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

Emerging diseases are those which have shown an increased in humans over the last 20 years. Re-emerging diseases are those which have reappeared after a period of significant decrease in incidence. The etiological agents of these diseases in the Western Hemisphere are viruses (HIV, dengue, oroupuche, sabia, guanarito, or hanta), bacteria (Vibrio cholera, Borrellia burgdorferi, Legionella pneumofila, Eseherichia coli 0157:H7, or other bacteria with a new pattern of antibiotic resistance), or parasites (Cryptosporidia, Cyclosporidia or drug resistant Plasmodium falciparum). Due to the widespread geographical distribution of these infectious diseases in the Americas, and an increasing number of travellers (more than 87 million persons within the region in 1997), there are many opportunities to contract an infection when travelling in developed or undeveloped countries. The infection may present with symptoms during the trip, or following the traveler s return to his or her place of origin. However, too often practicing physicians do not inquire about the travel history of their patients and, when they do, they often lack the information about diseases relevant to travelers. From the regional perspective, the emerging or reemerging agents that pose a higher risk to tourists or travelers are: 1) those that cause enteric infections; 2) sexually transmitted diseases; and 3) vector-borne diseases, including those present in ecotourism areas. Emerging and re-emerging diseases that physicians may encounter in their clinical practice while caring for travelers returning from different countries of the Western Hemisphere are briefly described (Lyme disease, legionellosis, dengue, yellow fever, P. falciparum malaria, cyclosporidiosis and cryptosporidiosis). This report attempts to draw attention to the fact that new clinical and etiological entities are present in several geographical areas of the Americas; to place each of these entities into an epidemiological context; and to end the misconception that only travel to poor countries carries a risk of acquiring an infection. By knowing which infectious agents occur in each area and the incubation period of each disease, the treating physician can often treat patients successfully. Health care professionals must be aware of the organisms circulating in the region so that they have them in mind during their clinical practice.
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PMID:Tourism and Emerging and Re-emerging Infectious Diseases in the Americas: What Physicians Must Remember for Patient Diagnosis and Care. 1109 91

Malaria is one of the most common infectious diseases in the world, and severe respiratory complications have been described mainly in association with Plasmodium falciparum. We describe a case of acute respiratory distress syndrome complicating infection with P. vivax in the setting of relatively low parasitemia in a 47-yr-old woman after a brief trip to Papua New Guinea. A review of the literature shows that pulmonary complications of P. vivax are rare but occur more frequently than generally acknowledged. Pathogenic mechanisms of these complications are discussed.
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PMID:Acute respiratory distress syndrome complicating Plasmodium vivax malaria. 1137 40

Fatal cases of malaria are rare in Japan. We report a case of a 47-year-old Japanese man with Plasmodium falciparum malaria. The patient was examined because of fever and headache after a trip to Africa. He was diagnosed with malaria. Chemotherapy begun on day three decreased the percentage of infected red blood cells (RBC) from 25% to 2%, but the patient fell into coma on the same day. The patient was considered brain dead for 3 days before he died, and he was autopsied on day nine. Brain hemispheres were preserved and swollen with meningeal congestion. The ventral area of the pons and medulla oblongata were softened, and the tonsils of the cerebellum were softened and herniated. The spleen was blackish, enlarged and showed a small infarction. The liver was yellowish and enlarged. Many infected RBC were seen in the capillaries of the brain and malaria pigments were seen in the spleen and liver. DNA of P. falciparum was detected by polymerase chain reaction from paraffin-embedded brain materials, however, the DNA could not be detected in other organs. Besides malaria, the patient had latent primary thyroid cancer, which was a small and invasive papillary carcinoma.
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PMID:Imported malaria in a Japanese male: an autopsy report. 1142 95

Mefloquine is widely used for prophylaxis in areas with chloroquine-resistant falciparum malaria. As the use of mefloquine has increased, so have the reports on its adverse effects. We sought to evaluate the possible association between serum levels of mefloquine and serious side effects caused by this drug by means of a case-control design study. The study population included 17 patients who presented to emergency rooms or travel clinics with symptoms suggesting serious adverse effects of mefloquine and 28 controls (healthy people, still taking mefloquine after travel). The mean age of the patients and the controls was 31.5 +/- 11.6 years and 34 +/- 12.2 years, respectively. The percentage of women among the patients was higher than in the control population (76% versus 40%, respectively; P = 0.03). Most of the complaints were related to the central nervous system (13 of 17); 5 patients interrupted their trip and 2 others were hospitalized. No difference in the level of mefloquine in the blood was found between the patients and the control groups. Also, no significant difference was found between mefloquine levels in the blood of men and women. These results suggest that blood levels of mefloquine do not correlate with its severe adverse events. Women tended to be more susceptible than men, despite having similar blood levels of the drug.
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PMID:Serious adverse events of mefloquine in relation to blood level and gender. 1220 73

This article deals with five cases of imported malaria among Haifa District citizens in 1999. Two patients died from multi-organ failure secondary to the infection. Malaria continues to be a serious health risk for travelers returning from endemic areas. Travelers require detailed advice on appropriate chemoprophylaxis against malaria and personal protection against mosquito bites. There has, however, been poor compliance to drug prophylaxis. Physicians should encourage travelers to seek advice from an accredited travelers clinic in advance of the trip. It is advisable for the physician to stress the importance of taking the recommended chemoprophylaxis.
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PMID:[Malaria in Israel--a preventable disease]. 1157 30

Malaria rarely mentioned in literary works has been dealt with by the two writers, both physicians, studied here. Louis-Ferdinand Destouches (1894-1961) alias Celine, studied medicine in Rennes and Paris from 1921 to 1924. He had been previously engaged by the Rockefeller Foundation to lecture on tuberculosis in Brittany. He later worked for the Commission of Hygiene of the League of Nations in Geneva and took part in 1925 to a long voyage in America (Cuba, United States) and Italy where malaria was still occurring. In 1926 he published a book: La quinine en therapeutique and participated to another voyage in West Africa where he contracted malaria. Numerous hints to this disease inspired to Celine by his first trip to Africa (Cameroun) in 1916-17 are found in Voyage au bout de la nuit (1932). Carlo Levi (1902-1975) studied medicine in Torino from 1919 to 1924. Painter and writer he wrote there his masterpiece: Christ has stopped in Eboli (1945). Malaria which then decimated a very poor population of peasants abandoned to themselves represents the background of the book and it is as a competent and human physician that C. Levi gained the friendship of the inhabitants of this remote and inhospitable province.
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PMID:[Malaria and the work of two writer-physicians: Louis Ferdinand Celine and Carlo Levi]. 1163 50

Four truck drivers involved in a humanitarian mission across the Sahara towards Mali fell ill 15 days after their return. Plasmodium falciparum malaria (thankfully, non pernicious) was diagnosed with 3 to 4 days delay. The four drivers had been treated with chloroquine and proguanil but the dosage may have been insufficient with regard to their body weight (average weight = 110 kg). These 4 travelers had all slept outside (in Tintane, near Kiffa in Mauritania), without any anti-vectorial protection, whereas their other 8 companions (none of whom caught malaria) had slept in their vehicles. The evolution of the 4 cases was favourable despite the difficulties involved in urgently obtaining sufficient amounts of quinine for treatment. How can these cases be explained in relation to prophylactic treatment of associated chloroquine and proguanil? One explanation might be resistance of the P. falciparum strain. We were unable to study this possibility. The high incidence and similitude of cases points towards a hypothesis of resistance both to proguanil and chloroquine. Resistance to chloroquine, as has been formally ascertained in Mauritania, reinforces such a conviction. And yet prophylaxis does not prevent pernicious malaria. This clinical form of the disease, with P. falciparum primo-invasion occurring under rigorous chemoprophylaxis is characteristic of a partially resistant strain. The most reasonable explanation besides "chance" is that we are dealing here with a partially resistant strain of Plasmodium falciparum which is thus also partially sensitive to--in this case highly effective--therapeutic treatment. Indeed, chloroquino-resistant strains are more sensitive to mefloquine and halofantrine. Another explanation might be under-dosage of Savarine with relation to the body weight of these 4 patients. We should be aware of adapting more rigorously the posology of prescribed prophylaxis. But above all, this outbreak should remind us that we should recommend to travelers and drivers planning a trip to Sub-Saharan Africa to take with them anti-vectorial protective gear. Finally, the observation of these cases indicates once more the difficulty in France of establishing a proper diagnosis in face of malaria. Health personnel must systematically call to mind malaria in face of thrombopenia or fever following a sojourn in an endemic area even when chemoprophylaxis has been correctly followed.
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PMID:[A collective malarial infestation during a humanitarian mission in west Africa]. 1214 60

There is still uncertainty about the frequency of side effects associated with the use of malaria prophylaxis. The biggest concern has been that of meflokin. The aim of the study was to compare different symptoms in travellers taking different prophylactic malaria drugs with a control group travelling to the same area. Travellers seeking advice at a vaccination clinic in the south of Sweden were asked to fill in questionnaires before and after returning from their travel. 303 participants returned both questionnaires, a response rate of 62%. The results showed that a greater proportion of the travellers taking malaria prophylaxis reported symptoms in comparison with that of the control group (59% vs. 41%). Also, in comparison to the control group, travellers taking chemoprophylaxis more often felt that their trip had been negatively affected by the reported symptoms. Neuropsychiatric symptoms were most common in the group taking meflokin although no significant difference between the different regimes was found. These symptoms were very rare in the control group. Gastrointestinal symptoms were most frequent in the group taking chloroquine and proguanil. A low proportion of those symptoms were connected to the chemoprofylaxis according to the travellers. Travellers taking meflokin more frequently associated their symptoms with the drug. The travellers, being most worried about taking malaria prophylaxis prior to the trip, reported symptoms more often than those not feeling any anxiety.
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PMID:[Many travellers suffer of side-effects of malaria prophylaxis]. 1217 Jun 84

USAID Administrator, Ronald Roskins, and the Secretary of Health and Human Services, Dr. Louis Sullivan, were given the task by President Bush of finding out what can be done to advance child survival in Africa and throughout the world. Roskins and Sullivan, joined by 7 officials from their organizations, visited Africa in early 1991. This article describes the team's experiences and major findings during their 2-week, 8-country tour. In general, the purpose of the trip was 2-fold; to promote goodwill among cooperative nations and to review the issues related to child survival. Several serious problems were identified that threaten child survival. These problems include over-population, high infant and maternal mortality rates, disease, e.g., malaria, dysentery, measles, and AIDS, and economic decline. The delegation found several healthcare programs that have been established by the African people, many in cooperation with US development groups. What the visitors saw was encouraging, but only seen as part of the "real solution". Roskins indicated that in order to make any real progress, "the underlying causes of disease, malnutrition, famine, etc., need to be addressed". The US officials stressed the need for education and research in the areas of family planning and AIDS prevention. The group also identified the importance of stimulating economic growth. One of the main recommendations was that through pooling the resources of the public, private, and voluntary sectors, stronger initiatives could be made to create change. Specifically, the group suggested transferring appropriate technologies, health-care professionals, seeking technical assistance, and conducting research in behavior change.
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PMID:Roskens, Sullivan lead presidential mission to Africa. 1231 39

Malaria is a major international public health problem, responsible for considerable morbidity and mortality around the world each year. As travel to tropical locations increases, U.S. physicians are being asked more frequently to provide recommendations for malaria prevention. An organized approach to reducing the risk of acquiring this disease is necessary. Physicians must review the itineraries of their patients in detail, paying particularly close attention to travel within malaria-endemic areas and drug-resistant zones. Appropriate chemoprophylaxis must be chosen to reduce the risk of acquiring malaria. It also is important to provide advice on the use of protective measures that reduce the risk of mosquito bites. Finally, travelers should be instructed to seek medical attention immediately if symptoms of the disease develop during or after the trip.
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PMID:Prevention of malaria in travelers. 1529 Oct 86


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