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

Human behaviour has been largely neglected in research on the parasitic diseases, in part because of the long-standing separation of the behavioural disciplines from the physical and biomedical sciences. Some of the reasons for the persistence of this "intellectual discontinuity" are discussed. The paper is principally concerned with the prospects for greater use of the methods and orientations of the behavioural sciences in parasitic disease research and control programmes. Behavioural research tends to fall into two categories employing, on the one hand, survey research and epidemiological methods and, on the other, participant observation and interviewing in depth. These approaches are shown to be complementary-equally useful and necessary. Various categories of health-related behaviour and kinds of research objective are reviewed in the following sections. Special attention is given to psychosocial cost-benefit studies, to analyses of control sectors, and to the formulation of a control philosophy. Finally, some specific behavioural research needs are discussed for some of the parasitic diseases of priority in the UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases-schistosomiasis, filariasis, American and African trypanosomiases, and malaria.
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PMID:Behavioural aspects of the control of parasitic diseases. 31 33

Immunological research on malaria has produced a wealth of information on the relationship between Plasmodium and the vertebrate host, introducing new serological tools into epidemiological methodology and experimentally proving the possibility of protecting vertebrates against malaria, thus moving vaccination from the realm of pure hypothesis to the level of feasibility.The alarming malaria situation in the world is reason enough to expand immunological research further to improve diagnostic and epidemiological tools and to develop methods for the protection of man against malaria. The programme of the Scientific Working Group on the Immunology of Malaria, UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases, complies with these objectives.A projection of potential effects of malaria vaccines on the malaria situation shows considerable promise in areas with relatively low basic reproduction rates; in areas with high basic reproduction rates they would need to complement other malaria control measures and may ultimately add the critical momentum required to render adequate malaria control feasible in tropical Africa.
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PMID:The orientation of immunological research in relation to the global antimalaria programme. 31 37

Fourteen patients infected with falciparum malaria admitted to the Hospital for Tropical Diseases in Bangkok, Faculty of Tropical Medicine, Mahidol University, were studied. In vivo and in vitro methods were used to compare the effects of chloroquine on Plasmodium falciparum. The results showed that RI in vivo corresponded to samples containing chloroquine base 2.5-3.5 millimicromoles per ml of blood in vitro and RII in vivo corresponded to samples with chloroquine base of 4.0 millimicromoles per ml of blood.
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PMID:In vivo and in vitro studies of chloroquine-resistant malaria in Thailand. 33 55

Drug resistance of malaria parasites is a major problem confronting efforts to treat and control malaria. Starting with chloroquine, the emergence of resistance to other drugs has led to multi-drug resistance patterns that pose increasing threats for the future. This report reviews work carried out over the past decades at the Hospital for Tropical Diseases, Bangkok, which monitors patients from many areas, including the Thai-Cambodian border, which harbors the world's most severe multi-drug resistant Plasmodium falciparum.
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PMID:Drug resistant malaria, with special reference to Thailand. 129 68

The study was carried out in 12 children aged 6 months to 2 years, with uncomplicated falciparum malaria admitted to the Hospital for Tropical Diseases, Bangkok. They were treated with mefloquine in the form of MSP (mefloquine 250 mg+sulfadoxine 500 mg+pyrimethamine 25 mg) at a single dose of 25 mg mefloquine base/kg body weight. All of them were cured (28 days follow-up) with minimal side effects. Pharmacokinetic parameter determination was carried out in 9 cases. The results revealed that MRT, t1/2 and tmax in this study (children 6-24 months old) are comparable to the values in children aged 5-12 years, but shorter than in adult patients. Cmax and AUC in children 6-24 months old are comparable to those in children of 5-12 years, but much higher than in adult patients. Vz/f values in this study are comparable to those in children 5-12 years old, but lower than in adult patients.
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PMID:Pharmacokinetics of mefloquine in children aged 6 to 24 months. 130 57

In its booklet 'Tropical Diseases 1990' the World Health Organization (WHO) Division of Control of Tropical Diseases (CTD) said, "Malaria remains the most important of the tropical diseases--widespread throughout the tropics, but also occurring in many temperate regions". The size of the malarial scourge was estimated as: number of people infected 267 million; clinical cases 107 million/year; mortality 1-2 million/year; number of people at risk 2100 million. Immunity to malaria is reduced in pregnancy. This makes the disease particularly dangerous for pregnant women, especially for nulliparae. Malaria causes a significant portion of the large number of perinatal and maternal illnesses and deaths in the tropical countries. It is the leading cause of indirect obstetric deaths. Even so, it is impossible to measure its full impact in this respect. It may masquerade as anaemia. A maternal death may be attributed to obstetric haemorrhage, when in fact it was malarial anaemia which tipped the scales. Fortunately, the disease can be prevented through chemoprophylaxis and personal protection. This is one of the most rewarding functions of antenatal care.
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PMID:Malaria in pregnancy. 134 Oct 85

Physicians enrolled 127 patients who were admitted to the Bangkok Hospital for Tropical Diseases in Thailand with acute, uncomplicated falciparum malaria between January-May 1991 into a randomized clinical trial of 3 oral treatments: artesunate, mefloquine, and artesunate followed by mefloquine. At the end of 28 days, 88% of patients who received only artesunate (total dose 600 mg), 81% of those who received only mefloquine (total dose 1250 mg), and all patients who received both artesunate and mefloquine were cured. Artesunate reduced the parasite count by 90% within 24 hours of 1st treatment. The 2 groups that received artesunate experienced considerably more rapid reduction in parasitemia and in fever than the group that received only mefloquine (p.002). Mefloquine was more adept than artesunate at clearing residual parasites. Mefloquine-treated patients experienced slightly more headaches and dizziness while they still had malaria than the other 2 groups. The physicians believed that these symptoms could actually have been due to the acute malaria infection. Patients who were on the sequential artesunate-mefloquine regime experienced more nausea and vomiting than the other groups, but the differences were insignificant. The combination therapy with artesunate and mefloquine was very effective and patients with acute, uncomplicated malaria tolerated it well.
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PMID:Randomised trial of artesunate and mefloquine alone and in sequence for acute uncomplicated falciparum malaria. 134 54

Plasmodium falciparum malaria in Thailand is resistant to available antimalarial drugs, which necessitates the search for alternative drugs. In a clinical trial mefloquine 1250 mg in divided doses was compared with oral artemether at 700 mg total dose given over 5 days in acute uncomplicated falciparum malaria. 46 adult men, aged 15-50 years and weighing 45-65 kg, with acute uncomplicated falciparum malaria, no history of liver or kidney diseases, and not history of tasking antimalarials for this episode of illness were recruited at the Bangkok Hospitak for Tropical Diseases. 12 were treated with mefloquine and 34 with oral artemether. Hospital follow-up was 28 days for the artemether group and 42 days for the mefloquine group. Parasites did not clear from the blood of 2 patients in the mefloquine group, although there was a decrease in parasitemia. The other 10 patients in the mefloquine group has a good initial response with mean parasite clearance times and fever clearance times of 64 and 27 hours respectively. Oral artemether gave a significantly faster parasite clearance time than mefloquine (30 vs. 64 hours), and a significantly better cure rate (97 vs. 64%) with fewer episodes of dizziness and vomiting. Oral artemether at 700 mg given over 5 days is effective and well tolerated. The cure rate with this regimen is higher than that reported with 600 mg intramuscular artemether given over 5 days. Mefloquine 1250 mg has a cure rate of 80-84% but it produces side effects such as vomiting. The treatment with artemether should last at least 5 days with a dose above 600 mg for a cure rate approaching 100%. This treatment is still likely to be more acceptable to patients than the combination regimen of quinine plus tetracycline for 7 days. These findings suggest that neither artemether nor mefloquine is effective against the intrahepatic stage of Plasmodium vivax. Primaquine is the choice of drug for radical cure.
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PMID:Comparison of oral artemether and mefloquine in acute uncomplicated falciparum malaria. 135 18

Seventeen adult patients with acute Plasmodium falciparum malaria, admitted to the Hospital for Tropical Diseases, were studied. Serial measurements of the serum concentration of C-reactive protein, serum amyloid A protein, and percentage parasitaemia were determined, together with initial measurement of serum electrolytes, liver function, haemoglobin, white cell and platelet counts. Initial C-reactive protein and serum amyloid A concentrations were increased (C-reactive protein mean 49.0 mg/l serum amyloid A 28 mg/l) falling towards the normal range by the seventh day of treatment. There was a significant correlation between the pretreatment parasite count and clinical and laboratory markers of inflammation. C-reactive protein and serum amyloid A concentrations correlated inversely with the serum sodium. These results indicate that measurement of acute phase reactants such as C-reactive protein and serum amyloid A may prove valuable in assessing the severity of P falciparum malaria, and in following the response to antimalarial treatment.
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PMID:Measurement of acute phase proteins for assessing severity of Plasmodium falciparum malaria. 170 16

Over the period from 1985 to 1989, 107 patients suffering from malaria were treated in the Institute for Infectious and Tropical Diseases in Belgrade. The eradication of malaria in Yugoslavia was carried out in 1960 and all the new cases originated from different African countries. Most of these patients were Yugoslav citizens working in these countries. Plasmodium falciparum was the cause of malaria in most of them. The parasytologic analysis of dense drops and smears of peripheric blood revealed it in 81 (75.5%) patients. Taking into account the great problem of treatment of malaria resistant to Resorchin (over 50% in our patients) the great role of chemioprophylaxix, antimalaric agents and appropriate vaccination is emphasized.
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PMID:[Imported malaria--clinical problems]. 179 34


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