Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Lessons learned from Haiti's integration of a training program for traditional birth attendants with the maternal and child health and family planning program are reported. The available data on illness and deaths reveal that Haiti has continuing problems of gastroenteritis, malnutrition, tuberculosis, malaria, and tetanus. The latter is of particular interest since neonatal tetanus derived from umbilical cord contamination continues to affect up to 10-20% of Haitian newborns in rural areas lacking health programs. Neonatal tetanus has largely disappeared in the Artibonite Valley due to a mass immunization program for the entire population, including young women, against tetanus. In the Albert Schweitzer Hospital program for indigenous midwives in Artibonite Valley, at least 36 midwives were reached on a regular basis in 1968 -- less than 1/3 of the midwives operating in the Artibonite Valley. There was a rapid decline in neonatal tetanus admissions during the period following 1968. This decline has been attributed to the use of rural health auxiliaries in immunizing the women in the hospital district, but indigenous midwives may have played a role. By 1970, the Albert Schweitzer Hospital program had grown from 36 midwives regularly attending midwife classes to 175 registered with the program during 1970. Although direct supervision proved difficult due to lack of communication and transport to the scene of delivery, some deliveries were observed and indirect supervision by the community became evident. An important finding of the traditional midwife training program of the Albert Schweitzer Hospital was the amount of time required for an indigenous midwife to have referred 50 newborns to the hospital for BCG vaccination. At the end of the 1st year of this program, only 2 midwives reached this goal. Another surprise was the increase in demand for "cord cut" services at the outpatient clinic rather than increased use of the nearby maternity unit. The elimination of neonatal tetanus as a cause of infant mortality was the most important outcome of the maternal and child health component of the community health program.
 ...
PMID:Traditional midwives, tetanus immunization, and infant mortality in rural Haiti. 667 3

The different vaccination programs in a large chemical company with 12,000 co-workers are discussed. On the one hand mass-vaccinations against influenza, tetanus, and polio are carried out; on the other hand attention is paid to special target groups (people on business trips, members of agro units who have to work several months in the tropics under bad hygienic conditions, laboratory personal which has daily contact with human blood, serum, urine, and faeces). On all this people special vaccinations are performed which are discussed in detail. Moreover great attention is paid on a regular and effective malaria prophylaxis in all co-workers travelling and working in the tropics.
 ...
PMID:[A comprehensive vaccination program as a preventive contribution in a large-scale chemical industry]. 670 14

Physicians counseling patients who are planning major travels should make sure that baseline immunizations (diphtheria-tetanus-pertussis, polio, measles, rubella) and any necessary boosters are current. In addition, several other immunizations may be warranted (yellow fever, typhoid, and cholera), depending on destination(s) and itinerary, and prophylaxis for malaria may be advisable. As worldwide requirements for immunization do change, the physician should verify current requirements before planning an immunization schedule for a particular patient.
 ...
PMID:Immunization. Around the world in 80 shots. 682 57

Health care problems are discussed by an employee of the Mozambican maternal and child health service. The most serious problems for children are malnutrition, infectious diseases, and a high incidence of illnesses in children under 5. The main objectives of health centers are to improve hygiene, combat tuberculosis, leprosy, and malaria as well as to provide maternal and child health care, including family planning. Trained staff advise pregnant women, and examine prospective mothers for anemia, malaria, and tetanus. Information on proper nutrition is provided, and every mother gets iron and folic acid pills, in addition to the antimalarial drug choloroquine. Incidences of tetanus in newborns have declined sharply in areas where a vaccination program has been carried out. By classifying the risk level of pregnant women, so-called "risk mothers" can be identified. Family planning methods include low-dose oral contraceptives, IUDs (the "spiral"), condoms, and foam. Regular weighing, examination, and vaccination of children is provided until age 5. Infant mortality is high, at least 150/1000 births, most of which are caused by diseases such as untreated diarrhea and measles. Malnourished children get specialized care, and vaccinations against polio, tuberculosis, diphtheria, tetanus, and measles are compulsory as is administration of chloroquine against malaria. Mobile teams of SMI (maternal-infant service) scan the countryside in remote areas where there is no village health center. Health personnel take a 6-month training course before being placed in charge of a village's hygiene, vaccination, and other tasks. The decline in illiteracy rates has resulted in better health of the population. The shortage of qualified health workers has been eased by an increase in the number of nursing and pediatric health care students. Finally, international assistance extended by the world Health Organization, Swedish-African aid organizations, and SIDA are contributing to the praiseworthy efforts of the Mozambican government to improve maternal and child health.
 ...
PMID:[Big venture to improve children's health]. 692 Sep 76

Between 1975 and 1983 health care expenditures in Ghana dropped to a low point as a consequence of the structural readjustment program instituted by the World Bank. During 1975-76 only 15% of available funds were spent on primary health care (PHC), which was officially introduced in the late 1970s. PHC made up 20-25% of the health care expenditures by 1991 with about 25% of health personnel engaged in PHC. 2/3 of health care delivery covered urban areas when 60% of the population lived in the countryside. The district of Ejisu-Juaben in the Ashanti region had high morbidity. Tetanus, polio, whooping-cough, and diphtheria had been brought under control, but measles, diarrhea, and malnutrition were still widespread among children under 5 years old. Malaria, bilharzia, intestinal parasites, respiratory infections, hepatitis, anemia, hypertension, and vitamin A deficiency were also grave problems. AIDS was on the rise. Child mortality amounted to 130/1000 live births and maternal mortality to 1400/100,000 cases. The medical structure of the district comprises 10 health posts (6 governmental and 4 mission). Only 72 villages and 120,000 people are cared for. Each post has a mobile team. In 1993 a new community-based health care program began funded by Save the Children Netherlands. In 60 villages a village health committee existed but they were substandard. They were either reactivated or new committees were set up. Training activities were also started in prenatal care, delivery, care of malnutrition and diarrhea, hygiene, and sanitation. Two years later safe motherhood indicators had improved; postnatal care increased from 16% to 49%; medical deliveries increased from 27% to 37%; the share of families with contraceptive acceptance increased from 7% to 21%; and tetanus vaccination among mothers was estimated to have increased from 27% to 86%.
 ...
PMID:[Primary health care in Ghana: no pay no cure?]. 750 Oct 68

A follow-up study was conducted in six community health centres during the period April 1989 to March 1990 to determine the risk factors which influence neonatal survival in central Sudan. The estimated neonatal mortality rate ranged between 20.0 and 36.0 per 1000 live births per year, and the major cause of death was tetanus neonatorum (29% of neonatal deaths). The mortality rate was lowest when tetanus toxoid was received during pregnancy and the umbilical cord was cleaned by a modern hygienic method (mortality rate of 11 per 1000). In contrast, the mortality rate was highest when no tetanus toxoid was received and no or traditional cord cleaning was used (mortality rate of 62 per 1000; relative risk (RR) = 5.6, 95% confidence interval (CI) 2.0-14.9). The major predictors of neonatal mortality were tetanus, short birth-to-conception interval, multiparity, reported malaria during pregnancy, low birthweight, low maternal weight and low socio-economic status. The population attributable risks were high, and the preventable factors collectively accounted for 93.5% of neonatal mortality. Safe deliveries and wider immunization coverage are needed to control neonatal tetanus in this community. Other interventions to lower neonatal mortality in central Sudan should include accessible family planning programmes and measures to lower the incidence of low birthweight.
 ...
PMID:Determinants of neonatal mortality in central Sudan. 750 83

Multiple antigen peptide systems (MAPs) allow the incorporation of various epitopes in to a single synthetic peptide immunogen. We have characterized the immune response of BALB/c mice to a series of MAPs assembled with different B and T cell epitopes derived from the Plasmodium vivax circumsporozoite (CS) protein. A B-cell epitope from the central repeat domain and two T-cell epitopes from the amino and carboxyl flanking regions were used to assembled eight different MAPs. An additional universal T cell epitope (ptt-30) from tetanus toxin protein was included. Immunogenicity in terms of antibody responses and in vitro T lymphocyte proliferation was evaluated. MAPs containing B and T cell epitopes induced high titers of anti-peptides antibodies, which recognized the native protein on sporozoites as determined by IFAT. The antibody specificity was also determined by a competitive inhibition assay with different MAPs. A MAP containing the B cell epitope (p11) and the universal epitope ptt-30 together with another composed of p11 and the promiscuous T cell epitope (p25) proved to be the most immunogenic. The strong antibody response and specificity for the cognate protein indicates that further studies designed to assess the potential of these proteins as human malaria vaccine candidates are warranted.
 ...
PMID:Immunogenicity of multiple antigen peptides containing Plasmodium vivax CS epitopes in BALB/c mice. 756 36

The use of universally immunogenic T cell epitopes, such as those identified in tetanus toxin or malaria circumsporozoite protein, could represent a major improvement in the development of synthetic vaccines. However, one limitation of this approach is the lack of T cell cross-reactivity between the vaccine and the pathogen. To determine whether the memory B cell response elicited by immunization with a synthetic peptide containing a B cell epitope linked to a T cell epitope can be restimulated by the same B cell epitope linked to different T cell epitope(s), we used a synthetic peptide which contains non-overlapping B and T cell determinants from hepatitis B surface antigen (HBsAg) of hepatitis B virus (HBV). The results of this study clearly show that primed T cells can increase the antibody response against a B cell epitope linked to the priming T cell determinant. However, the antibody response obtained was weaker than that obtained after two injections of the peptide containing both B and T cell epitopes, showing the important role played by memory B cells in secondary antibody responses. Moreover, a strong antibody response against the B cell epitope was elicited by boosting mice with the B cell epitope linked to a heterologous carrier, thus demonstrating that a strong B cell memory response can be revealed in the absence of primed T cells. These results therefore provide new important information for the design of synthetic or recombinant vaccines.
 ...
PMID:Stimulation of a memory B cell response does not require primed helper T cells. 758 22

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.
 ...
PMID:Analysis of hospital records in four African countries, 1975-1990, with emphasis on infectious diseases. 763 17

Maternal mortality is a three-step process (pregnancy, pregnancy-related complications, and death). Close birth spacing, early pregnancy, unwanted pregnancy, and access to family planning are determinants of maternal mortality. World Fertility Survey figures show that 35% of maternal deaths in Asia could be prevented if all women who did not want children had access to contraceptives. The status of women affects health during pregnancy. Many years of physical neglect and inequitable distribution of food, health care, and other resources effect stunting, an inadequately formed pelvis, low pre-pregnancy weight, anemia, and chronic illnesses such as malaria. Conditions such as aseptic abortion can be prevented. Clean delivery practices, proper management of the third stage of labor, and tetanus immunization are other preventive measures. Many complications are difficult to prevent and to predict; some studies have estimated that up to 50% of maternal deaths were to "low risk" women. The timing of detection of complication and the effectiveness and speed of treatment impact on survival. Intervention means preventing delays in seeking care, delays in reaching an appropriate facility (substantial numbers of deaths occur en route), and delays in receiving treatment, even after reaching the appropriate facility. The timing between the occurrence of the emergency and death involves sociocultural, logistic, and health services factors. When safe motherhood efforts become part of child survival efforts, maternal health will improve.
 ...
PMID:Unsafe motherhood: the determinants of maternal mortality. 765 35


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>