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

The morbidity of schistosomiasis mansoni was assessed in Makundju (population 547; prevalence 96%, mean egg load 791 epg) and Massimelo (pop. 363; prev. 19%, mean egg load 39 epg), 2 similar villages in the forest zone of Maniema, Zaire. The prevalences of other parasites including malaria (holoendemic) were comparable. "Intermittent diarrhoea" (mostly bloody) was a complaint of 55% and 3% of the populations, respectively, "intermittent abdominal pain" of 63% and 25%, and "fatigue" of 33% and 19%. Enlargement of the left liver lobe was present in 45% and 9% of the populations, right lobe hepatomegaly in 32% and 3%, splenomegaly in 29% and 9%. Hepatomegaly and splenomegaly in Makundju were often very impressive, and most frequent in the 6- to 18-year-old group. Anaemia (haematocrit less than or equal to 35%) was present in 30% and 9% of males and 36% and 21% of females. Mean length and weight were lower in Makundju for boys aged 11 to 18 years. Ergometric results (Astrand cyclometer, male adults only) were comparably low in both villages (mean VO2max. 19.3 and 18.9). Analysis of the data according to egg load within the Makundju community revealed a significant relationship only in the following cases: higher frequencies of diarrhoea, abdominal pain and fatigue in those excreting more than 200 epg compared with those excreting fewer; left lobe splenomegaly gradually increased with egg load in children under 18; in people over 40 it occurred at a higher frequency in those excreting more than 2000 epg than in those excreting fewer.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The morbidity of schistosomiasis mansoni in Maniema (Zaire). 311 2

Thirty six patients with culture-proven enteric fever and 15 patients of fever with etiology other than enteric fever as a control group were studied, with special reference to hepatic dysfunction and its relation to clinical features of the disease. Hepatomegaly was observed in 55% of enteric fever patients, and was slightly more common than splenomegaly (50%). Its incidence in typhoid fever (67%) was three times higher than in paratyphoid fever (22%). Hepatic dysfunction occurred in 55% of cases. Jaundice was noted in only 8% of the cases, whereas hyperbilirubinemia (serum bilirubin greater than 1.8 mg %) was present in 17%. Although hepatic manifestations of enteric fever were mild, a small but important group had sufficient hepatic involvement to mimick the clinical picture seen in viral hepatitis, amebic liver disease, and malaria with jaundice. It may be considered of clinical significance, since enteric hepatitis responds very well to specific therapy.
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PMID:The spectrum of hepatic injury in enteric fever. 312 48

Avian malaria (Plasmodium relictum) caused significant mortality in wild-caught Magellanic penguins (Spheniscus magellanicus) in 1986 at the Blank Park Zoo in Des Moines, Iowa (USA). In early winter, wild birds were captured off the southern coast of Chile and flown to Detroit, Michigan for a 38 day quarantine. After quarantine, 18 birds were dispersed to Lansing, Michigan, six to a facility in Maine, and 46 to Des Moines, Iowa. Upon arrival in Des Moines, several penguins became weak and inactive, had to be force-fed, and died after 2 days. Gross lesions at postmortem included splenomegaly, hepatomegaly, and pulmonary edema. Histopathological examination revealed numerous intraendothelial schizonts in spleen, lung, liver, heart and kidney. Schizonts were generally 16 to 28 micron by 11 to 16 micron and contained merozoites of two distinct sized (macromerozoites, nuclei 1.0 micron; micromerozoites, nuclei 0.5 micron). Based on the morphology of the abundant exoerythrocytic forms, a tentative diagnosis of avian malaria (Plasmodium sp.) was made. Subsequent transmission electron microscopic examination of schizonts in formalized tissue revealed merozoites with tear-shaped rhoptries. Antimalarial therapy was initiated early but deaths continued for 5 mo. Mortality, which eventually totaled 83%, occurred in three distinct waves, each separated by a hiatus of approximately 1 mo. Despite examinations of repeated blood smears, intraerythrocytic Plasmodium relictum was not detected until late in the outbreak. Diagnosis was based on morphologic characteristics including schizonts with eight to 12 merozoites/segmenter and round gametocytes that displaced and turned the infected erythrocyte nucleus. In addition to malaria, penguins showed evidence of aspergillosis, bacterial enteritis (Escherichia coli; Proteus sp.; and Edwardsiella sp.), and helminthiasis (Contracaecum sp. and Tetrabothrius sp.). Based on gross and histological lesions, disease prevalence in this group of penguins was malaria 58%, aspergillosis 61%, enteritis 60%, helminthiasis 26%. Epidemiologic investigation including group transport history, disease prevalence in co-quarantined birds not sent to Des Moines and climatological data implicated Des Moines as the likely site for initial exposure, although information is not conclusive. Stress and concurrent disease certainly contributed to the severe mortality in this group of penguins infected with P. relictum.
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PMID:Plasmodium relictum as a cause of avian malaria in wild-caught magellanic penguins (Spheniscus magellanicus). 319 55

In a malariometric survey of 594 non-pregnant women living in 17 villages in Madang Province, Papua New Guinea, village groups were identified with average spleen rates of less than 35%, 40-49% and greater than or equal to 50%, with no difference in parasite rates between groups. Most villages where a non-Austronesian language was spoken had high spleen rates, but the association was not consistent. Some women were not indigenous to the study area and to control for the effects of migration on spleen rates, women were grouped according to their area of origin. This analysis, which cuts across village groups, identified 2 subpopulations, one with a high, and the other with a low spleen rate (relative risk 2.23; P less than 0.0001). Persistent splenomegaly was observed more frequently in the high spleen rate population (P less than 0.025) which also showed a significantly increased spleen size (P less than 0.01). The existence of 2 subpopulations living under the same conditions of malaria endemicity, but with different splenic responses to malaria, suggests an altered host immune response to malaria in the high spleen rate group. The absence of intermarriage between these two subpopulations indicates genetic differences distinguish them.
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PMID:High and low spleen rates distinguish two populations of women living under the same malaria endemic conditions in Madang, Papua, New Guinea. 325 84

582 pregnant women living in a defined population were examined for splenomegaly when attending monthly rural antenatal clinics in Madang Province, Papua New Guinea, in an area with all-year malaria transmission. 712 non-pregnant women of child-bearing age from the same population were examined as controls. In non-pregnant women who later became pregnant spleen rates increased in early pregnancy. Peak spleen rates in early pregnancy occurred before 16 weeks gestation for all gravida classes. There was a decrease in spleen rate and a fall in average enlarged spleen size with increasing gestational age for women attending on a first clinic visit and before receiving chloroquine prophylaxis. It is suggested that pregnancy induces a change in splenic function early in gestation, which in primigravidae results in increased frequency of Plasmodium falciparum parasitaemia. In multigravidae these early gestational spleen changes did not predispose to parasitaemia, which indicated that these women had developed enhanced malaria immunity. There was a significant rise in spleen rates with rising parity in non-pregnant women with a peak rate at parity 3. This rise is considered to relate to responses induced by pregnancy in the first and second pregnancies. Weekly chloroquine prophylaxis increased the frequency of splenomegaly in pregnant women attending for 3 consecutive months, indicating that chloroquine had biological activity on the splenic immune response in vivo.
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PMID:A longitudinal study of splenomegaly in pregnancy in a malaria endemic area in Papua New Guinea. 325 85

We studied the effects of daily proguanil compared to weekly chloroquine as malaria prophylaxis in 170 children living in a malaria-endemic area along the Thai-Burmese border. Children aged 5-10 years were matched for age, weight, and presence of splenomegaly then randomly assigned to receive either proguanil (equivalent of 200 mg daily adult dose) or chloroquine (equivalent of 300 mg base weekly). All medications were administered by the investigators and malaria smears were performed on a weekly basis. Among 85 children taking proguanil for 524 human-weeks, there were 17 cases of falciparum malaria and 11 cases of vivax. Of 85 children on chloroquine for 537 human-weeks, there were 24 cases of falciparum and 1 case of vivax. There were no statistically significant differences between the two regimens when analyzed either as suppressive or as causal Plasmodium falciparum prophylactics. The data were suggestive that proguanil may have some causal prophylactic effect against falciparum malaria. There were significantly more vivax prophylactic failures (P less than 0.01) in the proguanil group. Side effects were infrequent, mild, and comparable in both groups.
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PMID:Malaria prophylaxis with proguanil in children living in a malaria-endemic area. 328 87

Plasmodium-infected erythrocytes lose their normal deformability and become susceptible to splenic filtration. In animal models, this is one mechanism of antimalarial defense. To assess the effect of acute falciparum malaria on splenic filtration, we measured the clearance of heated 51Cr-labeled autologous erythrocytes in 25 patients with acute falciparum malaria and in 10 uninfected controls. Two groups of patients could be distinguished. Sixteen patients had splenomegaly, markedly accelerated clearance of the labeled erythrocytes (clearance half-time, 8.4 +/- 4.4 minutes [mean +/- SD] vs. 62.5 +/- 36.5 minutes in controls; P less than 0.001), and a lower mean hematocrit than did the patients without splenomegaly (P less than 0.001). In the nine patients without splenomegaly, clearance was normal. After institution of antimalarial chemotherapy, however, the clearance in this group accelerated to supernormal rates similar to those in the patients with splenomegaly, but without the development of detectable splenomegaly. Clearance was not significantly altered by treatment in the group with splenomegaly. Six weeks later, normal clearance rates were reestablished in most patients in both groups. We conclude that splenic clearance of labeled erythrocytes is enhanced in patients with malaria if splenomegaly is present and is enhanced only after treatment if splenomegaly is absent. Whether this enhanced splenic function applies to parasite-infected erythrocytes in patients with malaria and has any clinical benefit will require further studies.
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PMID:Dynamic alteration in splenic function during acute falciparum malaria. 330 76

A trial was undertaken in a rural area of The Gambia to investigate the impact of permethrin-treated bed nets on malaria. Two groups of children, matched for age, sex, and malaria exposure, were followed through the rainy season of 1985 for illness and febrile episodes. One group of 205 children slept under permethrin-treated bed nets (0.5 g/m2); 184 children who slept under placebo-treated nets formed the control group. At the end of the rains the children were examined for splenomegaly and blood samples were taken for determination of packed cell volume (PCV) and parasitaemia. Permethrin treatment of bed nets was well accepted and was without side-effects. Children who slept under treated nets had significantly fewer episodes of clinical malaria than control children. However, at the end of the rains there was no significant difference in the prevalence of splenomegaly or parasitaemia or in the mean PCV between the groups. It is suggested that permethrin treatment of nets may have a greater effect on the duration of probing by mosquitoes for a blood meal than on the number of bites received.
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PMID:A trial of permethrin-treated bed nets in the prevention of malaria in Gambian children. 332 43

Plasmodium falciparum was cultured through a single intra-erythrocytic cycle of growth in the presence of sera from various areas of Papua New Guinea. Of 194 sera tested from healthy individuals or subjects with hyperreactive malarious splenomegaly (HMS), 107 (55%) significantly inhibited parasite development. Inhibition did not correlate with malaria experience or HMS, though it was to some extent a seasonal phenomenon. Sera with inhibitory activity lost this after dialysis. A possible explanation for these findings is the occurrence of a dietary toxin with antimalarial properties detectable in vitro.
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PMID:Inhibition of intra-erythrocytic growth of Plasmodium falciparum by human sera from Papua New Guinea. 332 44

Significant variations in the prevalence of splenomegaly were found among members of the three main ethnic groups resident in North Bank Division, The Gambia. Among young children splenomegaly and malaria were less prevalent in Mandinkas than in Wollofs or Fulas, suggesting that some genetic or environmental factors protect Mandinka children from this infection. Among older children and adults splenomegaly was found most frequently in Fulas. Six of 22 adults with very large spleens had a high serum IgM level and probably had the hyperreactive malarial splenomegaly (tropical splenomegaly) syndrome. Four of these six subjects were Fulas. This finding, together with the results of a previous study in Nigeria, suggest that Fulas have a predisposition to this condition.
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PMID:Ethnic differences in the prevalence of splenomegaly and malaria in The Gambia. 344 25


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