
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PMID:Virological investigations of acute encephalopathy in India. 203 25

Health care in Nicaragua has drastically deteriorated since the United Opposition (UNO) came to power in April of 1990. During the previous decade, when the Sandinistas were in power, Nicaragua saw vast improvement in primary health care. The number of auxiliary health workers, including birth attendants and hygiene and nutrition advisors, increased significantly. With the aid of volunteers, vaccination campaigns succeeded in eradicating polio and in greatly reducing the incidence of measles, tetanus, and typhoid. Malaria and diphtheria were also drastically reduced. But these days, vaccination campaigns have failed to take place or to reach the intended audience, and health clinics have been short on supplies. As a result, the last 6 months have seen a recurrence of all the diseases, some in the form of epidemics. As the new Nicaraguan health minister, Dr. Salmeron, explains, 1300 children have died over the last 8 months due to an outbreak of measles. Furthermore, he says, many more children are ill due to a lack of inoculation or oral rehydration solutions. Salmeron, a middle-of-the-road private practitioner, has been critical of the new government's health policies. The government has said it will close local clinics so that it can concentrate health care in 12 "centers of excellence" -- but these hospitals have yet to appear. Furthermore, not only has the Chamorro government failed in its pledge to bring inflation down to 0, it hasn't been able to stop it from climbing to 100%.month. Health authorities have not received their monthly budgets, there are medicine and supply shortages, and patients are having to share beds. As Salmeron points out, the new government is abandoning one of the most successful health care systems in the Third World.
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PMID:Whither Nicaragua? 226 27

In a clinical trial of stabilized yellow fever vaccine from Institute Pasteur in 77 children aged seven to eight months, fever was the most significant immediate and delayed side effect. Fever occurred in 12 (15.6%) children with in 48 hours of vaccination while it occurred in 10 (12.9%) children within ten days of vaccination. Other recorded side effects were pain at innoculation site in four (5.2%) children and vomiting in one (1.3%) child. Temperature recorded in 20 of the 22 febrile episodes ranged from 37.8 degrees C to 38.6 degrees C. One of the two patients who had temperatures of 39 degrees C and above had malaria parasites in her blood film. All episodes of fever except one responded to antipyretic. There was no episode of febrile convulsion and no feature suggestive of encephalitis. Of the 20 children who had neutralization test carried out against yellow fever virus six weeks after vaccination, the test was positive in post vaccination sera of 12 (60%) children whose pre-vaccination sera were negative. Two others showed evidence of partial protection. Although the seroconversion rate of 60% is less than reported in adults and older children, the result of this study shows that yellow fever vaccine is safe and fairly effective in infants. It is our suggestion that if a larger trial confirms our findings, the vaccine may be incorporated into the expanded programme on immunization (EPI) to be given at the age of seven months after completion of diptheria, tetanus, pertussis and poliomyelitis vaccinations and before measles vaccination is due.
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PMID:Safety and efficacy of yellow fever vaccine in children less thanone-year-old. 227 33

WHO's "Health for All by the Year 2000" gives as subsidiary objective number 5 "The elimination of measles, poliomyelitis, neonatal tetanus, congenital sequelae of rubella, diphtheria, congenital syphilis and malaria from the European region by the year 2000". This would be attained by a well organized primary care which guarantees effective epidemiological supervision, a vaccination programme with full support, instruction on the risks associated with syphilis, and screening and eventual treatment of pregnant women. It was earlier declared in Norway that congenital rubella should not occur after 1990. Vaccination is carried out; rubella has long been a notifiable disease, and the incidence thereof in females over the age of 15 years is registered in order to ascertain why and how women are nevertheless infected thereby.
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PMID:[Rubella monitoring in Norway]. 236 93


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