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Target Concepts:
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Query: UMLS:C0024530 (
malaria
)
44,886
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Vaccination has been one of the most successful and cost-effective health interventions ever employed. One disease (smallpox) has been eradicated, another (
poliomyelitis
) should disappear early in the new millennium and a third (measles) should follow shortly after. Conventional vaccines usually depend on one of three development processes, attenuation of virulent organisms (by passage in cell culture and/or experimental animals), killing of virulent organisms (by chemical inactivation) or the purification of immunogenic molecules (either proteins or carbohydrates) from whole organisms. These traditional processes, although serendipitous and poorly understood, have produced effective pharmaceutical products which give excellent protection against diseases such as smallpox, rabies, measles, yellow fever, tetanus and diphtheria. In spite of these successes however, the application of these protocols have failed to produce safe and efficacious vaccines against other infectious diseases which kill or maim tens of millions of people every year. The most important of these are
malaria
, AIDS, herpes, dengue fever and some forms of viral hepatitis. Consequently, fundamentally new technologies are required to tackle these important infections. One of the most promising has been the development of genetically modified viruses. This process normally involves taking a proven safe and efficacious vaccine virus, such as vaccinia or adenovirus, and modifying its genome to include genes coding for immunogenic proteins from other viruses such as HIV or measles. This review will describe the generation of such novel vaccine vectors and compare their advantages and shortcomings. In addition the literature describing their use as experimental vaccines will also be reviewed.
...
PMID:Genetically modified viruses: vaccines by design. 1148 48
In a retrospective study, we analyzed the immune status of 1134 travellers (621 males, 513 females), by comparing actual with recommended vaccinations, in particular with regard to
malaria
. 61.6% of travellers showed complete immunization against diphtheria, 73.3% against tetanus, and 66.3% against
polio
. Overall, women have better immunization rates than men. The best immunization rates were seen in young adults (< 20 years). The majority of travellers had destinations in Africa (35.2%), Asia (21.95) and South America (20.9%). Accordingly, vaccinations for yellow fever and hepatitis were the most commonly indicated and implemented vaccinations, and more than 50% received antimalarial chemoprophylaxis.
...
PMID:[Study of vaccination for travel shows: serious gaps in polio, diphtheria and tetanus vaccination]. 1149 43
In the first half of the 20th century, improved living conditions, preventive measures, vaccines and antibiotics led to a marked reduction in morbidity and mortality from infectious diseases. It was predicted that the conquest of all infectious diseases was imminent. However, 50 years later, in 1999, they were still the major cause of disease worldwide, and caused nearly one third of all deaths (a total of 55.9 million). The eradication of smallpox in the 1970s and the approaching eradication of
poliomyelitis
represent major achievements. The prevalence of measles, pertussis and tetanus neonatorum is also markedly reduced, but still 1.5 million children in developing countries die each year because of lack of vaccines.
Malaria
and tuberculosis are re-emerging. Tuberculosis and HIV/AIDS are the diseases with known aetiology that cause most deaths, altogether 5 million each year. Respiratory and gastrointestinal infections cause 6.5 million deaths annually. Infections in the immunocompromised host have become a "trade mark" of today's advanced medicine. Almost every year, new diseases related to new micro-organisms are described; over the last 30 years, approximately 40 new diseases/micro-organisms have been diagnosed. Among the best known are HIV/AIDS, peptic ulcer caused by Helicobacter pylori, Legionnaires' disease, borreliosis (Lyme disease), hepatitis C, gastroenteritis caused by rotavirus, and Ebola haemorrhagic fever. Antimicrobial resistance development of micro-organisms has become one of the major health problems worldwide; a number of preventive measures are being introduced.
...
PMID:[Microorganisms strike back--infectious diseases during the last 50 years]. 1180 14
Recent advances in travel medicine include the use of computer resources to obtain information on outbreaks and recommendations to travelers, the introduction of atovaquone/proguanil as chemoprophylaxis and treatment for
malaria
, the use of azithromycin as an alternative in the self-treatment of traveler's diarrhea, and the combination of hepatitis A and hepatitis B vaccines. At the same time, new challenges continue to appear. Shifts in the distribution of infections, such as West Nile virus and dengue fever, underscore the need for up-to-date information. Well-known infectious diseases, such as
polio
, meningococcal meningitis, and influenza are appearing in unexpected ways and settings. It is increasingly clear that travelers, while at risk for infections, also play a role in the global dispersal of pathogens, such as certain serogroups of Neisseria meningitidis and influenza. Increasing drug resistance affects the choice of drugs for treatment and chemoprophylaxis, and decisions about use of vaccines. Newly identified adverse events associated with yellow fever vaccine have prompted enhanced surveillance after vaccination and careful scrutiny of appropriate indications for the vaccine.
...
PMID:Recent Advances and New Challenges in Travel Medicine. 1185 57
The World Health Organization is the leading international agency in health. WHO's reputation reached a peak in the 1970s with the then director-general Halfdan Mahler's advocacy of Health for All by the Year 2000 and the successful worldwide eradication of smallpox. The 1980s and 1990s saw WHO lose much of its authority. Too easily, the blame was put on one man-Mahler's successor, Hiroshi Nakajima. In 1998, Gro Harlem Brundtland, Figure 1 a former Prime Minister of Norway, took office and WHO began a period of major strategic and structural reform. Almost 4 years into her first term as director-general, I visited WHO's headquarters in Geneva to learn about Dr Brundtland's successes and failures. Figure 2 The ground rules of my visit were that I could talk with anybody and attend almost any meeting (budget discussions were excluded). I interviewed Dr Brundtland, executive directors, members of the staff association, and directors and project managers of programmes such as StopTB, Roll Back
Malaria
, HIV-AIDS, violence prevention,
polio
eradication, essential drugs and medicines, and sustainable development. At senior levels, WHO is confident and clear about its purpose-in a way that matches Mahler's vision and goes beyond it in results. Brundtland told me that her most important achievements were to have "strengthened the credibility of WHO" and to have "raised the awareness of health on to the political and global development agendas". But there is a troubling schism between the aspirations of its leadership and the realities faced by the organisation on the ground. Rapid change during the past 4 years has reinvigorated WHO's mandate, but poor management has created new tensions that the organisation's leadership seems unwilling to address.
...
PMID:WHO: the casualties and compromises of renewal. 1235 5
How do global disease control priorities emerge? This paper examines the post-World War II histories of efforts to control three diseases--
polio
,
malaria
and tuberculosis--to investigate this issue. The paper draws from the policy studies literature to evaluate three models of the priority generation process. A rational model suggests logical selection based on global burden and the availability of cost-effective interventions. An incremental model suggests a drawn out process in which health priorities emerge gradually and interventions reach affected populations through slow diffusion. A punctuated equilibrium model suggests a more complex pattern: long periods of stability during which interventions are available only to select populations, punctuated by bursts of attention as these interventions spread across the globe in concentrated periods of time. The paper finds that the punctuated equilibrium model corresponds most closely to efforts to control these three diseases. Bursts are associated with the convergence of three conditions: the widespread acceptance of the disease as a threat; a perception that human interventions can control disease transmission; and the formation of a transnational coalition of health actors concerned with fighting the disease. The generation of each condition requires considerable groundwork, the reason for long periods of stability. Initiatives take off rapidly when the conditions couple, the reason for bursts. The paper aims to spark additional research on the subject of global disease control agenda setting, a neglected issue in the health policy literature.
...
PMID:The emergence of global disease control priorities. 1213 88
The Proceedings here reviewed are those of the meeting held in Geneva in October, 1983, which led to the establishment of the World Health Organization's Program for the Accelerated Development of New Vaccines. These papers reflect the state of the art in the development of vaccines for cholera, leprosy, pertussis, salmonella, shigella, dengue, foot-and-mouth disease, hepatitis B, herpes simplex, influenza,
poliomyelitis
, Chagas' disease,
malaria
, and schistosomiasis. The identification and isolation of epitopes and other antigenic fragments is presented, as well as considerations of mucosal immunity, antigenic determinants and antigenic variations, antigen presentation and T-cell activation, the use of anti-idiotypes as antigens, the development of recombinant viruses for use in vaccines, and the use of circumsporozoite antigens in the preparation of a
malaria
vaccine.
...
PMID:New approaches to vaccine development. Proceedings of a meeting organized by the World Health Organization. Book review. 1222 27
Child survival in Cameroon is measured in the 1991 Demographic and Health Survey and found to be substantially improved. The survey includes a sample of 3871 women aged 15-49 years and a sample of 814 husbands. Community services data is also collected. Child mortality is reported as declining from 198 to 126 deaths per 1000 births during 1976-91. Infant mortality is shown to decline to 65/1000. Mortality of children aged 1-4 years is 66/1000. 79% receive prenatal care from some source, and 70% receive a dose of tetanus toxoid vaccine during pregnancy. A health professional is present at delivery for 64% of pregnant women. 52% of children aged 12-23 months have a health card, and 41% have tuberculosis,
polio
, diphtheria, pertussis, tetanus, and measles immunization. One in five still does not have any immunization. 62% of children with mothers who have at least a secondary school education are immunized. Diarrhea morbidity in the two weeks preceding the survey is 18% for children aged under 5 years. 9% have a cough and rapid breathing, and 23% have a fever. Child mortality among children aged 1-5 years is due to diarrhea (27%),
malaria
(23%), measles (27%), and respiratory infections (16%). Only 3% of children aged under 5 years has acute malnutrition. One in four are stunted, which reflects prolonged or chronic undernutrition. The total fertility rate is 5.8 children per woman, which is a 10% decrease from 1978. The lowest fertility is among women in the main cities of Yaounde and Douala (4.4 children) and among women with a secondary or higher education (4.5). Over 50% of women have sexual intercourse before the age of 16 years, and 50% are married before the age of 17 years. 50% of married women have their first child at the age of 19 years. Contraceptive usage is 16% among women in any union, of which 25% is use of a modern method. Only 1 in 25 women use an effective method, but this rate is double the rate in 1978. Total fertility would be 10% if unwanted fertility were avoided. Most men and women want large families.
...
PMID:Improved child survival in Cameroon. 1228 22
The project for the struggle against childhood diseases began in Rwanda in 1984. Lack of birth spacing, malnutrition, unhealthy environments and infectious diseases sicken and kill children in all of Africa, and many may be alleviated by simple measures. The project focuses on diarrhea and
malaria
, attempting to reduce mortality by 25%, administering chloroquine to children with fever and pregnant mothers for
malaria
, and oral rehydration therapy (ORT) for diarrhea. Goals are breastfeeding and gradual weaning being as universal as possible, and proper alimentation for sufferers of infant diarrhea. ORT is expected to be administered by the mother herself, and should reduce the 60% to 70% of diarrhea deaths caused by dehydration. Measles, whooping cough, neonatal tetanus,
polio
, diphtheria, and tuberculosis among children will be the targets of innoculation campaigns. All of the diseases are major child killers in Africa; measles are responsible for an estimated 31.3% of child deaths from 1 to 4, 10.3% in the 1st year of life. Community oriented primary care of the type necessary to execute these programs is not presently a priority among medical personnel; it should become an important component of medical education. Education to counter ignorance and the designation of the family as the primary instrument of good health will assure child survival and eliminate the need for multiple births to maintain the family.
...
PMID:[Program to combat communicable diseases in children]. 1234 Mar 78
This document presents an interview with Dr. Anthony Fauci on the development of a new generation of vaccines to prevent and possibly eradicate a legion of deadly diseases ranging from tuberculosis to AIDS. Infections that have caused major devastations in the world today include tuberculosis,
malaria
, schistosomiasis, filariasis, pneumococcal pneumonia, influenza, AIDS, and Ebola. Agencies should be making sure that the basic research base in microbiology, immunology, antimicrobials, and vaccinology is at the very highest level. The integration of research efforts between countries depends on collaboration between the investigators of home countries with foreign investigators. Among new developments in vaccinology are an acellular pertussis vaccine for pertussis/whooping cough (an extremely contagious disease that causes death), DNA immunization (a new technique applicable to all types of diseases), and transgenic plants for immunization against hepatitis, pertussis, and
polio
. As of now, AIDS in Western countries has declined, while in Africa and Asia its spread has accelerated. Combination therapy for AIDS has had a profound impact on the level of the virus in the body; however, the treatment is still vague. The good news with regard to AIDS is that education is having an impact; this is exemplified by the situation in Thailand, where the government together with nongovernmental organizations and the military has begun a crash education campaign regarding prostitutes and the use of condoms. Progress is being made in the search for better vaccine candidates. AIDS-like epidemics involving new diseases are bound to emerge at some future point, though, given the long-term historical trend.
...
PMID:New drugs, new vaccines, new diseases. An interview with Dr. Anthony Fauci, Director of the National Institute of Allergy and Infectious Diseases (NIAID). 1234 52
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