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Query: UMLS:C0024530 (malaria)
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Plasmodium yoelii infection of mice depressed their capacity to build up humoral immune response to diphteria vaccine and protective immunity against tetanus toxin. This immunodepression was overcome by Freund's complete adjuvant or killed pertussis bacilli (whooping cough vaccine). These results suggest that vaccines should be given in association in malaria endemic area.
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PMID:Inhibition of the immune response to whooping cough and tetanus vaccines by malaria infection, and the effect of pertussis adjuvant. 86 3

Much progress has been made towards reaching an understanding of immune responses at the molecular level. This has provided much needed information for identifying the antigens which will afford protection against diseases such as rabies, malaria, whooping cough, hepatitis and acquired immune deficiency syndrome, and for presenting them to the immune system.
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PMID:Vaccines. 136 61

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

Mortality of infants aged 0-30 months was studied in a subdistrict of the eastern Ivory Coast with a population of 240,000 inhabitants. A cluster sample of the type recommended by the World Health Organization for evaluating progress of the expanded program of immunizations consisted of 2 samples with 30 clusters of 70 children each, 1 taken in urban Abengourou and the other in rural cantons of the subprefecture of Abengourou. A standardized questionnaire was administered to all the mothers about their births within the last 3 years. Supplementary questionnaires concerning all deaths of children of the sample mothers were interpreted by 3 physicians who agreed on a probably diagnosis in each case. The survey covered 2375 infants under 1 year and 1825 aged 12-30 months. The total mortality was 103 deaths in the total sample and 70 for infants aged 0-11 months, for a rate of 29.4%. The difference between the urban rate (31.7%) and the rural rate (26.8%) was not significant. The rate varied significantly by sex for deaths due to malnutrition (11 boys, 1 girl), and pneumopathies (6 girls, 1 boy). Mortality varied significantly according to treatment received and place of death. 55% received traditional treatment and 45% modern treatment. 53% died at home, 36% at a health center, and 9% at the home of a healer. Among infants aged 0-27 days, the cause of death was tetanus for 8, prematurity for 12, neonatal distress for 5, neonatal jaundice for 5, and infection for 2. Among infants aged 1-11 months the cause of death was malaria for 10, meningitis for 7, tetanus for 2, diarrhea for 9, pneumopathy for 3, measles for 4, whooping cough for 2, and unknown for 1. Among infants aged 12-30 months the cause of death was malaria for 11, malnutrition for 12, meningitis for 3, pneumopathy for 4, measles for 1, and sickle cell anemia for 2. Malaria was the single most important cause of death followed by malnutrition for the overall sample. In urban and rural areas respectively, the proportions of infants correctly vaccinated for their age groups were 78.1% and 76.0% for those under 11 months; 92.3% and 80.6% for those 12-17 months; 78.3% and 76.6% for those 18-23 months; and 66.5% and 71.4% for those 24 months and over. Mortality rates varied very significantly by vaccination status. 70 of the children dying had not been vaccinated. Their mortality rate was 19.6%, compared to .5% for children in process of vaccination, 1.1% for children incompletely vaccinated, and .9% for children correctly vaccinated.
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PMID:[Infant mortality and its causes in a sub-district of the Ivory Coast]. 196 15

Infection with the blood stage of the malaria parasite Plasmodium vinckei is uniformly lethal in mice. We found that immunization of BALB/c mice with a combination of killed P. vinckei antigens and an attenuated (aroA) Salmonella typhimurium strain induces high levels of protection against challenge with live P. vinckei. This is especially significant because, in our previous studies, immunization of mice with killed P. vinckei antigens and adjuvants such as Bordetella pertussis, complete Freund adjuvant, and saponin failed to induce protective immunity. Immunization with attenuated S. typhimurium alone did not provide any nonspecific immunity. In vivo depletion of CD4+ T cells in the mice immunized with attenuated S. typhimurium and P. vinckei antigens caused the loss of their immunity. Expression of this immunity required the presence of a spleen. These results support our previous hypothesis that a blood stage malaria vaccine may need both induction of CD4+ T cells specific for the parasite and modification of the spleen with a vaccine vehicle. Therefore, attenuated Salmonella strains such as the one used in this study, when expressing recombinant malarial antigens, might fulfill this requirement.
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PMID:Immunization of mice against Plasmodium vinckei with a combination of attenuated Salmonella typhimurium and malarial antigen. 197 14

A 70 million population for Malaysia by the year 2010 has been officially targeted for in the mid-term review of the Fourth Malaysia Plan, 1981-1985. In response to this, a preliminary investigation was undertaken into the health aspects of population growth; infant mortality rates are used as the health indicators. In recognition of the relevance of the medical, economic, and education factors to health, trends in Malaysia's population ratio, per capita gross national product (GNP), and rates of school enrollment are also drawn. The characteristics associated with low mortality and high life expectancy are identified as low population growth, high literacy, and high per capita GNP. Whatever the ideology--Malthusian or Marxist--there is no doubt that population is closely linked to development variables, of which health is a part. Linear regressions on West Malaysian trends show a very high correlation between percent school enrollment and number of medical doctors. Selected cross-country comparisons show that the real issue is not the size of the population but its pace of growth and the social and economic climate at the time. The most dramatic reduction in mortalities from 1957-1980 has been for infant mortality rates (IMR), which have fallen from 76 to 25/1000 live births. Significant control over IMRs has been achieved by effective treatment of malaria, smallpox, tuberculosis, whooping cough, and diarrheal diseases. Attempting a prediction on health outcome at population 70 million, various health statistics from selected countries near that population size were compiled. It is apparent that certain relevant features are associated with low infant mortalities and high life expectancy at birth: 1) low population growth rates, crude birth rates, and fertility; 2) high literacy rates; and 3) high per capita GNP. Overall, health improved for the nation as a whole, and this is highly correlated with school enrollment and health service ratios.
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PMID:Population 70 million: a consideration of health aspects. 383 89

Insights gained by a group of American maternal and child helath (MCH) care nurses during a 1983 exchange tour to Kenya, sponsored by Professional Seminar Counsultants, are decribed. Kenya is a poor, predominantly rural country. The annual population growth rate is 4.1%, and 60% of the population is under the age of 16. The government's annual per capita health expenditure is only US$4, there is little emphasis on pediatrics as a speciality, and the linguistic diversity of the population complicates the delivery of health care services. As a result of these factors, the MCH care system in Kenya differed markedly from the systems observed in previous exchange tours to China and the USSR. Kenya's population is served by a variety of government, private, and missionary hospitals and by government health centers. The health centers are staffed by 2 nurses and 2 assistants who provide maternity, family planning, and immunization services. The staff also diagnoses and treats common illnesses. Service are provided free for patients under the age of 16, and minimal fees are collected from older patients. The largest hospital in the country is the 1600 bed, Joma Kenyatta National hospital which employs 900 nurses and serves as a refereal hospital for complicated cases and as a teaching and research center. 42% of the hospital staff nurses are registered nurses and 58% are enrolled nurses. Disease patterns in Kenya and the US are markedly different. In Kenya, infectious diseases are more common than chronic diseases, and amony children the major causes of death are starvation, measles, whooping cough, malaria, tubercluosis, and diarrhea. Marasmus and protein calorie deficiency are the 2 major types of childhood malnutrition found in Kenya. Nurses frequently provide health education services and even teach mothers how to grow nutritious foods for their children. Rh incompatibility is rare in Kenya, but ABO incompatibility is common. Othr common diseases, raraly found in temperate climates, include Burkitt's lymphoma, leprosy, and tropical ataxic neuropathies. The visiting nurses were at 1st shocked by some of the practices and customs they observed; however, as they learned more about the rationall behind these practices, shock gave way to appreciation. Children's wards lacked playthings, the walls were devoid of pictures, and the rooms were sparsely furnished. The lack of material items, however, was more than compensated for by the rich stimuli provided family members and friends, who not only visited the chilren, but performed a variety of nursing tasks. The family centered approach also provided a sense of security for the patients. A Masai paramedic explained how the custom of polygamy ensures adherence to the 2-year postpartum sexual taboo which, in turn, facilitates prolonged breast feeding. The nurses also became acquainted with the social value of adolescent circumcision rites. These rites are illegal but still performed in many rural areas. The rites are physically painful, but they provide a mechanism for easing the transition from adolescent to adult status. The rites help young people assume measningful roles in the society and provide them with clearly specified identities. As a result, adolescent suicide is rara among the rural villagers.
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PMID:Health care in Africa. 646 42

Information about practices during childbirth and pregnancy has been obtained by interviewing a sample of 100 Dinka women in 7 villages in the Sudd, Southern Sudan. On an average, the women had 4 or 5 living children, and had lost another 4 in pregnancy, delivery on early childhood. Hard work during pregnancy combined with a low-calorie diet probably account for the frequent abortions. Enteritis, malaria, measles and whooping cough are responsible for high mortality before 5 years of age. Maternal mortality can only be estimated, because the traditional birth attendants, Dugems, are reluctant to admit failure. Cessation of menstruation and changes in the breasts are recognized as signs of pregnancy, but in the calculation of the duration of pregnancy the 1st month is excluded. The husband has intercourse frequently with his pregnant wife to help the child's growth. The fear of cephalopelvic disproportion shows itself in prenatal food taboos: fatty foods and sweets are forbidden during pregnancy to avoid dangerously difficult delivery. The Dugem is called in at the onset of labor, which is recognized by regular abdominal pains. No vaginal examinations are done, and the woman delivers in a squatting position. If delivery is delayed or the placenta is retained, a senior Dugem is called. Breastfeeding, which starts immediately after birth, is continued for between 1 to 3 years. Sexual relations are not resumed until the new baby is weaned. Compared with child birth practices reported from other African countries, the traditions of the Sudd have several good points. Setting up maternal and child health clinics with certified midwives will have to wait until literate women are available for training. Training the Dugems to the limit of their capacity should be done now. Sessions should be organized for the senior Dugems, with emphasis on hygiene and the avoidance of harmful customs.
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PMID:Maternity care in the Sudd, southern Sudan. 672 62

Recent experiments in the murine system have indicated that the passive acquisition by offspring of maternal anti-malarial IgG antibodies while conferring some degree of immunity against a primary infection, paradoxically prevents the generation of acquired immunity through vaccination. Therefore, in view of earlier findings concerning the competitive effects of specific IgM and IgG antibodies, we investigated whether specific monoclonal IgM antibodies could be used to potentiate the response to a blood-stage murine malaria vaccine. We now report that small amounts of purified monoclonal anti-parasite IgM can specifically potentiate both priming and memory cell generation in response to vaccination as evidenced by survival after infection, and that the magnitude of this effect is greater than that found with a more conventional nonspecific adjuvant (Bordetella pertussis). Additionally, in offspring of immune mothers, where vaccination is ineffective for up to 8 weeks due to the presence of maternal IgG, we have found that IgM when administered with the vaccine can completely overcome this inhibition by its adjuvant effect.
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PMID:Specific monoclonal IgM is a potent adjuvant in murine malaria vaccination. 683 62

The protective immunity conferred by subcutaneous injection of outbred CD-1 mice with a killed Plasmodium yoelii (YM strain) vaccine was strongly potentiated by saponin. By adjusting the dose of antigen, the number of immunizations and the number of living parasites in the challenge infection, conditions were defined where antigen alone was non-protective but 100% protection was obtained by the addition of saponin. Inbred BALB/c, CBA/CA and C57 B1 mice were much less responsive than the CD-1 mice. The following adjuvants were compared with saponin: mineral oil emulsions (Freund's incomplete and complete adjuvants); A1(OH)3(Alhydrogel); bacteria and synthetic bacterial derivatives (Bordetella pertussis, Corynebacterium parvum and muramyl dipeptide); surface active materials (digitonin, vitamin A, Arquad 18, dimethyldioctadecyl ammonium bromide, and the polyene antibiotics, Nystatin and Amphotericin B). None of these adjuvants were as effective as saponin, although FCA, A1(OH)3 and C. parvum augmented immunity considerably. The possible reasons for the efficacy of saponin as an adjuvant for protozoal vaccines are discussed. The P. yoelli/mouse system provides a sensitive and rapid screening assay for comparison of potential adjuvants suitable for use with a malaria vaccine.
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PMID:A comparison of saponin with other adjuvants for the potentiation of protective immunity by a killed Plasmodium yoelii vaccine in the mouse. 714 65


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