Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
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Antioxidant and/or free radical scavenger vitamins (A, E) as beta carotene are unequally distributed among intertropical peoples from Africa. In Ivory coast for example the values observed are clearly enhanced in the regions where Palm oil is usually eaten than in savanna regions. Primary liver cancer (PLC) is more frequently observed in savanna regions. Furthermore it has been recently suggested that retinoic acid which is derived from vitamin A and beta carotene could interact with the genes which are involved in the primary liver carcinogenesis. In PLC patients as in subjects suffering from sickle cell anaemia, malaria, kwashiorkor or marasmus, and AIDS, the plasma levels of vitamin A, Vitamin E and beta carotene are decreased. Though disturbances in the digestion of fats that may be observed in some pathologies (mainly in Kwashiorkor) affect the discussion of the results, haemolysis and/or acute phase reaction with increased respiratory burst are always observed. That explain, at least in part, the lowering of lipophilic-antioxidant-vitamin plasma levels. As a consequence crude palm oil addition or vitamin A and E therapy would enhance the natural defences against the deleterious effects of the oxidative stress induced by these affections. It is worth checking about.
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PMID:[Antioxidant and/or free radical scavenger vitamins in tropical medicine]. 130 94

In 1992, the worst drought in recorded history hit southern Africa. It especially affected the eastern area of Swaziland where staff at a rural district hospital, Good Shepherd Hospital in Siteki, struggled to treat rising numbers of ill and malnourished people. 10% of the population in this area reached the advanced stage of starvation. Almost 50% did not have enough food to meet their nutritional needs. Women had to travel as far as 15 miles to retrieve water from tankers and sometimes wait for days because other water sources evaporated. Maize did not grow. The subsistence farmers and their families, who made up most of the population, were able to use food stored from the year before, but it only postponed hunger. They sold their cattle (their symbol of wealth), borrowed money, and migrated to cities, leaving children and grandparents to provide for themselves. This area also had an influx of refugees from Mozambique who tended to receive more food than the natives. The incidence, but not the types, of diseases increased much during the drought. These diseases included diarrhea, respiratory infections, measles, marasmus, kwashiorkor, and vitamin deficiencies. The drought did reduce the incidence of malaria, however. Nongovernmental organizations helped with food and in measuring the effects of the drought, e.g., with anthropometric surveys of young children. The international community offered to send Swaziland more than 100,000 tons of cereal, but by December 1992 the cereal had not arrived. The people distributed the limited food to those most in need. The limited maize available for distribution was yellow, but the people were accustomed to white maize and believed yellow maize to be poisonous. When droughts occur, the crux of the problem in developing countries is the pressure exerted by multinational lending institutions to earn foreign currency to pay interest on national debt.
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PMID:Another African disaster. 846 97

Mortality under seven years of age in a rural population in the Gambia in 1982-1983 is analyzed. The population examined is one with a high level of infant immunization but poor access to health facilities. An infant mortality rate of 142 per 1,000 live births and a mortality rate for children aged 1-4 years of 43 per 1,000 are observed. Acute respiratory infections, malaria, and chronic diarrhea with marasmus are shown to be the major causes of death after the first month of life. The authors conclude that very little impact could be made on these rates by expanded immunization efforts.
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PMID:Deaths in infancy and early childhood in a well-vaccinated, rural, West African population. 244 58

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

The antibody response to group C meningococcal polysaccharide vaccine was studied in a Nigerian village. Household clustering of poor responders to immunization was detected. Age had a marked effect on antibody response, maximal titres being obtained only in those over the age of 10 years. Children with malaria parasitaemia had a lower antibody response than those without parasitaemia and subjects with the genotype AA had a lower antibody response than those with the genotype AS. The antibody response to the vaccine was not influenced by mild degrees of malnutrition but children with clinical marasmus or kwashiorkor were excluded from the study.
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PMID:The immune response to a meningococcal polysaccharide vaccine in an African village. 677 65

One of the major factors in the development of severe protein-energy malnutrition (PEM) is infection, such as diarrhea, upper respiratory infection, and malaria. Social and environmental factors include family size, access to land and occupation of parents, and exposure of rural populations to urban centers. Breast milk has been shown to play a role in the prevention of infections; however, the mother must be well-nourished to provide the optimum product. Traditional foods available to rural children in most developing countries are difficult to digest and low in energy and protein and inadequate nutritional education prevents the inclusion of good protein sources in children's diets. Severe PEM, called marasmus and kwashiorkor is indicated by wasting of muscles, absence of subcutaneous fat, wrinkled skin, thin and sparse hair, and weakness. The basic treatment for severe PEM is dietary. Treatment of kwashiorkor and marasmus is divided into 3 stages: 1) attending to acute problems, 2) restoring nutritional balance, and 3) ensuring nutritional rehabilitation. Care must be taken to ensure a minimum daily intake of 3-4 gm of protein and 120-150 Kcal of energy/kg of body weight. There must be, in addition, replacement of vitamin A, zinc, potassium, magnesium, and iron. An initial regimen which has been advocated is based on dry skim milk, sugar, and vegetable oil, divided into 6-12 feedings/day, which prevents vomiting. It is not necessary to remove lactose from the diet, and other animal protein sources such as meat and meat extracts are also well accepted. Soy and vegetable protein have been used successfully. In treating mild and moderate PEM it is important to ensure the intake of these food supplements by the child and to avoid a major substitution effect in the household diet. It is crucial for the physicians, nutritionists, public health workers, and educators to convince parents about the safety of using foods that are fed only to adults and older children. In addition nutritional and health education must not be restricted to the rehabilitation of the child but the prevention of nutritonal deterioration of the entire family and sometimes to the entire community.
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PMID:Infantile malnutrition in the tropics. 681 12

Tens of thousands of Cambodian refugees are entering Thailand. Many of the new arrivals are survivors of months of starvation and are critically ill with marasmus, kwashiorkor, beriberi, anemia, malaria, diarrhea, and respiratory diseases. With volunteer medical help, field hospitals are treating patients under primitive conditions that are gradually improving. Based on experience at the Sa Kaeo refugee camp, a brief survey of the nutritional and other diseases likely to be encountered is given for the potential volunteer who may be unfamiliar with tropical medicine.
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PMID:Medical care of Cambodian refugees. 735 64

Although the association between nutritional status and mortality risk is obvious for extreme malnutrition, the issue is not so clear for mild to moderate undernutrition. We have investigated this association in children of 0-5 years in the rural area of Bwamanda, Zaire, where an integrated development project, with good medical facilities, has operated for 20 years. A random cluster sample of 5167 children was taken; newborn infants and immigrants were included at six quarterly survey rounds from October, 1989, until February, 1991. All surveys included clinical and anthropometric assessment of nutritional status. Deaths were recorded up to April, 1992; there were 246 deaths. Marasmus, kwashiorkor, and other causes of death were defined by the verbal autopsy method and checked against medical records kept at the central hospital and the peripheral dispensaries. As expected, we found an increased risk of death in severe malnutrition. When deaths directly attributed to marasmus or kwashiorkor were excluded, mild to moderate stunting or wasting were not associated with higher mortality in the short term (within 3 months of the previous study round) or in the long term (from 3-30 months after study entry). The commonest causes of death were malaria and anaemia. Extreme marasmus and kwashiorkor caused 16% of deaths, and are important causes of death even in this favoured area with an integrated development project. Nutritional interventions should be targeted more selectively so that children with moderate malnutrition can be protected from progression to marasmus or kwashiorkor.
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PMID:Influence of nutritional status on child mortality in rural Zaire. 810 46

Tropical pediatrics often is more a study of the consequences of poverty than of exotic infections. Pediatricians involved with the care of children in or from the tropics must deal with poverty, place an appropriate emphasis on preventive medicine, and seek to bridge their own cultural and linguistic barriers. Malaria, diarrheal disease, and malnutrition account for a large part of pediatric morbidity and mortality in tropical countries. P falciparum can cause severe malarial disease. Treatment must be initiated promptly; resistance to antimalarial drugs is possible. Hygienic and nutritional prevention of diarrhea must be coupled with widespread use of oral rehydration therapy for acute cases of diarrhea. Identification and early treatment of mildly malnourished children can prevent some of the mortality of overt marasmus and kwashiorkor.
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PMID:Tropical pediatrics. 851 35

38 children with kwashiorkor and 41 with marasmus participated in a study of vitamin E supplementation in a nutritional rehabilitation center in the Dakar suburb of Pikine. Kwashiorkor, or edematous malnutrition, is a major factor in infant mortality in Senegal. Vitamin E supplementation was undertaken to test the hypothesis that kwashiorkor results from aggressive oxidation linked to excess free radicals, vitamin E being a major antioxidant in humans. The children attended the center daily, accompanied by their mothers, until they were cured, defined as disappearance of edema and achievement of 80% of the international standard of weight for height. All children were treated for parasites and malaria prevention. Children with kwashiorkor were given ampicillin, metronidazole and supplements of particular minerals. Between October 1993 and July 1994, 17 children with kwashiorkor and 19 with marasmus were given the vitamin E supplements, the other 43 children serving as controls. The cure rate was slightly higher for the groups receiving supplements, but the difference was not statistically significant. The highest cure rate, 89.5%, was in children with marasmus receiving the supplement, and the lowest cure rate, 68.2%, was in control children with marasmus, but the difference was not statistically significant. Among children with kwashiorkor, weight gain after disappearance of edema was 15.2 +or- 4.9 g/kg/d in the vitamin E group and 16.4 +or- 3.6 g/kg/d in the control group. Several factors may explain the absence of a favorable effect of vitamin E. The hypothesized relationship between aggressive oxidation and kwashiorkor may not exist, or the low plasma levels of vitamin E may not truly reflect deficiencies at the tissue level. The treatment dose of 10 mg/d of vitamin E may have been too low, or the existence of multiple deficiencies may have masked the possible beneficial effect of vitamin E.
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PMID:[Vitamin e supplementation in Senegalese children with kwashiorkor]. 902 18


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