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

Two hundred Hausa primigravidae at Zaria were divided into five groups in a randomized double-blind trial of antenatal oral antimalarial prophylaxis, and haematinic supplements. Group 1 received no active treatment. Groups 2 to 5 were given chloroquine 600 mg base once, followed by proguanil 100 mg per day. In addition, group 3 received iron 60 mg daily, group 4 folic acid 1 mg daily, and group 5 iron plus folic acid. Forty-five percent were anaemic (haemoglobin (Hb) less than 11.0 g dl-1) at first attendance before 24 weeks of gestation, and malaria parasitaemia (predominantly Plasmodium falciparum) was seen in 27%, of whom 60% were anaemic. The mean Hb fell during pregnancy in group 1, and seven patients in this group had to be removed from the trial and treated for severe anaemia (packed cell volume (PCV) less than 0.26). Only five patients in the other groups developed severe anaemia (P = 0.006), two of whom had malaria following failure to take treatment. Patients in group 1 had the lowest mean Hb at 28 and 36 weeks of gestation, and patients receiving antimalarials and iron (groups 3 and 5) had the highest Hb at 28 weeks, but differences were not significant, possibly due to removal from the trial of patients with severe anaemia. Anaemia (Hb less than 12.0 g dl-1) at six weeks after delivery was observed in 61% of those not receiving active treatment (group 1), in 39% of those protected against malaria but not receiving iron supplements (groups 2 and 4) and in only 18% of patients receiving both antimalarials and iron (groups 3 and 5). Folic acid had no significant effect on mean Hb. Proguanil was confirmed to be a highly effective causal prophylaxis. Prevention of malaria, without folic acid supplements, reduced the frequency of megaloblastic erythropoiesis from 56% to 25%. Folic acid supplements abolished megaloblastosis, except in three patients who were apparently not taking the treatment prescribed. Red cell folate (RCF) concentrations were higher in subjects with malaria, probably due to intracellular synthesis by plasmodia. Infants of mothers not receiving antimalarials appeared to have an erythroid hyperplasia. Maternal folate supplements raised infants' serum folate and RCF. Fourteen per cent had low birth weight (less than 2500 g), and the perinatal death rate was 11%; the greatest number were in group 1, but not significantly. A regime is proposed for the prevention of malaria, iron deficiency, folate deficiency and anaemia in pregnancy in the guinea savanna of Nigeria.
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PMID:The prevention of anaemia in pregnancy in primigravidae in the guinea savanna of Nigeria. 353 Jan 58

Clinical observation has suggested that iron deficiency may be protective in malaria, and we have found that desferrioxamine (DF), an iron-specific chelating agent, inhibited Plasmodium falciparum growth in vitro. It was difficult to be confident that DF would be effective in an intact animal, however, because continuous exposure to DF was required in vitro and, in vivo, DF is rapidly excreted. Also, the in vitro effect of DF was overcome by addition of iron to the culture and in vivo there are potentially high local iron concentrations when iron is absorbed from the diet or released from reticuloendothelial cells. We now show that DF given by constant subcutaneous infusion does suppress parasitemia in P. falciparum-infected Aotus monkeys.
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PMID:Desferrioxamine suppresses Plasmodium falciparum in Aotus monkeys. 354 39

An assessment of iron and folic acid status, blood thick film and haemoglobin (Hb) electrophoresis was performed on 126 pregnant women (and their newborn infants) and in ninety-five menstruating women in Cotonou (Benin). Anaemia (according to the World Health Organization (1972] was observed in 55% of pregnant women and in 39% of menstruating women. Fe-deficiency was defined as a low serum ferritin concentration (12 micrograms/l or less), combined with a low transferrin saturation (less than 16%) or a high erythrocyte protoporphyrin level (more than 3 micrograms/g Hb), or both. A moderate elevation in the serum ferritin concentration (between 13 and 50 micrograms/l), associated with a low transferrin saturation or a high erythrocyte protoporphyrin level, or both, indicated Fe-deficiency in an inflammatory context. Fe-deficiency was present in 73% of pregnant women and in 41% of menstruating women. Folate deficiency (defined as erythrocyte folate below 160 micrograms/l) was observed in 45% of pregnant women. In pregnant women, anaemia was associated with Fe-deficiency in 83% of cases and with folate deficiency in 48% of cases. Haemoglobinopathies were mainly heterozygous and did not seem to contribute significantly to anaemia. Intensity of malaria was not related to Hb level, but Plasmodium falciparum was found in 99% of subjects. Hb concentration and mean corpuscular volume were significantly lower in babies born of Fe-deficient mothers than in babies born of Fe-sufficient mothers. Hb concentration in newborn infants was positively correlated with maternal serum ferritin.
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PMID:Nutritional anaemia in pregnant Beninese women: consequences on the haematological profile of the newborn. 355 28

A study was made of 544 mothers and their 556 newborns in an area of endemic malaria, to analyse effects of total dose intravenous iron infusion (TDI) to mothers during pregnancy. 34% of these mothers received TDI before delivery. A range of haematological tests was carried out on newborns and mothers in addition to anthropometry. 84% of mothers had had ante-natal care and data were also collected retrospectively from ante-natal records. TDI was associated with more slide positive peri-natal malaria in primipara (odds ratio: 5.46) but not in multipara. When all relevant factors were considered TDI was not associated with an overall improvement in haemoglobin status from the first ante-natal level recorded to the post-natal check. Post-natal malaria was associated with lower ante-natal and post-natal haemoglobin levels. There was no evidence of any effect of TDI in pregnancy or of maternal malaria on foetal maturity or birth weight. Gestational age, maternal weight, parity and maternal post-natal haemoglobin were all significantly correlated with birth weight. TDI to the mother was associated with higher neo-natal serum ferritins and lower neo-natal haemoglobins. Maternal post-natal malaria was associated with significantly lower iron in serum in newborns. It is suggested that routine total dose iron infusion to anaemic pregnant mothers in malaria endemic areas may be contraindicated.
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PMID:Total dose iron infusion, malaria and pregnancy in Papua New Guinea. 360 23

The effect of a combined supplement of iron, thiamine, riboflavin and vitamin C on malarial incidence in 5 to 14-year-old children was tested in a malnourished rural community in a region of The Gambia noted for high prevalence of malaria during the rainy season. 190 children, divided into 2 matched groups, received either the supplement or a matching placebo for 3 months. No significant difference in malarial incidence was observed between the 2 groups, despite a major improvement in biochemical indices of nutrient status in the supplemented group, especially for riboflavin and vitamin C. Severity of episodes was also similar between groups, but in subjects who developed parasitaemias there was a trend towards higher parasite counts in those receiving the active supplement. Nutritional interventions in malarious areas may have adverse effects on malaria, and the increase in parasitaemia was compatible with the hypothesis that a small but significant reduction in defences had occurred. However, the absence of increases in the incidence of proven malaria cases and their severity must also be taken into account, in order to make a balanced assessment of the possible increase in risk. Further investigations are needed to measure the risk in benefit rates, and to consider the effects of individual nutrients in isolation.
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PMID:Effect of supplementary vitamins and iron on malaria indices in rural Gambian children. 361 93

A controlled trial of iron dextran prophylaxis in infants 2 months old was carried out on the north coast of New Guinea, where malaria is holoendemic. These infants have a high carrier rate (80%) for alpha + thalassaemia. The neighbouring highland area has a low rate of both malaria and alpha + thalassaemia. The results of clinical and haematological examination of these infants at 6 and 12 months were analysed to determine the relationship between alpha thalassaemia and susceptibility to malaria. Infants were divided according to haemoglobin Bart's levels found at birth into 3 groups corresponding to probable genotypes. Homozygotes had higher slide malarial positivity and spleen rates at 6 and 12 month than the normal or heterozygote groups. Analysis of variance of haemoglobin levels showed that the anaemia associated with malaria was greatest in the normals and least in the homozygotes at 6 months. A possible protective mechanism of alpha thalassaemia is discussed.
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PMID:The interaction of alpha thalassaemia with malaria. 361 98

The training and use of trained birth attendants (TBAs) in Guinea Bissau was started in 1977 as part of the primary health care program. The majority of TBAs are illiterate, making accurate record-keeping of antenatal visits ineffective. This paper presents an antenatal card developed by the Ministry of Health and Social Affairs in use since 1982. The card was designed for several purposes: to help nurse-supervisors find and correct mistakes, to help TBAs remember what to look for during antenatal visits, and to enable them to identify at-risk pregnancies and refer them if necessary. The card requires no writing other than the initial visit, when it is suggested that a literate person assist the TBA in recording name, age, and village. Pictorial symbols are used on the rest of the card, which is retained by the patient between visits. The card is divided into 3 areas: a history (number of live children, number of dead children, number of abortions) recorded by placing the correct number of ticks in the proper column; examination (weight if possible, signs of anemia and edema indicated by a +or-, height of uterus, presence of fetal heart sounds); care (reminding TBAs to give nutritional advice, malaria prophylaxis, dispense iron tablets, determine if referral is necessary). The card needs to be field tested by nurses and midwives who will be training the TBAs, and then evaluated for its use in detecting at-risk pregnancies, making any additions or changes as necessary.
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PMID:Antenatal card for illiterate traditional birth attendants. 376 84

Haematological measurements were made in 198 Nigerian children aged three months to two years who received weekly malaria chemoprophylaxis with chloroquine from shortly after birth until the age of one or two years and in 185 age-matched control children. Children protected against malaria had a higher mean haemoglobin level and a higher packed cell volume than control children, and they showed fewer abnormalities of their red cells. Total and differential white blood cell counts, mean plasma folate and mean serum ferritin concentrations were similar in both groups of children. However, the geometric mean red cell folate level of children exposed to malaria was significantly higher than the mean level of control children; and it may be that malaria raises the red cell folate through intracellular synthesis by malaria parasites. Children with malaria parasitaemia had a significantly lower haemoglobin and packed cell volume and a significantly higher geometric mean red cell folate and ferritin level than children without parasitaemia. Serum ferritin is probably an unreliable index of iron status in children with malaria.
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PMID:Malaria chemoprophylaxis with chloroquine in young Nigerian children. IV. Its effect on haematological measurements. 383 42

Children two to nine years old from an area of holoendemic malaria in northern Liberia had mean HbA2 and haematocrit values significantly (P less than 0.001) lower than others from a neighbouring town where malaria is hypoendemic. After regular administration of chloroquine over two years to 38 children living in a holoendemic village, their mean HbA2 rose from 2.1%, SE +/- 0.04, to 2.6%, SE +/- 0.08 (P less than 0.001) and their mean haematocrit from 0.348, SEM +/- 0.004, to 0.382, SE +/- 0.004 (P less than 0.001), values similar to those of children from the neighbouring town. In another village where chloroquine was not given regularly, mean HbA2, haematocrit and malariometric indices were little changed at the end of the two-year period. We conclude that persistent malarial parasitaemia was the main factor in the relatively low values of the village children. Although it is not clear how malaria depresses HbA, the findings were consistent with the hypothesis that chronic malaria induces iron-deficiency.
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PMID:The effect of persistent malarial infections on haemoglobin A2 levels in Liberian children. 400 95

Plasmodium vinckei kills NMRI mice within 6 days after infection. Treatment of infected animals with desferrioxamine B for 5 days was found to suppress the parasitemia in a dose-dependent manner. The desferrioxamine B-iron complex (DFO/Fe3+) was ineffective, which suggests that the iron-chelating capacity of free desferrioxamine B is the antimalarial principle. All mice survived when they were given 0.3 mg desferrioxamine B/g every 12 hr for 14 days after infection. In addition, they were resistant to reinfection for at least 8 weeks. Eight months after desferrioxamine B treatment, all mice had lost their induced immunity and were as susceptible to malaria as controls. These results illustrate the dependence of the malarial parasite on ionic iron and suggests new methods for the therapy of parasitic diseases.
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PMID:Plasmodium vinckei: suppression of mouse infections with desferrioxamine B. 402 47


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