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

One hundred and thirteen children with symptomatic uncomplicated falciparum malaria were treated with either chloroquine 25 mg/kg body weight over 3 d (51 subjects) or mefloquine 25 mg/kg body weight single dose (62 subjects). The cure rate in the chloroquine group was 65% and in the mefloquine group 100%. 14 patients with chloroquine-resistant falciparum malaria (7 RI, 6 RII and one RIII) were successfully treated with mefloquine. The clearance times of parasitaemia and fever were 60 +/- 21.5 h and 24.7 +/- 10.1 h respectively in the chloroquine-sensitive group and 52.3 +/- 18.2 h and 24.5 +/- 23.7 h respectively in the mefloquine group. In the chloroquine-resistant group treated successfully with mefloquine, these clearance times were 44.0 +/- 8.9 and 24.0 h respectively. The only remarkable adverse reaction in the chloroquine group was pruritus which occurred in 7 subjects. Abdominal pain and diarrhoea (8 subjects) and dizziness (3 subjects) were the only important adverse reactions in the mefloquine group. It is concluded that, despite previous reports of primary reduced susceptibility to mefloquine in vitro of some West African isolates of Plasmodium falciparum, this drug may be useful in the treatment of both chloroquine-sensitive and chloroquine-resistant falciparum malaria in West Africa.
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PMID:Clinical efficacy of mefloquine in children suffering from chloroquine-resistant Plasmodium falciparum malaria in Nigeria. 209 99

Halofantrine hydrochloride (HF) belongs to a new class of antimalarials, the phenanthrene methanols. Preliminary clinical studies suggested that an adult dose of 500 mg 6-hourly for three doses, with a weight-based regimen of 8 mg/kg 6-hourly for three doses in children, would be effective. In an ongoing clinical programme, 1973 patients with acute malaria were analysed, of whom 1474 (1315 with P. falciparum and 122 with P. vivax malaria) received the above regimen. In the studies 931 adults and older children were treated (61 with capsules and 870 with tablets) while 520 infants and young children used 5% or 2% suspension. The majority of studies were performed in areas of high chloroquine or multidrug resistance. Only eight (0.6%) of 1282 evaluable patients with falciparum malaria failed to clear their parasitaemias within 7 days. Recrudescence of parasitaemia occurred in 77 patients (6.0%). Reinfection cannot be excluded in several of the cases, where protection from malaria transmission was not maintained. The majority of recrudescent patients were either non-immune (normally residing in malaria-free areas) or were infants below 2 years of age. In vivax malaria cases, there were six recrudescences (5.4%). The mean parasite clearance time was 57.9 h and the fever clearance time 50.2 h in falciparum malaria cases, while the clearance times for vivax cases were 57.3 h and 49.6 h respectively. Clinical events were uncommon and consisted of mild transient diarrhoea or abdominal pain in less than 5% of cases. Laboratory findings were generally abnormalities related to the acute disease rather than drug treatment. Experience to date would indicate that HF is a safe and useful drug for the treatment of acute malaria, particularly in areas where there is extensive resistance to current antimalarials.
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PMID:Clinical experience with halofantrine in the treatment of malaria. 210 Jul 32

In spite of Vietnam's 40-year history of war, infant mortality rate of 50-60/1000 live births in urban areas, life expectancy of 55 years for women and 61 years for men, growth rate of 21.5/1000 population and population totaling 61-66 million in 1986, the health status of the Vietnamese, is better than the mean for all African countries and no worse than developing countries with a GNP per head greater than Vietnam's US 210. The incidence of infectious disease remains high for both adults and children, with malaria leading for adults and diarrheal disease for children as well as malnutrition due to dietary insufficiency. Air pollution, poor sanitation, and chemical pollution of water supplies pose a serious threat to health in Saigon, as do dioxin-related diseases in the surrounding countryside. A decentralized government hospital service with health centers in all communities provides 1 doctor for every 18,000 population. This system is criticized for lack of attention to socioeconomic conditions or diet. The health care strategy developed in 1986 targets the following goals for 1990: adequate nutrition, drinking water, essential drugs, and sanitation as well as more extensive immunization, family planning services, and home treatment of illness. Along with the 3000 community health centers, community health workers provide basic treatment and health education from their homes. Although the health system is paternalistic, vital provisions of salts and sugars for combating diarrhea, and A and D supplements and food are given to the poor. Dr. Duong Quynh Hoa's pediatric research institute, children's hospital, and new medical school are principally concerned with the development of socioeconomic conditions where the doctor is only 1 among many collaborating to improve the quality of life. One pediatric center project, for example, has been successful in promoting the active participation of people in an environmental hygiene program, a clean drinking water program, immunization efforts, and a diarrhea control program funded through UNICEF, WHO, and French and British charities. Investment is being sought from developed countries for economic development and food aid.
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PMID:Establishment of primary health care in Vietnam. 212 Nov 82

Morbidity due to infection with Schistosoma mansoni was investigated in a recently discovered highland focus around Lake Cohoha, Burundi. The distribution of the infection was very focal and morbidity patterns in populations from an endemic area A (prevalence 38%, mean egg load of positive subjects 231 eggs per gram [epg]), a less affected area B (16%, 90 epg) and a virtually non-endemic area C (5%, 45 epg), were compared; apart from schistosomiasis, the profiles of these populations were highly similar. The overall frequencies of diarrhoea were 36%, 25%, and 19%, respectively; of abdominal pain 86%, 78%, and 83%; of fatigue 7%, 2%, and 1%; of left lobe hepatomegaly 30%, 18%, and 9%; of right lobe hepatomegaly 18%, 10%, and 5%; of splenomegaly 18%, 10%, and 7%. Organomegaly was generally mild, even in area A. Within area A, the association between the presence of infection and diarrhoea, fatigue, hepatomegaly and splenomegaly was significant, but far less impressive than the results of the community-based comparison with areas B and C. The correlation with intensity was limited to an increased prevalence of diarrhoea and fatigue in the highest egg count group, and a more gradual increase (varying with age) in hepatomegaly and splenomegaly. The data are compared to other morbidity studies in subsaharan Africa, in particular one in the nearby Rusizi Plain. The lesser impact of malaria, the higher egg loads, the recent establishment of the focus and possibly parasite strain differences may account for the more apparent and more important schistosomiasis morbidity in the Cohoha focus.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The morbidity of schistosomiasis mansoni in the highland focus of Lake Cohoha, Burundi. 212 66

The literature on health implications and effects of government-sponsored resettlement in Ethiopia is reviewed with the objective of providing an initial evaluation of the health status of settlers and the health hazards of resettlement in western Ethiopia. Emphasis is on the 1984/85 resettlement program, which resulted in the movement of about 600,000 drought victims from northern and central Ethiopia to the western part of the country. Malaria, trypanosomiasis, onchocerciasis, yellow fever, nonfilarial elephantiasis, sand-flea infestation, and psychological stress are identified as immediate and greater health hazards than in the areas of settler origin, based on the geographic distribution and ecology of the major communicable, nutritional, and geochemical diseases in Ethiopia, and on the impact of program deficiencies on settler health. More studies are needed on the epidemiology and ecology of bancroftian filariasis, visceral leishmaniasis, dracunculiasis, eye and skin diseases, tuberculosis, meningitis, intestinal parasitism, diarrhea, and calorie/protein malnutrition before their public health and economic significance in settlements can be evaluated. Schistosomiasis appears to be less common, for the time being, in resettlement areas than in the areas of outmigration. Research needs and constraints in resettlement planning, implementation, and operation are identified, and some recommendations made for disease control programs.
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PMID:Health aspects of resettlement in Ethiopia. 218 82

The acquired immune deficiency syndrome (AIDS) is fundamentally the same disease in all parts of the world, but the prevalence of microorganisms in an environment governs the patterns of disease arising from reactivated latent infections, invading pathogens and opportunistic infections. AIDS in Africa has certain characteristic presentations. Enteropathic AIDS is most common: Cryptosporidium and Isospora belli are identified in up to 60% of patients, but it is uncertain whether they are the causes of diarrhoea. Pneumocystis carinii pneumonia is rare. Tuberculosis, both pulmonary and extrapulmonary, is the supreme complicating infection. Herpes zoster is frequently the first clinical presentation, and has a 95% positive predictive value for HIV positivity. Measles may be more frequent in infants born to HIV-infected mothers, and appears to be worse in HIV-infected children. There is accelerated progress of both diseases in patients infected by HIV and Mycobacterium leprae. Salmonellosis is frequent. There is no direct interaction between malaria and HIV, but, by being a potent cause of anaemia, malaria enhances transmission of HIV to children through blood transfusion. HIV-positive subjects are liable to new or reactivated visceral leishmaniasis with dissemination to unusual sites. Cerebral toxoplasmosis is common. There are no apparent interactions between HIV and helminths, although there is one report of hyperinfection with Strongyloides stercoralis. Cryptococcal meningitis has high frequency. Infections with Histoplasma encapsulatum are common in tropical America, but there has been no increase of frequency of H. duboisii in Africa since the advent of AIDS.
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PMID:Opportunistic infections in AIDS in developed and developing countries. 220 Nov 7

A survey of the health, social and economic problems of the village of A1 Awayda, in Gezira province, Sudan, by medical students, was conducted over 2 weeks as part of their field training research and rural development curriculum. A 40% random household survey was based on a pretested structured questionnaire. The village comprises 195 households of 1201 people, with 40% under 15. As a result of the Sennar Sugar Scheme begun in 1978, 58% of the population work in the sugar factory. Rain-fed crops have failed for the last 2 years because of drought, and subsistence acreage has contracted because of sorghum planting for sugar. Sanitation consists of latrines in 15% of houses. People are at risk of contracting schistosomiasis from crossing the irrigation canal to reach the well. The diet is based on the staple starch, dura in the form of kisra. Breast feeding is continued for 1-2 years, with 47% supplementation by bottle or kisra or rice water at an average of 7 months. The major health problems are malaria, schistosomiasis, cough and diarrhea. 54% of families were immunized. 11.5% of women used modern contraceptives. Non-users cited religion as a reason for non-use. Female circumcision is common. It was recommended that latrines be dug, and that health education, immunization, prenatal care and family planning be provided.
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PMID:Community health in a rural area of Sudan. 221 96

373 travellers to countries outside Europe and North America were recruited before departure summer 1988 at the Vaccination Office, Trondheim, Norway, and participated in a follow-up study on health problems related to travel. 313 of the travellers (84%) responded by answering a postal questionnaire one month after return; it dealt with prophylactic measures, life-style, and health problems associated with travelling. An 18% failure in malaria prophylaxis and some risk-taking behaviour related to alcohol and sex were recorded. Diarrhoea (usually mild) was reported by 59%; other symptoms were also frequent. Medical advice was sought by 18% while abroad; 7% consulted a doctor. Ill health made travelling less enjoyable than expected for 8%. After return, 25% had health problems; 9% saw a doctor, three travellers were hospitalized, and 6% were absent from work. Total morbidity was high, but seldom serious. Targeted advice, which can well be given by primary health care personnel, could help to reduce morbidity and risk behaviour and improve travellers' handling of ill health.
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PMID:Health problems in Norwegians travelling to distant countries. 221 61

Mefloquine pharmacokinetics were compared in a randomized clinical trial in Thailand among patients with malaria and healthy volunteers. A single oral dose of 1500 mg mefloquine hydrochloride was administered to 11 patients and 5 volunteers and 750 mg was given to 16 patients and 5 volunteers. Efficacy was 82% for 1500 mg and 63% for 750 mg. In cured patients taking 750 mg mefloquine, peak plasma drug concentration (Cmax) and area under the plasma concentration-time curve (AUC) were significantly greater than in the patients for whom treatment failed (p less than 0.0005 and p less than 0.01, respectively), and plasma mefloquine levels were significantly higher from 8 hours to 18 days after treatment. Mefloquine AUC was reduced and variable in the presence of diarrhea. Compared with noninfected volunteers, clinically ill patients displayed a delayed time to reach peak concentration (p less than 0.01) and significantly higher mefloquine plasma levels in the first 2 days after administration of either the 750 mg or the 1500 mg dose. Mefloquine AUC was similar in patients with malaria and healthy volunteers. Because plasma levels increased in temporal relationship with clinical illness, mefloquine volume of distribution or clearance (or both) was reduced during the acute phase of illness.
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PMID:Mefloquine kinetics in cured and recrudescent patients with acute falciparum malaria and in healthy volunteers. 222

Supervision of health care centers is needed to ensure quality health care. Visits to health centers by supervisors should consist of 6 primary components: communication, teaching, seeing patients, tour of the health center, assessing performance, and follow up. Effective communication skills between the supervisor and health care workers is needed. Suggestions for good communication include regular and frequent visits, the same supervisor to encourage relationships between the supervisor and health center staff, and few cancellation of visits. Good communication is also dependent on the supervisor's attitude; criticism should be constructive. In teaching, information should be based on standard protocols and treatments. Teaching methods such as tutorials and discussions encourage group participation and are effective in solving problems. Common problems which should be discussed are child health issues such as coughs, diarrhea, fever, immunization, and nutrition; maternal health problems such as antenatal care, contraception, and labor management; communicable disease problems such as water supply and disposal, tuberculosis, and malaria; and sexually transmitted diseases. Seeing patients is the 3rd component of health center visits; this allows the supervisor to observe daily problems encountered by the staff and to teach workers. A tour of the health center should be conducted for the purpose of improving the center and should focus on water supply and disposal. The objectives of assessing performance is to identify problem areas which can be improved. This visit component can be conducted throughout the visit. Areas of assessment include clinical skills, dispensary, and health education. Data from records can be collected and utilized to demonstrate the center's effectiveness. At the end of the visit, problems should be identified and actions of improvement should be proposed. Follow up is important to correct deficiencies and problems.
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PMID:Visit a health centre in a developing country. 224 54


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