Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

India has launched a liberalization of its economy with restructuring, privatization, and increased imports in order to achieve higher economic performance. This drive also affected the pharmaceutical industry and drug distribution, but in a negative manner. In the 1980s there were 9000 drug manufacturers that together produced up to 60,000 different preparations. In 1992, only 20,000 drugs were produced. The Voluntary Health Organization of India (VHAI) has fought for 10 years for a rational policy on medicines to halt the production of worthless or outright harmful products. For instance, anabolic steroids are sold as nutritional supplements to children, and the banned clioquinol is regularly used against diarrhea despite an international boycott. In recent years unscrupulous manufacturers have sold contaminated water as glucose for infusion bags and anti-D-immunoglobulin which was contaminated with HIV-infected blood. In northern India, a criminal organization bought up used cannulas from hospitals and repacked them for resale as new supplies. While a new medicine policy is formulated, there is a serious shortage of life-saving drugs such as insulin and rifampicin. In the last years, prices have exploded as some products have become six times more expensive. The whole national health system has undergone cost cuts to comply with an ultimatum from the World Bank and the International Monetary Fund; otherwise, sorely needed dollar loans would not be forthcoming. Funds for fighting tuberculosis and malaria have been trimmed, although AIDS and family planning budgets have been increased. One-fourth of the state health expenditures go to combat AIDS, since about 1 million people are infected with HIV. The pharmaceutical industry has also been embroiled in a patent protection wrangle with American drug exporters who claim that Retrovir or AZT (developed by Burroughs Wellcome) was pirated by the Cipla firm, whereas Cipla countered that it was ferreted out from scientific journals.
 ...
PMID:[India: an expensive and dangerous drug]. 130 Jun 63

The US Centers for Disease Control has published recommendations for and information on public health concerns of populations displaced for disasters, such as civil strife and famine. Most recent relief programs use the sustainable primary health care approach of preventive medicine and refugee involvement. This report lists leading, intermediate, and trailing indicators of famine (e.g. low acreage under cultivation, crop failure, and increased malnutrition rates, respectively). Mortality rates are the best reflection of the health status of displaced and refugee populations. The leading causes of death in these populations are the same leading causes as those in nondisplaced populations in developing countries: malnutrition, diarrhea diseases (even cholera), measles, acute respiratory diseases, and malaria. Much of the excess mortality in refugee and displaced populations is due to synergism between high malnutrition prevalence and increased incidence of communicable diseases. Public health practitioners should be prepared for sudden population displacement by targeting the most important public health problems identified in earlier emergencies that cause considerable mortality. Response preparedness should be an integral component of existing health programs in developing countries. A health information system (HIS), diarrheal disease control, immunization, basic curative care, endemic disease control and epidemic preparedness, and maternal and child health care should be the first programs to be established after an emergency. This report provides detailed program-specific recommendations for rapid health assessment, HIS, nutrition, control of vaccine-preventable diseases, control of diarrheal diseases, malaria control, tuberculosis control, and epidemic investigations. For rapid health assessment, for instance, it has a checklist addressing preparation, field assessment, health information, nutritional status, mortality, morbidity, environmental conditions, and resources available. It provides a sample weekly surveillance reporting form.
 ...
PMID:Famine-affected, refugee, and displaced populations: recommendations for public health issues. 132 13

Malaria treatment of children is particularly difficult because of the absence of palatable suspensions for young children. Halofantrine hydrochloride is available as a suspension which is both palatable and simple to administer, and has been studied in a number of trials in the past 5 years. Children (331) ranging from 4 months to 17 years of age (mean 4.7 years) were treated with the 5% suspension using various dose regimens and 364 children ranging from 4 months to 14 years of age (mean 5.7 years) were treated with the 2% suspension 6 hourly for 3 doses. Using the 3-dose regimen there were only 2/462 (0.4%) who failed to clear the initial parasitaemia. Recrudescence occurred in 28/367 (7.6%) children with evaluable follow up data. The mean parasite clearance time in this group was 57.1 h (n = 417) and the mean fever clearance time was 50.9 h (n = 325). Symptoms related to malaria cleared rapidly following treatment generally by 24-48 h post treatment. Side effects possibly related to treatment were uncommon but were similar to those reported in adults. The frequency of diarrhoea and abdominal pain was lower than that seen in adults and was also less frequent following multiple doses and the use of the more dilute suspension. Since there was evidence that the majority of recrudescences were seen in younger children or those living in areas with low or seasonal transmission it is recommended that a further course of treatment 7 days later is given to these patients to prevent recrudescence.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:The treatment of falciparum malaria in children with halofantrine suspension. 134 99

Halofantrine is an orally administered blood schizontocide which is active against both chloroquine-sensitive and chloroquine-resistant plasmodia. Dose-finding and noncomparative clinical trials have confirmed the efficacy of halofantrine in the treatment of falciparum malaria in areas of chloroquine- and sulfonamide/pyrimethamine-resistant malaria and vivax malaria. However, poor results obtained in patients who failed mefloquine prophylaxis suggest that the efficacy of halofantrine may not extend to mefloquine-resistant P. falciparum, although more studies are needed to confirm this. Data concerning halofantrine in the treatment of P. ovale and P. malariae infections are still limited. One comparative study indicates that halofantrine has an efficacy equivalent to that of mefloquine and may be better tolerated. Halofantrine is generally well tolerated in both adults and children, the most common drug-associated effects being abdominal pain, pruritus, vomiting, diarrhoea, headache and rash, although it is difficult to distinguish between disease- and treatment-related events. The development of parasite resistance to halofantrine, like other blood schizontocides, is inevitable. Poor absorption resulting in variable peak plasma halofantrine concentrations, and possible cross-resistance with mefloquine, may accelerate the emergence of resistance to halofantrine. Thus, it is of primary importance that halofantrine is used only in areas where chloroquine- and sulfonamide/pyrimethamine-resistance are established in order to preserve and sustain its efficacy. If used with care, halofantrine will provide an important treatment option for falciparum malaria, a widespread parasitic disease associated with considerable morbidity against which the number of effective drugs available is being increasingly compromised by the spread of resistance.
 ...
PMID:Halofantrine. A review of its antimalarial activity, pharmacokinetic properties and therapeutic potential. 137 21

The study, which is based on data from a household level health survey conducted in 1990 in Freetown, Sierra Leone, examines the coverage of an Expanded Program on Immunization (EPI), infant mortality, and infant morbidity among children in Greater Freetown, capital of Sierra Leone. The results of the study indicate that there was a decline in infant mortality in the recent period of the survey, 1988-89, compared to earlier periods. This decline seemed to have been the result of immunization coverage, which considerably increased by 1989-90, reaching above 70% of the children under age 5. The study further reveals that the increased immunization coverage of children and their mothers might have considerably reduced the incidence of tetanus. While reduction of tetanus might have played the leading role in the latest reduction in infant mortality, the incidence of diarrhea, measles, and malaria continued to be high, suggesting that the increase in the quality and quantity of basic immunizations, oral therapy for diarrheal disease, and provision of chloroquine and improved drugs for malaria disease could further reduce most of the deaths from these prevailing diseases among children under age 5.
 ...
PMID:Immunization coverage, infant morbidity and infant mortality in Freetown, Sierra Leone. 141 85

Positive outcomes, constraints, and future involvement of traditional healers in community health projects is reviewed. 17 projects of which 2 were nongovernmental were included in the analysis of traditional practitioners trained in implementing 1 or more primary care (PHC) activities. Traditional medical persons were, for instance, herbalists, diviners, spiritual or faith healers, traditional midwives, and birth attendants, who worked well with other staff and were willing to contribute to PHC. Skills were taught in promotion of 1) health education and prevention relevant to local problems; 2) improving nutrition and food supplies (breast feeding, weaning foods balanced diets, kitchen gardens); 3) safe drinking water supplies and sanitation; 4) maternal and child health care and family planning (pregnancy monitoring, risk referral, contraceptive distribution); 5) prevention and control of local endemic diseases (diarrhea and oral rehydration therapy--ORS, tuberculosis, leprosy, malaria, malnutrition) and referral for treatment; 6) immunization and referral of children 5 to clinics for vaccination; and provision of 7) treatment of common diseases and injuries (1st aid and accident prevention); and 8) essential drugs and maintenance of a basic dispensary. Examples are given for Ghana, Swaziland, Nepal, and brazil and show the high level of interest of healers. There was increased use of ORS and decreased use of purges, use of handwashing in basins, construction and use of latrines, increased referrals, and increased use of midwives for birthing. 7 projects showed improvements in attitudes, knowledge, and behavior of healers; in the health status of population; and in attitudes and behavior of health staff. Constraints were the lack of government recognition of the value of traditional healers, of government commitment, and of dialogue between healers and government staff. Clearly defined roles and tasks are important for deterring problems. Harmful practices of healers can interfere with proper medical care. Recommendations were to stimulate government action to incorporate traditional healers into health services, to define carefully the role of healers, to engage in evaluation research with other sectors, to tailor training programs to the needs of local traditional healers, and to develop effective strategies to integrate healers. Traditional healers are a valuable resource in PHC.
 ...
PMID:Traditional healers and community health. 141 32

An investigation of child mortality in a semi-urban community, Bandim II, in the capital of Guinea Bissau was carried out from April 1987 to March 1990. 153 deaths were recorded among 1426 live-born children who were followed for 2753 child-years. The under-five mortality risk was 215 per 1000 children (95% confidence interval [CI] 176-264), infant mortality 94 per 1000 (95% CI 73-115), and perinatal mortality 52 per 1000 (95% CI 41-63). By prospective registration of morbidity, post-mortem interviews, and examination of available hospital records, a presumptive cause of death was established in 86% of the deaths. Persistent and acute diarrhoea were the most frequent causes of death, accounting for 43 and 31 deaths per 1000 children, respectively. Fever deaths (possibly malaria), neonatal deaths, acute respiratory infections, and measles were other frequent causes. The access to health services was relatively easy: 75% of the children who died had attended for treatment at a hospital or a health centre. It is important to find ways of preventing and managing persistent diarrhoea, the major cause of death, and to improve the control of acute diarrhoea by a targeted approach.
 ...
PMID:Persistent and acute diarrhoea as the leading causes of child mortality in urban Guinea Bissau. 144 Jul 94

WHO finds that the health services and the health systems in India have improved. For example, India has made considerable improvement in expansion of health services to rural areas (7-10% expansion) and to the poor. Further, allocation to the minimum needs program, according to the state sector plan, has risen from 42.6% to 50%. In addition, infant and maternal mortality rates have fallen. Improved immunization coverage, prenatal care services, diarrhea prevention, malaria control, and contraceptive use have all contributed to the reduction in infant and maternal deaths. Health and welfare programs have generally institutionalized the primary health care concept of community participation. Training for health workers, policymakers, and personnel from nongovernmental organizations has expanded. Nevertheless, life expectancy has essentially not changed. Besides, WHO notes that the disease patterns have not changed. Some regions of India have disease patterns of developed countries, however. India has the highest number of malaria cases in southeastern Asia (almost 71%) and the second highest number of women with anemia. The number of HIV-positive and AIDS cases is growing. More than 374 million people are at risk of lymphatic filariasis, and Japanese encephalitis has become entrenched in India. 5% of the population are positive for hepatitis viruses. 1% have iodine deficiency disorders.
 ...
PMID:WHO commends India. 145 31

The effect of 3 types of intervention schemes on the scientific knowledge and attitude of Kanuri towards malaria, diarrhoea and dysentery and intestinal worms was assessed using the Likert scale response type statements. 1383 respondents in our identical Kanuri villages were used in the study. The effect of still pictures and card games (Goramari), drama songs, storytelling and discussions (Yerimari) and a combination of both (Shetimari) on knowledge and attitude was tested. Gotimari was used as the control. Quarterly assessment of changes in knowledge and attitude showed that Goramari was the least effective while Yerimari and Shetimari were the most effective. Women were more influenced than men by health education schemes which involve drama songs and stories while card games and still pictures had very little effect on them (women). The implication of these findings on disease management through health education is discussed.
 ...
PMID:The effect of selected health education schemes on knowledge and attitude of the Kanuri towards certain parasitic diseases. 146 75

All episodes of acute illness, in children aged 0-9 years, were registered during 3 years in a health clinic in a village of about 500 inhabitants in a malaria holoendemic area on the Tanzanian coast. Of 668 clinical episodes, 395 were diagnosed as malaria. There was no death. Only 5% of the children with malaria episodes came to the clinic after more than 3 d of symptoms. All 11 severe anaemias occurred among these children. Fever was reported in 98%, vomiting in 15%, and diarrhoea in 8% of the malaria episodes. Intermittent fever was reported in 98% of the malaria patients with more than one day of fever, compared to 4% of those with other febrile illnesses. Parasite densities > or = 10,000/microliters were found in 48% of the malaria episodes. Densities > or = 400/microliters were found in 96% of the malaria episodes and in only 8% of the other febrile illnesses. The 16 malaria episodes (4%) with densities below that level were all in children under one year of age. The ability of the rural medical aid or the doctor to differentiate malaria episodes from other febrile illnesses without microscopical examination was limited. Although very few malaria episodes were missed, substantial over-diagnosis resulted in specificity values of only 13% and 52% for their respective malaria diagnoses. It is concluded that intermittent fever was strongly associated with malaria, but a high accuracy of malaria diagnosis in febrile children requires microscopical examination.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:Fever episodes in a holoendemic malaria area of Tanzania: parasitological and clinical findings and diagnostic aspects related to malaria. 147 9


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>