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Query: UMLS:C0024530 (malaria)
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The atoll community of Fenuafala was surveyed during July-August, 1987. A disproportionate demographic structure was found: There was a large, young population with an uneven sex distribution in the adolescent cohorts. Adoption of relatives was frequent. Employment varied according to sex, with women restricted from horticulture, fisheries, and hard labour. The use of alcohol and tobacco was common. Causes of mortality included cancer, heart failure, meningitis, alcoholism, and accidents. Bacterial and fungal skin infections were prevalent. There were several cases of congenital disorders. Malaria, leprosy, and most other tropical diseases were absent. However, there was a single case of filariasis. Musculoskeletal disorders were numerous and more common among women. Falls from trees have resulted in serious sequelae including epilepsy and death. Hypertension, diabetes, and gout appear to be on the increase, but angina and myocardial infarction were not reported. There were also cases of epilepsy and Parkinson's disease.
Asia Pac J Public Health 1989
PMID:Fenuafala health survey: the ecology of health and disease on a coral atoll village. 280 43

In vitro studies were carried out on the nature of immunoglobulin synthesis and secretion by peripheral blood mononuclear leukocytes (PBMLs) and on the function of T and B cells from malaria patients. The mean values of secreted IgG and IgM concentrations of 22 malaria patient PMBLs were significantly higher than those of 20 normal PBMLs. When the suppressor T cell activity and the function of B cells in response to suppressor T cells were assayed by the cell co-culture technique, it was found that there was a decrease in suppressor T cell activity and the B cell function in response to normal suppressor T cells in malaria patients. The defects of these T and B cell functions may play some role in the immunological abnormalities seen in some malaria patients.
Asian Pac J Allergy Immunol 1986 Jun
PMID:Regulation of immunoglobulin secretion by T lymphocytes in human malaria. 294 47

Observational and survey methodologies were used to probe human behavioral factors influencing the use of insecticide-impregnated bednets to control malaria in rural Sabah, Malaysia. One aim was to investigate why a field trial of such nets in an interior area yielded disappointing results. A second aim was to gather baseline data prior to a field trial proposed for a coastal area. Interior villagers reported a significantly higher net usage rate than that observed directly, suggesting that subject self-reports need to be validated in some way. The poor results of the interior field trial appeared related to reluctance to regularly use nets, which were not in wide use previously. Prospects for reducing malaria transmission through bednets appeared better for the coastal area since nearly half of observed villagers were sleeping in them. However, significantly more coastal than interior villagers were observed watching television at night, an activity that may increase malaria risk by keeping villagers awake and out of bednets.
Asia Pac J Public Health 1994
PMID:Observations of human behavior influencing the use of insecticide-impregnated bednets to control malaria in Sabah, Malaysia. 794 56

In Thailand, the epidemiological data on scrub typhus infection represents only "the tip of an iceberg" especially in malaria clinics where patients come to seek attention because of other febrile illnesses that may have initial clinical signs that are indistinguishable from malaria. The objectives of this study were to determine the prevalence of antibody titers to Orientia tsutsugamushi, and its various strains, among patients at some malaria clinics in three western provinces of Thailand. The sample was represented by 200 patients from 6 malaria clinics in Ratchaburi, Petchaburi and Kanchanaburi provinces between June and November, 1994. Blood specimens were collected with their consent. Immunofluorescent antibody assays (IFA) were used for measuring IgM and IgG antibody titers for scrub typhus infection. The results showed that the prevalence rate for scrub typhus infection (IgM and/or IgG titer > or = 50) was 59.50% (119 cases). The immunofluorescent antibody response to various strains of O. tsutsugamushi showed that co-infections with the Karp, the Gilliam and the Kato strains were the most common (found in 68.10% of cases). Geometric mean antibody titers (GMT) were highest for the Karp strain, followed by the Gilliam then Kato strains. In conclusion, this study indicates that the prevalence rate of scrub typhus is not rare in these areas.
Asian Pac J Allergy Immunol
PMID:Seroprevalence of scrub typhus infection in patients with pyrexia at some malaria clinics in three western provinces of Thailand. 987 50

Malarial diarrhoea in children are very variable and sometimes clinically indistinguishable from other diarrhoea in malaria endemic areas. This descriptive study was carried out to examine the proportion of malaria infection among diarrhoea children and compare the diarrhoea pattern to those of that diarrhoea without malaria infections. During January 1992-December 1994, data were collected and analysed. Out of 2,013 hospitalised children, there were 421 (20.91%) with diarrhoea. Out of 421, there were 150 (35.63%) diarrhoea with malaria infections. All cases are caused by Plasmodium falciparum. Majority of the cases are in age group of under one, where fever is the predominant symptom. The length of stay of diarrhoea with malaria cases is longer than those of that diarrhoea without malaria infections.
Asia Pac J Public Health 1995
PMID:Malaria diarrhoea in children. 1005 Jan 87

Two types of antimalaria antibodies in the serum of 54 villagers living in a malaria endemic area of Thailand were determined by indirect immunofluorescence assay in order to define the status of malaria immunity within the group. Antibodies to parasite-derived antigens in the membrane of ring stage-infected erythrocytes were very high (> or = 1:1,250) in 44%, moderate to low (< or = 1:250) in 37% of the sera, and the rest did not have the antibody. However, all the sera had antibodies to antigens of the intraerythrocytic mature parasites, showing a very high level in 65% and moderate to low levels in 37% of the sera. Sera with high antibody titers to either type of antigen significantly inhibited cytoadherence of P. falciparum-infected erythrocytes. All the sera variably inhibited rosette formation of the parasites but showed no association with the antibody titers. These results suggest that the antibodies to cytoadherence and rosette formation can be elicited and sustained in the malaria experienced host while living in the endemic area. This may be a natural preventive mechanism against the severity of P. falciparum infection in the infected host. How long the antiparasite adherence activity will last remains to be investigated.
Asian Pac J Allergy Immunol 1999 Mar
PMID:Antiparasite adherence activity in Thai individuals living in a P. falciparum endemic area. 1040 6

A hospital and clinic-based study was conducted in one malaria endemic area, Taikkyi Township, Yangon Division, Myanmar, for analysis of cost incurred by different types of malaria cases and the factors influencing the cost of illness from July to October 1995. A total of 100 patients admitted to hospital and 100 patients receiving ambulatory care from malaria clinics were interviewed using a structured questionnaire. Total cost of one episode of malaria was estimated to be kyats 559 for ambulatory care, kyats 2582 for an uncomplicated admitted case, kyats 4056 for one episode of cerebral malaria, kyats 4568 for one episode of other severe and complicated malaria and kyats 4758 for one episode of malaria with other disease. This study showed that the cost of illness for patients attending outpatient malaria clinics who received early diagnosis and prompt treatment was four to seven times cheaper than the cost of illness for hospitalized malaria cases. Multivariate analysis revealed the factors that contributed to high cost of care. Duration of illness before getting any type of treatment was the key factor that contributed to high or low cost of care. Long duration of illness before getting any type of treatment can lead to high malaria parasite density, long duration of actual illness and high total attendance cost. Therefore, it is recommended that people from malaria endemic areas should be informed to seek early treatment from health staff, and primary health care services should be made accessible to people who live in malaria endemic areas. The information obtained from this study will be useful in planning future malaria control programs and influencing policy makers to focus on timely and effective treatment of non-severe cases, which can save a large amount of economic loss due to treatment of severe malaria.
Asia Pac J Public Health 1999
PMID:Cost analysis of malaria patients in Taikkyi Township Myanmar. 1119 65

According to this statement presented to the Committee on Population of the UN Economic and Social Commission for Asia and the Pacific, combined effects of continuing high fertility and declining mortality account for Nepal's current growth rate of 2.7%, which will produce a population of 25.4 million in the year 2000, up from 9.4 million in 1961 and 15 million in 1981. Children under 15 comprise over 40% of the population. The rapid expansion of public health facilities and successful efforts to control cholera, smallpox, and other communicable diseases account for an increase in life expectancy to an estimated 46 for males and 44 for females. There has been no significant decline in fertility, and the total fertility rate is 6.3. The infant mortality rate of 152/1000 live births is still very high. Population pressure in the mountains and hills has reduced the average size of individual family land holdings to less than .4 hectare, and average productivity of the land has fallen due to cultivation of marginal lands, landslides, loss of ground water, erosion, and nutritional deficiency of the soil. Wasteful forest cutting and soil erosion have occurred as the terai or plains have become more densely settled following the eradication of malaria and internal migration. Nepal adopted its 1st official population-related program in 1965 when the 3rd plan called for family planning to reduce the birth rate and help achieve balance between population and natural resources. During the 5th 5 year plan a multisectorial population policy aimed at managing spatial and temporal population distribution was adopted. The demographic target of the 6th plan was to reduce the total fertility rate to 5.8 by 1985. The population strategy recently formulated by the reconstituted National Commission on Population calls for reducing the growth rate from 2.6% to 1.2% in 15 years, integrating population and development programs in all sectors, increasing female literacy and employment rates, regulating immigration, and registering vital statistics. The family planning program is giving more emphasis to younger couples aged 20-30, who are offered a mix of temporary methods for child spacing. To combat the high drop out rate, all family planning programs will include IEC activities, and family planning service delivery programs have been extended. Maternal-child health programs, especially tetanus toxoid innoculation to prevent neonatal tetanus, are also receiving high priority.
Asian Pac Popul Programme News 1985 Sep
PMID:Nepal (country/area statements). 1226 50

This article explores the readiness to the spread of AIDS of the Solomon Islands, which have the highest incidence of malaria worldwide. Treatment approaches to control the disease are favored by inexpensive health care services. However, primary health care is never practiced in the country and training of health care providers is just getting off the ground. Given this picture, the country is totally unprepared for the upcoming battle against AIDS. In 1980, the AIDS epidemic struck many areas of the globe where the Solomons are now located. The WHO reported 11 million AIDS cases in the world in 1992, 70% of which were found in Africa. Due to the rapid increase in AIDS cases in the world, it was made clear that major health problems of the society that contributed to the spread of the disease are the same diseases that underlie other causes of illness including malaria. Therefore, if diseases such as malaria remain uncontrolled, surely, AIDS will destroy the entire population. Based on this assumption, community mobilization against malaria is very crucial to the control of AIDS.
Pac AIDS Alert Bull 1993
PMID:Is Solomons ready for AIDS? 1229 30

There is a need for a national urbanization policy in Nepal as a means of redressing regional disparities in development between the hills, the Kathmandu Valley, and the Terai versus rural and urban areas. A settlement system would complement urban and rural development and reduce dependency on India. An urbanization policy would be both systematic and guided by public and private investment in existing urban and rural settlements. Regional investment in development would contribute to commercialization and agricultural industrialization (development and linkage of market towns and service centers, strengthening of basic infrastructure and land use patterns, strengthening of urban areas around transportation centers, promoting nonfarm employment opportunities, establishing strong financial and technical institutions in middle-sized cities, and strengthening municipalities' mobilization of local resources and financing). Nepal has been one of the least developed countries in its region. The agricultural economy provides economic support for 80% of total population. In 1991, density was 130 person per sq. km. 9% of the total population live in urban areas, but the rate of urban growth is the highest among South Asian Regional Cooperation countries (7.3% in Nepal compared to 6.1% in Bangladesh and 3.7% in India). Rural markets and towns are rapidly becoming urbanized but without basic infrastructure. The spatial component of urbanization must be emphasized. Total population increased in the Terai from 37% in 1971 to 47% in 1991, which increased population density by 31% but not cultivation. Harsh physical conditions in mountainous regions and lack of cultivable land are push factors. Pull factors are employment opportunities in emerging urban centers and the availability of agricultural employment in the Terai. Movement to lowlands is enhanced by the eradication of malaria. 53% of the urban population is in the Terai in 1991, which also has 65% of cultivable land, 35% of roads, and 63% of industry. Urban settlements increased from 10 in 1951 to 33 in 1987 and 36 in 1991. In the Terai, the increases are from five to 21 urban centers. The central and eastern region have experienced faster urban growth than the other three regions. Kathmandu is the most populated urban center followed by Biratnagar, Pokhara, and Birganj. Government ministries are ill-equipped to handle the technical and manpower needs in the process of urbanization.
Asia Pac Popul J 1994 Sep
PMID:The need for a national urbanization policy in Nepal. 1231 88


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