Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
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The cultural context of forest onchocerciasis was studied in the Boulou and Baka ethnic communities in the Dja-Lobo Division of southern Cameroon. A 2-day survey used focus group interviews followed by a questionnaire administered to 212 randomly selected individuals in 8 communities (88 male and 124 females heads of household) to assess their knowledge about onchocerciasis. Most people (98%) had some knowledge about the disease. Minak was the term used for filariasis by most people (97%) and people knew (90%) that black fly (nyamendimi) was responsible for its transmission. Other vectors of the illness identified were mosquitoes, dirty water, sorcery, and taboo foods. 81% thought that maternal transmission was possible and 66% indicated that filariasis could be transmitted sexually. Virtually all respondents associated itching and rash with minak (filariasis) and more than 60% also recognized the swelling of the skin and leopard skin as manifestations of filariasis. Filariasis, malaria, worms, and blindness were placed in the middle category when the severity of various diseases was ranked by 20 Boulou adults. In contrast, the Baka did not think that filariasis caused blindness, nor that it is linked to eye-worms. However, the 212 individuals ranked blindness as the most severe among other diseases (filaria, malaria, diarrhea, and intestinal worms). 80% of the Boulou and Baka adults had had filariasis in the previous year, but only 5% of the Boulou children and none of the Baka children had had filariasis during that time period. With respect to intestinal worms, 71% of the Boulou adults and 60% of the Baka adults had had intestinal worms in the previous year, while more than 90% of the Boulou children and all of the Baka children had had intestinal worms. Of the 90% who revealed that they had had filariasis at least once before, 69% sought treatment. 54% had tried traditional treatment, while 50% had tried Notezine, 49% had tried Phenergan, and 38% had tried M.G. Lumiere.
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PMID:Ivermectin distribution and the cultural context of forest onchocerciasis in South Province, Cameroon. 864 8

Clinical epidemiology is going to be the Discipline par excellence of the next century, if not the millennium. Coming as it does from one who has spent decades in clinical medicine and therapeutics, this is a bold statement. Clinical epidemiology answers the questions what? Where? How? When? Who? Why? And Which? In matters of health and disease. It is because these questions have come to be answered effectively with respect to bancroftian Filariasis that it has been included in the world's six "potentially eradicable" diseases. In his impressive Review Article on page (), Dr. Gyapong takes us through answers to these epidemiology questions [1]. Filariasis occurs in 38 African countries where the mere presence of a hydrocele affords "a rapid diagnostic index" for infection [2], while the so-called "filarial dance sign" is known to be present in intrascrotal lymphatics of microfilaraemic patients [3]. That the social and economic consequences of filarial morbidity are enormous on community preventive measures. People must be told that the mosquito, not juju or other "supernatural factors: [1] is the culprit. I am old enough to remember the "Town council Man" in colonial Gold Coast. He would visit every house assigned to him, enforcing environmental sanitation and destroying pools of water and mosquito breeding places. If but one cocoanut shell was found in the compound with water in it,whether or not it contained a mosquito larva, the head of the household was given summons to go to court and pay a fine. Came independence and the community also became independent of the "Town Council Man" with the result that there are infinitely more mosquitoes now in independent Ghana than there were in the colonial Gold Coast. "The WHO", it is widely held, "will do it for us". Today, a vaccine is awaited for most things while the insects flourish. Deal with mosquito, and both malaria and Filariasis will be dealt a death blow. Fortunately, ivermectin will reduce the parasitic reservoir from which transmission occurs, and diagnosis of subclinical cases no longer has to rely on blood sampling at night or on Diethyl Carbamazine provocation tests [4], but is reliably achieved using finger prick to detect Og4C3 circulating antigens day or night [5,6]. Mosquito nets reduce nocturnal bites and hence incidence of both malaria and Filariasis. Doctors should keep long-term records and ascertain whether insecticide impregnanted nets lead to pesticide resistance or not. Spraying should never be abandoned as it had often been on the rumour that "it does no good, and produces insecticide resistance". These preventive measures are best supervised through decentralised programmes [1,7] and are most effectively conducted in the mother tongue of the community at the grassroots [8]. Local businessmen and market women should be encouraged to assist chiefs and community leaders in giving monthly prizes in environmental sanitation while public health experts chart the effect of such sanitation on morbidity of Filariasis and mortality from malaria. We should go back to the "Sanitary Branch" institutions of the colonial days[9] when clinical epidemiology did much to protect the health of the community. Central government should fund trips to Japan, Taiwan, Solomon Islands, South Korea and some parts of China [1] for African health workers to learn first hand how those communities managed to eradicate lymphatic Filariasis. Even with the current AIDS problem, I remain convinced that clinical epidemiology is the answer [10]. Vaccines have achieved much this century, but to "wait for WHO to give us vaccines" while we neglect ourselves and our environment is wholly irresponsible.
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PMID:Supreme worth of clinical epidemiology in Africa:bancroftian Filariasis as just one case in point. 1758 Oct 27