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

Incidence and prevalence of malaria was studied in the predominantly tribal district of Koraput, Orissa state. In the mass blood surveys in 61 malarious villages, a total of 12,122 persons were examined and 1,604 (13%) were found positive for malaria. Infant parasite rate was 23% and young children 2-4 years old were the worst affected (parasite rate 27.2%). P. falciparum, P. vivax, and P. malariae accounted for 80, 10 and 3% respectively of all infections. A sample of 2,554 children below 10 years of age were examined for splenomegaly. The spleen rate in 2-9 year old children was 22% and the average enlarged spleen (AES) was 2.06. There was no association between size of the spleen and species of parasite. Fever survey was done for a year in 22 villages and 5,511 blood samples were collected of which 24.8% were positive for malaria parasite. The annual parasite incidence (API) was 32.4 per 1000 infants and 89.5 per 1000 population. Children, 2-4 years old recorded the highest incidence (457/1000). The age pattern of prevalence and incidence indicate high level of acquired immunity in the population. Prevalence and incidence varied among different tribal communities. Prevalence of infection and splenomegaly was higher among children of Bonda, Kondh and Poroja tribes. The role of genetic factors in malaria is discussed.
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PMID:Malaria in Koraput district of Orissa. 280 71

Eight patients diagnosed as having chronic lymphocytic leukaemia (CLL) from clinical and haematological data were also observed to possess immunological characteristics similar to tropical splenomegaly syndrome (TSS). We suggest that the raised IgM level in these cases may be the effect of chronic exposure to malaria in patients who later developed CLL. Consequently, raised serum IgM, which is a feature of TSS, may also be found in some cases of CLL in Nigeria.
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PMID:Chronic lymphocytic leukaemia with raised serum IgM levels. 282 3

The clinical and pathological features of malaria have been well recognized for a long time. Macroglobulinaemia accompanies malarial infections and these patients have increased susceptibility to secondary infection. They may also have splenic enlargement. However, how these changes are brought about is still not fully explained. For over a decade many researchers have looked into the possibility of a parasite-derived mitogen being partly responsible for some of these features. This paper appraises, in the light of evidence so far advanced, the role of mitogenic factors in the pathogenesis of hypergammaglobulinaemia, immunosuppression and splenomegaly associated with malarial infection. The nature of the stimulatory material in parasite extracts is also discussed.
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PMID:The role of mitogenic factors in the pathogenesis of certain features of malarial infection. 285 66

A study was undertaken in the Farafenni area of The Gambia to determine the relation between morbidity from malaria in children and the use of bed-nets (mosquito-nets). From comparisons of parasite and spleen rates in bed-net users and in non-users it seemed that bed-nets had a strong protective effect. However, the prevalence of malaria in the study population was also influenced by ethnic group and place of residence, and the association of bed-net use with these two confounding factors accounted for some of the differences observed between bed-net users and non-users. Nevertheless, a significant inverse correlation between splenomegaly and the use of bed-nets remained. This suggests that bed-nets give Gambian children some protection against malaria and that the use of bed-nets, either untreated or treated with an insecticide such as permethrin, should be investigated further as a means of malaria control in Africa.
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PMID:Bed-nets (mosquito-nets) and morbidity from malaria. 287 48

188 schoolchildren aged 10-15 living in a malaria endemic area along the Thai-Burmese border were matched for age, splenomegaly, and weight and were then randomly assigned to receive either doxycycline (adult equivalent of 100 mg daily) or chloroquine (adult equivalent of 300 mg base weekly). All drugs were administered by the investigators and blood smears were done weekly. In 95 subjects taking doxycycline for 597 man-weeks there were 5 cases of falciparum malaria and in the 93 controls taking chloroquine for 488 man-weeks there were 31. Doxycycline was more effective than chloroquine in the prevention of falciparum malaria infections (p less than 0.0001). The doxycycline group did not have significantly more side-effects than the chloroquine group.
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PMID:Doxycycline prophylaxis for falciparum malaria. 288 88

Three repeated cross-sectional surveys were undertaken among children (1 month to 15 years) of a rural community in southeastern Tanzania. The study was part of a longitudinal project on the interactions among nutrition, parasitic infections and immunity within a primary health care programme emphasizing village health workers. All children underwent interviews and parasitological, anthropometric, anamnestic and clinical examinations. Out of 550-590 children examined each year, a cohort of 170 children could be followed for three consecutive years. Malaria was holo- to hyperendemic in the community, P. falciparum accounting for greater than 90% of the infections. The parasite and spleen rates were 88% and 67%, respectively, and the average enlarged spleen index was 2.0 among children from 2-9 years in 1982. Transmission of malaria was high and stable as indicated by a parasite rate of 80% among infants between 1 month and 1 year during the whole period of study. G. lamblia, hookworm (N. americanus), Strongyloides spp. and Schistosoma haematobium were highly prevalent and annual incidence rates were high, while Entamoeba histolytica, Ascaris and Trichuris were of minor importance. Prevalence and incidence of parasitic infections did not differ by sex. Multiparasitism was very frequent and less than 11% of all children were parasite-free in each year. Not a single child remained parasite-free for three consecutive years. An anthropometric assessment showed a high degree of stunting (35-71%) and a substantial proportion of wasting (3-20%). The growth potential was normal in girls and boys during the whole period of study. There were indications that malaria was the main contributory factor to growth retardation among young children. Hookworm infection did not significantly affect the packed-cell volume of the children, probably owing to the low intensity of infection. Due to the multiparasitism and the lack of parasite-free individuals, single-parasite and single-nutrient effects were difficult to unravel. A latrine campaign followed by a single mass treatment against hookworm (single oral dose of albendazole, 400 mg) and/or G. lamblia (single oral dose of ornidazole, 40 mg/kg) only temporarily affected the prevalence and incidence of G. lamblia, and only resulted in a decrease in the intensity of hookworm infections up to six months after the interventions. As the effects of the latrine campaign and a single mass treatment on the parasite load were only transient, no sustained impact on nutritional variables was observed.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Longitudinal study on the health status of children in a rural Tanzanian community: parasitoses and nutrition following control measures against intestinal parasites. 289 Dec 67

10 asymptomatic young male patients with moderate splenomegaly detected at a routine examination are presented. The history and clinical examination failed to reveal the aetiology of the splenomegaly. Further investigations, including screening for blood dyscrasias, clotting abnormalities and reticuloendothelial abnormalities were likewise unrevealing. Liver biopsies, rectal biopsies for bilharzia and bone marrow aspirates for Gaucher's Disease were found to be normal. Serology for malaria and Ebstein Barr Virus infection was also negative. Positive immunofluorescent tests for IgG antibodies specific for cytomegalovirus were found in 5 patients. We consider that these patients have splenomegaly which is not of a specific nature, but may be associated with a severe antigeneic response to the previous cytomegalovirus infection. In view of the otherwise negative findings these patients should be considered to have 'True Idiopathic Splenomegaly', a term which would indicate the benign nature of the splenic enlargement. This diagnosis should be considered in the differential diagnosis of asymptomatic patients who have splenomegaly of undetermined origin.
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PMID:True idiopathic splenomegaly--a distinct clinical entity. 302 8

An intervention trial was undertaken in a rural area of The Gambia to assess the impact on malaria morbidity of the use of bed nets. Bed nets were allocated at random among a group of 16 Fula hamlets, where they were previously rarely used. The incidence of febrile episodes with associated malaria parasitaemias throughout the rainy season and the prevalence of splenomegaly and parasitaemia at the end of the rainy season were determined in 233 children aged 1-9 years who slept under bed nets and in 163 children who did not. Bed nets were used correctly by the children in the study cohort, but direct observations showed that a significant number of children left their nets for a period during the night. There was no significant difference in the incidence of clinical attacks of malaria or in any other malariometric measurement between the 2 groups. Thus, bed nets were not effective in reducing malaria morbidity in this group of children. The apparent protection from bed nets demonstrated in previous retrospective surveys may have been due to an increased number of infective bites being received by exposed individuals sleeping close to users of bed nets.
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PMID:A trial of bed nets (mosquito nets) as a malaria control strategy in a rural area of The Gambia, West Africa. 305 56

Splenomegaly and parasitaemia were correlated in 2891 children examined in outpatient clinics during 13 consecutive months in 4 Punjabi villages. The average monthly splenomegaly rate varied from 0.05-0.13 before the monsoon malaria transmission season to 0.18-0.27 during and after this season. Moderate splenic enlargement reached a peak during the malaria transmission season, while the highest proportion of very enlarged spleens occurred towards the end of, and after, the transmission season. Children with splenomegaly were 3 times more likely to have Plasmodium falciparum and 1.5 times more likely to have P. vivax parasitaemias than were children without palpable spleens. The larger the spleen the more likely a P. falciparum infection, whereas P. vivax was more commonly associated with minimal spleen enlargement. Although the probability of a child with splenomegaly having a malaria parasitaemia was highest (0.58-0.72) during and immediately following periods of malaria transmission, the odds ratio of malaria infections among those with splenomegaly to those without was at its lowest (1.41-2.11) during those months. Mean P. falciparum parasitaemias were significantly higher in infected children with moderately enlarged spleens than in infected children with nonpalpable spleens or in those with minimal or extensive splenomegaly. These results are compatible with splenomegaly being a result of both the malaria infection and the immune response. Early in infection many children had parasitaemia without splenomegaly; after the parasitaemia had cleared splenomegaly often persisted.
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PMID:Malaria and splenomegaly in the Punjab. 307 51

106 children aged 1-10 years who had pure Plasmodium falciparum infections and temperatures greater than or equal to 38 degrees C were treated with chloroquine base, 25 mg/kg body weight. 29% of the infections were sensitive in vivo, 41% recurred within 4 weeks (RI), 26% were RII resistant, and 4% were RII resistant. Rieckmann micro in vitro tests were successful in 64% of isolates obtained from these children; 63% were resistant to chloroquine. In 58 paired isolates obtained before and after treatment, the level of chloroquine sensitivity was lower in the parasites persisting or recurring after treatment. All children except 2 of the 4 with RIII resistance became afebrile an average of 1.4 d after starting treatment and their other symptoms resolved in an average of 1.8 d. By day 28, 57% of the children with RI resistance and 78% of those with RII resistance had recurrence of fever and other symptoms, compared with 19% of children with sensitive infections. No relationship was observed between the clinical or parasitological response and age, nutritional status, haematocrit, splenomegaly, presence of sickle-cell trait, or seropositivity to malaria by enzyme-linked immunosorbent assay. The study demonstrates that, in most children with malaria in an area of intermediate chloroquine resistance, fever and other symptoms resolve at least temporarily when treated with chloroquine.
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PMID:Chloroquine treatment of falciparum malaria in an area of Kenya of intermediate chloroquine resistance. 307 97


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