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Query: UMLS:C0024530 (malaria)
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Childhood hyperpyrexia is associated with serious infections particularly bronchopneumonia, infective diarrhoea, meningitis, measles, urinary tract infections, otitis media, septicemia and sickle cell crisis Hyperpyrexia was found most in children aged 6-12 months followed by children aged 12-18 months. Hyperpyrexia occurred least in children aged 2-6 months. Febrile convulsion was associated with 38% of the cases. Malaria was a cause of convulsion in 27% of children with fever. This appears to contrast earlier reports by Lennox (1953) and Familusi (1971). The study confirms the rarity of hyperpyrexia in children aged 3 months and under. Deaths recorded were in children brought at the late stages of their ill health. Intensive health education is recommended to obviate unnecessary death of children through ignorance and poor knowledge of simple first aid measures.
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PMID:Childhood hyperpyrexia in Benin City, Nigeria. 709 25

Data collected on 150 sickle cell patients in Nigeria were analyzed to determine the frequency of parasitic infections in clinical and hematologic crisis. Fifty-three adult and 97 pediatric patients (mean age: 27.6 years and 9.7 years, respectively) were studied. Of these patients, 82 were males and 68 females. One hundred thirty-nine had the SS and 11 the SC genotype. Blood samples collected from patients on admission for sickle cell-related illnesses were examined microscopically for evidence of Plasmodium sp, and stool samples were analyzed for presence of any helminth. A total of 102 parasitic infections associated with clinical cases of sickle cell crisis were recorded (malaria, 36[35.3%]; helminths, 49 ([48%]; and malaria and helminths together, 17 [16.7%]). Of the 49 helminthic infections, 26 (53.1%) were due to Ascaris lumbricoides, 15 (30.6%) were due to hookworms, 7 (14.3%) were due to Trichuris trichiura, and 1 (2%) was due to Strongyloides stercoralis. The mean hemoglobin levels during clinical crisis were 7.1 g/dL for helminths, 6.4 g/dL for malaria, and 6.1 g/dL for malaria and helminths together. Reticulocyte counts were 1.4% for helminths, 1.5% for malaria, and 1.2% for both malaria and helminths together. Severity and duration of the clinical crisis were longer for events associated with a single parasitic organism infection than for those with multiple organisms. Routine blood smear examination for malaria and stool analysis should be included in the laboratory evaluation of individuals with sickle cell anemia in developing countries as these infestations could play an important role in precipitating a crisis.
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PMID:Parasitic infections in sickle cell crisis: Nigerian experience. 914 35

For many years the study of Red Blood Cell (RBC) deformability has been limited to specialised hematological research institutes and this has hampered a widespread clinical testing of this dynamic RBC property. Consequently, the clinical relevance of such in vitro measurements has remained questionable now for a considerable time. The recent availability of the LORCA, a routinely applicable and computer assisted instrument for this purpose, opens now the possibility to evaluate RBC deformability on a large scale in various pathological situations associated with impaired microcirculatory flow. In this communication we present our clinical experience obtained thusfar with this instrument. Besides the effect of physiological aging of normal RBC, the results of a clinical study on malaria tropica, case studies of hereditary elliptocytosis, Smith-Lemli-Opitz syndrome (a cholesterol biosynthesis defect), the treatment of sickle cell crisis with hydroxy-urea as well as the clinical intervention with Cyclosporin, are collected. In conclusion, it can be stated that the limited clinical experience with the LORCA as is reported here, yields sufficient evidence about the clinical potential of this technique.
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PMID:Clinical potential of in vitro measured red cell deformability, a myth? 1071 55

A retrospective study of pregnancy outcome in 60 HbSS sickle cell disease patients, exclusively managed in accordance with standard management modality, as obtained in the obstetric Unit of the Lagos University Teaching Hospital (LUTH), was carried out over a 3-year period (1995-1997). The study shows an increase in the number HbSS patients seeking antenatal care in the LUTH. Although the patients maintained a stable haematological profile, all through pregnancy and delivery, as reflected by the booking, pre-delivery and post-delivery PCV of 23.2 +/- SD 4.6% and 23.6 +/- SD 4.5% respectively; pregnancy was complicated in 96.6% of cases (n = 58). Sickle cell crises of bone pain (41.4%), acute haemolysis with anaemia (34.4%); malaria (22.4%) and other systemic infections (22.4%) were the major causes of pregnancy complications. Antenatal and postpartum blood transfusion rates were 45.0% and 81.6% respectively. The perinatal and maternal mortality rates were 121 and 67/1000 respectively, while caesarean section rate was 43.2%. It is observed that while more patients with HbSS sickle cell disease are seeking antenatal care in the LUTH, with improved prognosis, pregnancy complications from sickle cell crisis, remain a major problem in the care of these patients.
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PMID:Pregnancy outcome in HbSS-sickle cell disease in Lagos, Nigeria. 1208 64

Using files related to children admitted at the Brazzaville teaching hospital (Congo) between May 1995 and May 2002, the authors have studied the part of sickle cell crisis (SCC) in the sickle cell disease, have assessed the epidemiological particularities, the relation between some clinical, biological factors as well as the severity of the disease. On the whole, 587 SCC have been observed in homozygous SS children aged 6 to 17. The distribution was as follows: painful osteo-articular crisis (58.6%), abdominal crisis (23.5%), acute chest syndrome (14%), neurological strokes (3.2%) and priapism (0.7%). The neurological strokes (75%) and the hand-foot syndrome (77.8%) were predominant in male. As regards the interaction age-localization of the crisis, the hand-foot syndrome mainly concerned children under five, long bones and rachis impairment those aged 11 to 15; abdominal and neurological crisis were observed especially before the age of 10, the acute chest syndrome after 10 (68.3%). Malaria (48.9%) and bacterial or viral infections (24.5%) proved to be the triggering factors when these are identified (188 cases). SCC occurred in 67.5% of the cases during the hot and rainy seasons. Moreover the haemoglobin F rate above 10% was correlated with a low prevalence of SCC, in particular the potentially severe crisis, revealing at the same time its protective value. These results show that SCC, by their frequency and/or their severity constitute a major handicap when the vital prognosis is not involved. Rigorous health habits, appropriate vaccination programme, adequate malarial prophylaxis, optimal transfusional strategy and especially the use of hydroxyurea, prove to be urgent preventive measures to put into practice. Their efficient implementation will provide a better quality of life to the sickle cell patient and will decrease the risks of severe crisis.
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PMID:[Sickle-cell crisis in the child and teenager in Brazzaville, Congo. A retrospective study of 587 cases]. 1642 15

In today's society, immigration and travel has resulted in large-scale population movements. This poses an additional challenge to the clinician when he or she takes the patient's history. The differential diagnosis of any presentation would need to include any diseases endemic to the area where the patient had been in. Ghana is considered a holoendemic high-risk area for the transmission of malaria. Moreover, compound heterozygous inheritance of hemoglobin (Hb) S and HbC often occurs in this area. We present a case of mixed Plasmodium falciparum-Plasmodium malariae infection complicating HbSC disease in a 34-year-old Ghanaian immigrant. We postulate that the malaria infection has transformed the patient's silent combined hemoglobinopathies (HbS/HbC) into a syndrome resembling a sickle cell crisis.
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PMID:Mixed Plasmodium falciparum-Plasmodium malariae infection and hemoglobin SC disease: a case report. 1655 99