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

In a coastal population in whom anaemia was common, two randomised controlled trials were undertaken to investigate the effectiveness of treating iron deficiency anaemia at a dispensary and at primary schools. For anaemic adult villagers treated at a dispensary, one dose of tetrachlorethylene for hookworm infection and a once per week visit to collect medicines were found to be satisfactory. A small but significant increase in haemoglobin level was produced by four weeks oral iron therapy, but this was only maintained after seven months by the group that had initially also received tetrachlorethylene. In children (5-14 years) no significant rise in haemoglobin level was obtained by using oral iron and/or TCE, either at the dispensary or at the primary schools. This suggests that malaria was a more potent cause of anaemia in these children.
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PMID:Anaemia treatment trials in a rural population of Tanzania. 34 70

Porotic hyperostosis was observed in 34 percent of 539 crania excavated from sites in Arizona and New Mexico. Common causes of this cranial pathology in the Old World (thalassemia, sickel cell anemia, and malargia) do not explain its occurrence in the American Southwest, as malaria and hemoglobinopathies are not known to have existed in the New World prior to European contact. Iron deficiency anemia which may also be assoicated with porotic hyperostosis occurs on a mass level only with hookworm infestation or nutritionally-related iron deficiency. Since hookworm infestation is rare in the American southwest and has not been reported in prehistoric southwestern American Indians, the hypothesis of nutritional anemia was examined. In canyon bottom sites where the diet was heavily dependent on maize, which is low in iron and also contains an inhibitor of iron absorption, significantly more crania had porotic hyperostosis than in sage plain sites, where the diet included ample animal protein rich in easily absorbable iron (p less than .001). Furthermore, canyon bottom children, who were more susceptible to iron deficiency anemia, had a higher incidence of porotic hyperostosis lesions than adults (p less than .0001).
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PMID:The paleoepidemiology of porotic hyperostosis in the American Southwest: Radiological and ecological considerations. 110 84

This analysis reviews published studies of cord haemoglobin values in developing countries and compares findings for populations that are either exposed or not exposed to malaria. The review indicates: first, that fetal anaemia is common in women with chronic moderate-to-severe iron deficiency anaemia; second, that a severe degree of fetal anaemia is reported in several areas where malaria in pregnancy is common. Different levels of fetal anaemia or polycythaemia arise in relation to the duration and severity of maternal anaemia during pregnancy, but in malarious areas the fetal anaemia appears to be out of proportion to the level of maternal anaemia. Haemoglobinopathies are likely to play a contributory role in causing fetal anaemia. The concept is advanced that malaria may contribute to fetal anaemia as a result of immune haemolysis of sensitized red cells. Sensitization could be from malaria antibodies and antigens which cross the placenta. Further evidence is required to prove this hypothesis. The importance of fetal anaemia is that it is likely to relate to the pattern and risk of developing anaemia in infancy.
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PMID:Fetal anaemia in malarious areas: its causes and significance. 128 47

Recently introduced chloroquine resistant malaria has altered the clinical picture and complicated the overall management of malaria. 113 adults with proved malaria admitted at Harare Central Hospital, Zimbabwe, were evaluated to determine the incidence, nature, relationship to morbidity and mortality and response to treatment of the complications due to malaria. 47.7 pc (52 of 109) patients had relatively chloroquine resistant malaria. 87.4 pc (99 of 113) had complications whose percentage frequency of occurrence were: Anaemia 51.2 pc, diarrhoea and/or vomiting 42.2 pc, cerebral malaria +/- fits 39.2 pc, renal insufficiency +/- hyperkalaemia 26.4 pc, hypoglycaemia 15.6 pc, jaundice 15.2 pc, neuro-psychiatric 15.0 pc, shock 10.6 pc, concurrent sepsis 8.9 pc, pulmonary oedema 3.5 pc and hyperpyrexia 1.7 pc. Multiple complications in the same patient were common. The combination of cerebral malaria and renal insufficiency had the worst mortality (p less than 0.001). All patients dialysed, however, survived. Non-iron deficiency anaemia, 91.7 pc (51 of 55) and diarrhoea and/or vomiting, were common, worsened morbidity but not mortality (p = 0.555). A seriously-ill patient with malaria should be suspected of having complications and chloroquine resistance and should be referred promptly to a centre with facilities for dialysis. Anti-malaria drugs should be mixed in a dextrose solution and iron supplements should not be given routinely.
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PMID:Complications of seasonal adult malaria at a central hospital. 209 79

The mechanism(s) underlying the apparent resistance to malaria in certain inherited red cell disorders and iron deficiency anaemia remain poorly understood. The possibility that microcytic erythrocytes might inhibit parasite development, by physical restriction or reduced supply of nutrients, has been considered for many years, and never formally investigated. We sought to determine whether in vitro growth studies of P. falciparum could provide evidence to suggest that small red cell size contributes to malaria resistance in those red cell disorders in which microcytosis is a characteristic feature. Invasion and development of P. falciparum in iron deficient red cells (mean values for mean cell volume [MCV] 66 fl, mean cell haemoglobin [MCH] 19 pg) and in the red cells of two gene deletion forms of alpha-thalassaemia (mean MCV 71 fl, MCH 22 pg) were normal, assessed both morphologically, and by 3H-hypoxanthine incorporation. Although parasite appearances were normal in all cell types, morphological abnormalities were noted in iron deficient and thalassaemic cells parasitized by mature stages of P. falciparum, notably cellular ballooning and extreme hypochromia of the red cell cytoplasm. Using electron microscopy, the red cell cytoplasm in parasitized thalassaemic cells showed reduced electron density and abnormal reticulation. Normal invasion rates were observed following schizogony in microcytic cells of both types. Our findings indicate that whilst minor morphological abnormalities may be detected in parasitized iron deficiency and thalassaemic erythrocytes, development of P. falciparum in these conditions is not limited by small erythrocyte size.
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PMID:Unrestricted growth of Plasmodium falciparum in microcytic erythrocytes in iron deficiency and thalassaemia. 218 91

Iron deficiency and vitamin A deficiency are both reported to predispose to infection morbidity and to mortality. In both situations, however, the data are insufficient to draw firm conclusions, primarily owing to flaws in the design of the studies. To be sure, these are difficult studies to carry out, and the investigators whose reports have been reviewed should be praised rather than adversely criticized for their efforts. In the case of iron deficiency, there is a further complication in interpretation, that is the suggestion that iron deficiency states may be protective and that conditions of iron overload may predispose to infection. These concepts appear to pertain most convincingly to malaria and Yersinia infections, and to situations in which iron dextran is given parenterally to young children in the first few months of life. There are still two few data to suggest that oral iron is harmful and there is no reason at present that it should not be employed for the correction of iron deficiency anemia.
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PMID:Micronutrients and susceptibility to infection. 219 69

The aetiology of severe anaemia (haemoglobin less than 7.0 g dl-1) has been studied in 37 pregnant Zambians. Aetiology was usually multiple; 31 (84%) had Plasmodium falciparum malaria, 23 (62%) were folate deficient, 13 (35%) were iron deficient, one had sickle-cell anaemia and one had the acquired immunodeficiency syndrome (AIDS). Folate deficiency was most often secondary to malarial haemolysis: iron deficiency was nutritional, but hookworm was contributory in about one-third of patients. The anaemia of malaria and folate deficiency was both more common and more severe than anaemia due to iron deficiency; it was seen in younger women although primigravidae were not over-represented, it occurred earlier in pregnancy, and was associated with low birthweight. AIDS must now be included in the differential diagnosis of anaemia in pregnancy. Vigorous antimalarial treatment and prophylaxis are essential in the management and prevention of anaemia in pregnancy. Total dose iron infusion is indicated only when severe iron deficiency anaemia has been proven, and must be accompanied by antimalarial therapy and folic acid supplements. Because of the risk of transmission of human immunodeficiency virus, it is more important than ever to prevent anaemia and malaria in pregnancy, and to give blood transfusion only as a life-saving treatment.
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PMID:The aetiology of severe anaemia in pregnancy in Ndola, Zambia. 268 77

Amounts of radio-labelled substances as low as 10(-18) moles incorporated into individual cells can be measured by utilizing techniques of quantitative autoradiography. For this purpose, radioactive standard sources are processed with the labelled cells smeared to slides. Carbon-14 is a favourable isotope with regard to minimal loss of beta-disintegrations due to self-absorption, and to limited cross-fire effects complicating the attribution of silver grains to individual cells. Silver grain densities can be counted by automated microphotometry allowing on-line data processing by an interfaced computer. Rate measurements of 14C-thymidine incorporation into individual cells yield values of the DNA synthesis rate provided that the endogenous pathway of thymidine-phosphate formation has been previously blocked. From the rate values of individual cells the DNA synthesis time of a cell compartment is derived. This is an essential time parameter for the evaluation of kinetic events in proliferating cell populations. This method is applicable to human cells without radiation hazard to man, and provides an optimal source of detailed information on the kinetics of normal and diseased human haematopoiesis. Examples of application consist of thalassaemia, malaria infection, iron deficiency anaemia and acute myelogenous leukaemia.
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PMID:Quantitative carbon-14 autoradiography at the cellular level: principles and application for cell kinetic studies. 701 61

The iron status of 120 anaemic pregnant Igbo women was investigated. Of the 120 patients whose haemoglobin was less than 10%, 30 (25%) had iron deficiency anaemia; 89 (74%) had megaloblastic anaemia (most probably due to folate deficiency), while 1 had Hb sickle cell disease. Malaria parasites were detected in only 7.5% of our patients, and seemed not to have a important factor in the causation of anaemia.
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PMID:The iron status of anaemic pregnant Igbo women in Nigeria. 728 Dec 11

Anemia is estimated to affect one-half of school-age children in developing countries. The school years are an opportune time to intervene, and interventions must be based on sound epidemiologic understanding of the problem in this age group. We report on the distribution of iron deficiency and anemia across age, sex, anthropometric indexes, and parasitic infections in a representative sample of 3595 schoolchildren from Pemba Island, Zanzibar. Iron status was assessed by hemoglobin, erythrocyte protoporphyrin (EP), and serum ferritin concentrations from a venous blood sample. Overall, 62.3% of children were anemic (hemoglobin < 110 g/L), and 82.7% of anemia was associated with iron deficiency. The overall prevalence of iron-deficient erythropoiesis (EP > 90 mumol/mol heme) was 48.5%, and the prevalence of exhausted iron stores (serum ferritin < 12 micrograms/L) was 41.3%. In bivariate analyses, iron status was slightly better in girls than in boys, and was better in children aged 7-11 y than in those older or younger. Hemoglobin but not EP or serum ferritin concentrations were lower in stunted children. Infection with malaria, Trichuris trichiura, Ascaris lumbricoides, and hookworms were all associated with worse iron status; the association with hookworms was strongest by far. In multivariate analyses, hookworm infection intensity was the strongest explanatory variable for hemoglobin, EP, and serum ferritin. Sex, malarial parasitemia, A. lumbricoides infection, and stunting were also retained in the multivariate model for hemoglobin. Twenty-five percent of all anemia, 35% of iron deficiency anemia, and 73% of severe anemia were attributable to hookworm infection; < 10% of anemia was attributable to A. lumbricoides, malaria infection, or stunting. We conclude that anthelminthic therapy is an essential component of anemia control in schoolchildren in whom hookworms are endemic, and should be complemented with school-based iron supplementation.
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PMID:Epidemiology of iron deficiency anemia in Zanzibari schoolchildren: the importance of hookworms. 898 28


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