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

This review is aimed at emphasizing the need for basic neuroscience research on two tropical diseases, malaria and sleeping sickness (African trypanosomiasis), that still represent major health problems and in which severe involvement of the nervous system is frequently the direct cause of death. The life cycles of the two parasites, the protozoan Plasmodium and Trypanosoma brucei, which are the causative agents of malaria and sleeping sickness, respectively, are briefly reviewed. The historical contribution to the pathogenesis and therapy of malaria by a renowned pioneer in neuroscience, Camillo Golgi, is pointed out. The different strategies for survival in the host by the intracellular Plasmodium and the extracellular African trypanosomes are summarized; such strategies include sites favorable for hiding or replication of the parasites in the host, antigenic variation, and interactions with the cytokine network of the host. In particular, tumor necrosis factor-alpha and interferon-gamma may play a role in these infections. The parasites may paradoxically interact with cytokines to their benefit. However, cytokine receptors are expressed on neuronal subsets sensitive to cytokine action, and stimulation of these subsets may cause neuronal dysfunctions during the infections. Finally, the clinical symptoms of cerebral malaria and African trypanosomiasis and research aiming at deciphering their pathogenetic mechanisms that could affect the nervous system at a molecular level are described. The need for neuroscientists in this endeavor is emphasized.
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PMID:Neurobiology of cerebral malaria and African sleeping sickness. 936 1

Microhematocrit centrifugation (Woo test) and miniature anion exchange are the most widely used techniques for routine detection of Trypanosoma brucei gambiense in endemic areas. The QBC technique developed for diagnosis of malaria has been successfully used for detection of trypanosoma in blood. The purpose of this laboratory study was to evaluate the end-point sensitivity of the QBC test in comparison with the Woo test. Decreasing concentrations from 15 x 10(5) to 15 trypanosomes/ml of human blood were tested using the two techniques. Sensitivity was calculated in function of reading time at each concentration. Results showed that the sensitivity of the QBC test was 95% down to a concentration of 450 trypanosomes/ml. In comparison 95% sensitivity of the Woo test was observed only down to 7500 trypanosomes/ml and reading time was twofold longer. These findings were reproducible for two hours after sample preparation but deterioration was rapid thereafter. Given its simplicity and sensitivity, QBC test would appear to be a suitable technique for in-field screening programs for human African trypanosomiasis.
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PMID:[Detection of trypanosomes in blood by the Quantitative Buffy Coat (QBC) technique: experimental evaluation]. 951 49

West Africa has a rich medical history. Herbal medicine has been practiced for hundreds of years and the establishment of an effective herbal pharmacopoeia was probably the first medical research carried out in West Africa. Arabic medicine was practiced in the countries of the Sahel in the 15th and 16th centuries. The coming of the Europeans focused research on infectious diseases such as malaria, yellow fever and sleeping sickness, to which Europeans were very susceptible and which caused devastating epidemics among the populations of their new colonies. The end of the colonial era saw the establishment of a few large, well-equipped teaching hospitals but these proved too expensive for the newly independent states of West Africa to run effectively, and the second generation of West African medical schools was based on more modest government hospitals. This led to a change in the focus of research away from the more unusual conditions seen in a specialist referral hospital to an interest in conditions, such as the common infectious diseases, seen more frequently in district hospitals. The advent of the primary health care movement in the 1970s was followed by an increased emphasis on community studies. Molecular biology is likely to have an enormous impact on medicine in general in the coming years. One of the main challenges facing medical researchers in West Africa is how these new technologies can be used most effectively to improve health in countries with limited resources.
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PMID:Traditional medicine to DNA vaccines: the advance of medical research in West Africa. 959 54

The statuses of vector-borne diseases have changed over recent years. How a few such diseases have changed and the primary causes of change (urbanization, increased conflict, changes in water-resource management, ecological and environmental change, and reduced health service resourcing) are the subjects of the present review. The key impacts which these primary causes have on selected vectors and the infections they transmit are tabulated. The success of vector-control programmes against onchocerciasis and Chagas disease is discussed, and the methods used to evaluate the epidemiological impact of such controls are described. Bednet programmes for control of malaria are recognized as a potential future means of reducing morbidity and mortality in children. In contrast to the success achieved in limiting Simulium and Triatoma populations through vertical programmes, control of tsetse, whilst successful in Uganda, has not been utilized to stem recent epidemics of sleeping sickness in resource-stressed settings in Central Africa. Vector-borne diseases will continue to be a problem because of the adaptability of vectors, the potential problems of managing effective vector controls within decentralized health systems, and the influence of activities outside the health sector itself. Changes beyond the health sector can increase the problem posed by a vector and increase the frequency of transmission.
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PMID:Patterns of change in vector-borne diseases. 962 39

This paper summarises the impact of different changes (environmental, ecological, developmental) on the one hand, with the impact of control measures on the other. The former group of changes have tended to exacerbate the incidence and prevalence of vector-borne parasitic diseases while the reduced public funds available for the health sector have reduced disease surveillance systems. However, some vector control/eradication programmes have been successful. Vector control in onchocerciasis and Chagas' disease and immediate host control in Guinea worm have reduced the public health importance of these disease. This contrasts, with malaria, where the complexity of different ecological situations and the variable vector ecology have made control difficult and epidemics frequent and unpredictable. Advances in our knowledge of how to implement and sustain insecticide-impregnated bednets which reduce morbidity and mortality in under 5-year olds will be a key issue for the coming years. In African trypanosomiasis and leishmaniasis, where control is dependent on effective diagnosis and surveillance followed by high-cost drug treatment, the health services are faced with major challenges--lack of drug availability and diagnostics no vector control--the diseases in some areas assuming epidemic status yet health services are unable to respond. Human African trypanosomiasis and visceral leishmaniasis are fatal if untreated, and require an emergency response approach. Changing vector distribution of Glossina is related to the ability of riverine flies of Glossina palpalis group to adapt to new vegetation patterns. In leishmaniasis changes have occurred in the distribution of the disease associated with development impact, urbanisation, civil unrest and changed agroforestry practice.
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PMID:Vector-borne parasitic diseases--an overview of recent changes. 967 71

Leishmania donovani promastigotes were cultured in a protein-free medium for 3-5 days and the spent medium used to prepare antibody-detection ELISA plates. When the plates were used to test 29 Kenyan and 16 Nepalese patients with visceral leishmaniasis (VL; kala-azar), all the sera collected at diagnosis were found to have high levels of parasite-specific IgG. The levels of these antibodies dropped 6-12 months post-initiation of antileishmanial therapy in all but one of the patients. Although the levels in sera from 59% of the treated patients fell to those measured in sera from healthy controls, those in sera from 17% of the patients did not drop below those seen at diagnosis. The antigen used did not cross-react with sera from patients with parasitological diagnosis of malaria, filariasis, African trypanosomiasis or echinococcosis. Antibodies to antigens in the spent medium were detected, by western blot, in all the sera from Nepalese patients with VL. Promastigote-conditioned media could be the source of cheap antigen for the immunodiagnosis of leishmaniasis.
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PMID:A diagnostic ELISA for visceral leishmaniasis, based on antigen from media conditioned by Leishmania donovani promastigotes. 979 30

This article highlights the crisis experienced in the beleaguered Democratic Republic of Congo (DRC). The peace talks to be conducted beginning January 20, 2000, will focus on the near-total collapse of health services and the impending humanitarian megacatastrophe in the country. The two civil wars for the past decades have resulted in an essentially bankrupt health sector and a widespread inaccessibility of basic health care. On December 1999, the UN Security Council president described the situation as the major challenge facing Africa, the UN, and the international community. Reports continue of outbreaks of epidemic infections, including vaccine-preventable diseases and hemorrhagic fevers, and unchecked diseases such AIDS, malaria, and sleeping sickness. On the other hand, the chronic malnutrition rate was reported to be as high as 31%, with some cities on the brink of famine. In addition, life expectancy has fallen by 5 years and maternal mortality has doubled, with hundreds of thousands of displaced people in refugee camps unable to sustain themselves. The meeting on January 10, 2000, will tackle the AIDS epidemic in Africa, and the DRC will be the major test of this policy, since its infection rate reached 4.35% in 1997. The withdrawal of international cooperation, which was blamed for worsening the situation, was refuted by another author stating that war and political violence killed the people.
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PMID:Agency warns of crisis in beleaguered Democratic Republic of Congo. 1067 31

Peptide deformylase is found only in Eubacteria, making it a logical target for discovering new antibacterial agents. Although this protein is absent from animal or fungal cells, evidence supports its existence in eukaryotic protists, including the causative agents of malaria, sleeping sickness, Chagas disease and leishmaniosis. Here, Thierry Meinnel discusses the idea that deformylase inhibitors could be used as very broad-spectrum antibiotics against bacterial infections, as well as parasitic diseases.
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PMID:Peptide deformylase of eukaryotic protists: a target for new antiparasitic agents? 1139 47

On 1 October 1997 Ocean Road Hospital in Daressalam commemorated one hundred years of its existence. As early as 1888 a provisional hospital had been set up in Zanzibar by the German Lutheran Church to serve the needs of the Germans living and working on the East African coast. But when the British established their protectorate over Zanzibar in 1890, the hospital was moved to Dar es Salaam. As cooperation between Mission hospital and Government authorities proved difficult, the German colonial administration was determined to build an hospital of its own. Lack of funds delayed the construction of the building which had to be built on a more modest scale than originally planned. But when the hospital was inaugurated in October 1897, people were impressed both by its functional usefulness and aesthetic attraction. The history of the German Government Hospital reflects the political context of the time as well as the progress of medicine in combatting endemic diseases. While patients were often segregated by race--the Government Hospital in Daressalam almost exclusively reserved for Europeans--all were benefitting from the results of medical science. For Robert Koch the hospital (and its laboratory) served as basis for his research in the field of malaria, black water fever, sleeping sickness, and relapsing fever. It was from Africa that the embarked on his journey to Stockholm to receive the Nobel Prize in December 1905. During the First World War Ocean Road Hospital, as it was called from now on, was taken over by the British. Since independence, the Tanzanians are in charge. It is presently the only tumor hospital of the country, closely cooperating with the German Cancer Research Center (DKFZ) in Heidelberg. Restoration of Ocean Road Hospital, completed at the beginning of this year, was made possible by a grant of the Federal Republic of Germany.
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PMID:[Early days of the Ocean Road Hospital in Dar es Salaam: from mission hospital to government hospital]. 1106 15

Encephalopathies are the most feared complications of sleeping sickness treatment with melarsoprol. To investigate the existence of risk factors, the incidence of encephalopathic syndromes and the relationship between the development of different types of encephalopathies and the clinical outcome was studied in a clinical trial with 588 patients under treatment with melarsoprol. The 38 encephalopathy cases were classified into three types according to the leading clinical picture: coma type, convulsion type and psychotic reactions. Nine patients were attributed to the convulsion type, defined as a transient event of short duration with convulsions followed by a post-ictal phase, without signs of a generalized disease. None of these patients died from the reaction. Febrile reactions in the 48 h preceding the reaction were generally not observed in this group. Twenty-five patients were attributed to the coma type, which is a progredient coma lasting several days. Those patients often had signs of a generalized disease such as fever (84%), headache (72%) or bullous skin (8%) reactions. The risk of mortality was high in this group (52%). About 14/16 patients with encephalopathic syndrome of the coma type were infected with malaria. Patients with psychotic reactions or abnormal psychiatric behaviour (3/38) and one patient who died after alcohol intake were excluded from the analysis. The overall rate of encephalopathic syndromes in the cases analysed (n=34) was 5.8%, of which 38.2% died. We did not find any parameters of predictive value for the risk of developing an encephalopathic syndrome based on the symptoms and signs before treatment initiation. The appearance during treatment of febrile reactions (RR 11.5), headache (RR 2.5), bullous eruptions (RR 4.5) and systolic hypotension (RR 2.6) were associated with an increased risk for the occurrence of encephalopathic syndromes especially of the coma type.
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PMID:Clinical description of encephalopathic syndromes and risk factors for their occurrence and outcome during melarsoprol treatment of human African trypanosomiasis. 1134 33


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