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

There have been many recent developments in techniques for the diagnosis of malaria. The quantitative buffy coat (QBC) system and immunological and molecular biological methods are discussed, and compared with the present slide microscopic methods for the diagnosis of malaria. The suitability of each of these techniques for use in the field is reviewed.
P N G Med J 1992 Dec
PMID:The diagnosis of malaria: traditional and contemporary approaches. 134 Oct 84

In its booklet 'Tropical Diseases 1990' the World Health Organization (WHO) Division of Control of Tropical Diseases (CTD) said, "Malaria remains the most important of the tropical diseases--widespread throughout the tropics, but also occurring in many temperate regions". The size of the malarial scourge was estimated as: number of people infected 267 million; clinical cases 107 million/year; mortality 1-2 million/year; number of people at risk 2100 million. Immunity to malaria is reduced in pregnancy. This makes the disease particularly dangerous for pregnant women, especially for nulliparae. Malaria causes a significant portion of the large number of perinatal and maternal illnesses and deaths in the tropical countries. It is the leading cause of indirect obstetric deaths. Even so, it is impossible to measure its full impact in this respect. It may masquerade as anaemia. A maternal death may be attributed to obstetric haemorrhage, when in fact it was malarial anaemia which tipped the scales. Fortunately, the disease can be prevented through chemoprophylaxis and personal protection. This is one of the most rewarding functions of antenatal care.
P N G Med J 1992 Dec
PMID:Malaria in pregnancy. 134 Oct 85

Malaria is a major problem in children in many parts of Papua New Guinea; it has a high mortality and, if observations from other countries are applicable, significant long-term morbidity. Standard treatment regimens are the backbone of management of malaria throughout the country, but these must continue to be reviewed and updated in the face of changing patterns of parasite drug sensitivity. Diagnosis of malaria will for practical purposes remain primarily clinical for the foreseeable future. There is a need for uniform reporting of malaria statistics using the established definitions of uncomplicated, treatment failure and severe malaria, in order to assess incidence and outcome throughout the country, and to compare malaria patterns and outcome in Papua New Guinea with those in other parts of the world. Congenital malaria should always be considered in a febrile or ill neonate. Awareness of the complications of severe malaria, particularly hypoglycaemia, needs to be increased. Methods for the diagnosis and facilities for treatment of hypoglycaemia should be widely available. The characteristics of those children most at risk from hypoglycaemia need elucidation, and the current standard management regimen for severe malaria needs to be assessed for its propensity both to cause and to prevent hypoglycaemia. It would be reasonable to incorporate phenobarbitone prophylaxis of convulsions into the standard management regimen for cerebral malaria.
P N G Med J 1992 Dec
PMID:Malaria in children in Papua New Guinea. 134 Oct 86

It is said that William Withering's discovery of digitalis arose out of curiosity engendered during a stage-coach journey, by witnessing an old woman collecting foxgloves by the side of the road. Whilst we are not aware of an analogous stroke of genius reported from ancient China, the story of qinghaosu has certain parallels. Just as foxgloves had been used traditionally for centuries to treat 'afflictions of the heart', the plant Artemesia annua has been used as a treatment for fever in China for almost two thousand years. Artemesia annua, also known as 'sweet wormwood', is found in many parts of the world, but it was not until the early 1970s that Chinese scientists recognized its potential for treating malaria and isolated the active principle, artemesinin or qinghaosu. This paper describes the evidence for the efficacy of this drug and some of its derivatives in the treatment of malaria and the potential of these drugs for the standard management of malaria in Papua New Guinea and elsewhere.
P N G Med J 1992 Dec
PMID:A new look at an old drug: artemesinin and qinghaosu. 134 Oct 87

The pathological features of cerebral malaria in 24 fatal cases are described. The cases included 18 adults aged from 16 to 45 years and 6 children aged from 1 to 15 years. All were unconscious before death. Gross pathological findings in the brain included cerebral oedema, vascular congestion and petechial haemorrhages. Little clinical and laboratory information was available on these patients. Histological examination revealed parasitized red blood cells in all, ring haemorrhages in 6, hyaline material in the wall of medium-sized blood vessels in 4, and vascular thrombosis in 4.
P N G Med J 1992 Dec
PMID:The brain in cerebral malaria: a pathological study of 24 fatal cases in Papua New Guinea. 134 Oct 88

A placebo-controlled chemoprophylaxis trial was carried out in 1980 in 318 semi-immune school children in the Madang area of Papua New Guinea, where there was a high prevalence of strains of Plasmodium falciparum resistant to 4-aminoquinolines. Since prophylaxis with amodiaquine at 5 mg/kg weekly had failed, amodiaquine at a dose of 10mg/kg weekly and Maloprim (half a tablet or one tablet depending on body weight, which gave ranges of dapsone of 1.7-3.3mg/kg and pyrimethamine 0.2-0.4 mg/kg) weekly were tried. Neither regimen was completely successful in preventing parasitaemia, though after 13 weeks of prophylaxis the slide positivity rate was 16% for the amodiaquine group and 2% for the Maloprim group, which was in each case significantly lower than the normal baseline rate in the controls of 42%. Amodiaquine was completely successful in suppressing Plasmodium vivax infections. Breakthrough parasitaemia occurred, with either P. falciparum or P. vivax, in 5% of subjects on Maloprim at some time during the 13-week period of prophylaxis. Significantly more children in both the amodiaquine and Maloprim groups than in the placebo group showed a reduction in spleen size. All groups showed an unexplained fall in haemoglobin level over the study period but the fall was significantly less in both the prophylaxis groups. There was no adverse effect on white cell counts by either drug regimen. Chemoprophylaxis as a component of an integrated malaria control program should not be overlooked, provided that compliance can be maintained. However, in this particular case the principal purpose of the study had been to evaluate the proposed chemoprophylactic regimens in school children before embarking on an intervention study in young children. As a result of this study it was decided not to go ahead with the chemoprophylactic intervention in young children but to adopt an approach based on early presumptive treatment.
P N G Med J 1992 Dec
PMID:Chemoprophylaxis against malaria in Papua New Guinea: a trial of amodiaquine and a combination of dapsone and pyrimethamine. 134 Oct 89

The range of possible malaria vaccines, against different species of Plasmodium and various stages in the life cycle of the parasite in both human host and mosquito vector, is reviewed. The importance, in a malaria-endemic area, of protection by a malaria vaccine against disease rather than infection is emphasized, and the ways by which disease prevention may be achieved are discussed. Mechanisms of production and presentation of vaccines are considered, including the importance of appropriate and more effective adjuvants. The variety of immune responses to malaria is set out and linked to both human and plasmodial genetic factors. Host genetics may also modify susceptibility to malaria through mechanisms which are not immunological. There is a need for entomological studies of the Anopheles vectors, especially but not only in preparation for transmission-blocking vaccines. This overall complexity justifies a multidimensional approach to epidemiology and field-site preparation. An iterative procedure is proposed for initial field evaluation, through adult male volunteers to community studies in immune adults and then to semi-immune school children, before evaluation in the principal target population of nonimmune young children. The outcome variables for epidemiological evaluation are specified. After this brief review of malaria vaccines, the baseline studies being undertaken by the Malaria Vaccine Epidemiology and Evaluation Project of the Papua New Guinea Institute of Medical Research in the Wosera area of East Sepik Province are discussed in some detail, and their rationale linked to the range and complexity of the malaria vaccines that have been reviewed. These studies are described under the headings of their principal components of epidemiology, parasitology, immunology, genetics and entomology.
P N G Med J 1992 Dec
PMID:The Malaria Vaccine Epidemiology and Evaluation Project of Papua New Guinea: rationale and baseline studies. 134 Oct 90

The objective of this study was to determine which clinical features of typhoid and malaria are most helpful in distinguishing the two diseases among Papua New Guinean highlanders. In a study of 35 patients with culture-positive typhoid and 49 with blood-slide-positive malaria (Group 1), the odds of typhoid were increased most in patients with altered bowel habit, an illness of more than 2 week's duration, tremor or the presence of typhoid facies. The odds of typhoid were lowest in patients with pallor or jaundice. These findings were used to derive a clinical diagnostic algorithm, which was then evaluated in a further group of 34 typhoid patients and 41 malaria patients (Group 2). The sensitivity of the algorithm in diagnosing malaria was 91% in Group 1 and 71% in Group 2, with specificities of 85% and 79% respectively. For typhoid, the sensitivity of the algorithm was 85% and 79% for Groups 1 and 2, respectively, and the specificities were 91% and 71%. We conclude that the algorithm merits further evaluation in a primary health care setting and may prove useful in making an earlier diagnosis of typhoid.
P N G Med J 1992 Dec
PMID:An algorithm for the clinical differentiation of malaria and typhoid: a preliminary communication. 134 Oct 91

In a study of malaria and pregnancy in East Sepik Province of Papua New Guinea 45 maternal and cord serum pairs were tested for Plasmodium falciparum-specific IgE antibody. There were 17 positive sera: 6 cases of maternal serum alone, 5 cases of cord serum alone and 3 pairs of maternal and cord sera. IgE antibody positivity rates in the mothers increased with parity, whereas placental parasitaemia rates decreased. Cord serum positivity was not affected by parity. Immunoblots of the sera revealed a diversity of IgE antibodies to specific antigens of the P. falciparum lysate, but an IgE antibody to a 48kd antigen was present in all positive maternal and cord sera.
P N G Med J 1992 Dec
PMID:Prenatal immune hypersensitization to malaria: Plasmodium falciparum-specific IgE antibody in paired maternal and cord sera from Papua New Guinea. 134 Oct 92

Three groups of highland subjects were questioned about malaria and their visits to coastal areas: patients admitted to Goroka Base Hospital with malaria, patients admitted with diagnoses other than malaria who had visited the coast within the previous six months, and health staff working in Goroka. Nearly a third in all groups reported having had two or three attacks of malaria. 82% of malaria patients had visited the coast in the previous 4 weeks compared to 26% of patients without malaria. Most malaria seen in Goroka is imported from the coast. Most patients in the survey came from rural areas and were uneducated. However, health workers also failed in most cases to take adequate precautions when they visited the coast. It is suggested that a malaria prophylaxis station should be set up at the gateway to the highlands on the Highlands Highway, where malaria education and the means for chemoprophylaxis and protection from mosquitoes could be made available for all travellers.
P N G Med J 1992 Dec
PMID:Travel to the coast by highlanders and its implications for malaria control. 134 Oct 93


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