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Query: UMLS:C0038187 (starvation)
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In 1992, the worst drought in recorded history hit southern Africa. It especially affected the eastern area of Swaziland where staff at a rural district hospital, Good Shepherd Hospital in Siteki, struggled to treat rising numbers of ill and malnourished people. 10% of the population in this area reached the advanced stage of starvation. Almost 50% did not have enough food to meet their nutritional needs. Women had to travel as far as 15 miles to retrieve water from tankers and sometimes wait for days because other water sources evaporated. Maize did not grow. The subsistence farmers and their families, who made up most of the population, were able to use food stored from the year before, but it only postponed hunger. They sold their cattle (their symbol of wealth), borrowed money, and migrated to cities, leaving children and grandparents to provide for themselves. This area also had an influx of refugees from Mozambique who tended to receive more food than the natives. The incidence, but not the types, of diseases increased much during the drought. These diseases included diarrhea, respiratory infections, measles, marasmus, kwashiorkor, and vitamin deficiencies. The drought did reduce the incidence of malaria, however. Nongovernmental organizations helped with food and in measuring the effects of the drought, e.g., with anthropometric surveys of young children. The international community offered to send Swaziland more than 100,000 tons of cereal, but by December 1992 the cereal had not arrived. The people distributed the limited food to those most in need. The limited maize available for distribution was yellow, but the people were accustomed to white maize and believed yellow maize to be poisonous. When droughts occur, the crux of the problem in developing countries is the pressure exerted by multinational lending institutions to earn foreign currency to pay interest on national debt.
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PMID:Another African disaster. 846 97

Malnutrition, the most pervasive human problem especially in less developed countries (LDCs), not only adversely affects quality of life but also socioeconomic development. 25% of pregnant women in LDCs suffer from protein energy malnutrition while only 4% do in developed countries. This and other forms of malnutrition cause low birth weight infants and consequently high infant mortality and morbidity rates and limited fetal brain development. Child mortality due to measles is 200-400 times greater in malnourished children in LDCs than those in developed countries. In addition, measles brings about acute malnutrition in marginally nourished children. Malnutrition also adversely affects fertility, such as reducing a woman's fecundity during the menstrual cycle. Studies demonstrate that severe malnutrition during the 1st 6 months of life and maybe up to the 1st 2 years impairs intellectual development and the effects cannot be reversed. However, breast milk provides adequate nutrition and protects infants from infection when they are most susceptible. Inadequately nourished children are often apathetic, nonresponsive, impulsive; exhibit nongoal directed behavior; do not respond normally in social interactions; and cannot cope with stress or frequent daily demands. Studies indicate that even inadequately nourished adults develop behavior patterns similar to those of malnourished children. A starvation period among adults reduces muscle strength by almost 30% and precision of movements by 15-20%. In addition, childhood malnutrition reduces adult body weight and therefore restricting working capacity. The known effects of malnutrition should convince policy makers of the need to invest in programs that improve the nutritional standards of the populace for humanitarian reasons and to stimulate economic growth.
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PMID:Undernutrition and quality of life. 355 80

A 24 hour energy balance study was carried out on 20 black Kenyan children with acute measles and repeated after recovery. The energy content of a weighed 24 hour food intake and of a simultaneous collection of faeces and urine was determined by bomb calorimetry. Energy expenditure was measured by indirect calorimetry using a purpose built flow over calorimeter. The nutritional state of the children was assessed by anthropometry at the time of each study and during convalescence. The results showed a fall of roughly 75% in the intake of gross and metabolisable energy during measles, while the resting energy expenditure was little affected. Thus the severe degree of negative apparent energy balance observed during measles is the combined effect of underfeeding in ill children, and failure, during starvation related to infection, of the early fall in metabolic rate that characterises simple underfeeding.
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PMID:The nutritional cost of measles in Africa. 395 20

Insights gained by a group of American maternal and child helath (MCH) care nurses during a 1983 exchange tour to Kenya, sponsored by Professional Seminar Counsultants, are decribed. Kenya is a poor, predominantly rural country. The annual population growth rate is 4.1%, and 60% of the population is under the age of 16. The government's annual per capita health expenditure is only US$4, there is little emphasis on pediatrics as a speciality, and the linguistic diversity of the population complicates the delivery of health care services. As a result of these factors, the MCH care system in Kenya differed markedly from the systems observed in previous exchange tours to China and the USSR. Kenya's population is served by a variety of government, private, and missionary hospitals and by government health centers. The health centers are staffed by 2 nurses and 2 assistants who provide maternity, family planning, and immunization services. The staff also diagnoses and treats common illnesses. Service are provided free for patients under the age of 16, and minimal fees are collected from older patients. The largest hospital in the country is the 1600 bed, Joma Kenyatta National hospital which employs 900 nurses and serves as a refereal hospital for complicated cases and as a teaching and research center. 42% of the hospital staff nurses are registered nurses and 58% are enrolled nurses. Disease patterns in Kenya and the US are markedly different. In Kenya, infectious diseases are more common than chronic diseases, and amony children the major causes of death are starvation, measles, whooping cough, malaria, tubercluosis, and diarrhea. Marasmus and protein calorie deficiency are the 2 major types of childhood malnutrition found in Kenya. Nurses frequently provide health education services and even teach mothers how to grow nutritious foods for their children. Rh incompatibility is rare in Kenya, but ABO incompatibility is common. Othr common diseases, raraly found in temperate climates, include Burkitt's lymphoma, leprosy, and tropical ataxic neuropathies. The visiting nurses were at 1st shocked by some of the practices and customs they observed; however, as they learned more about the rationall behind these practices, shock gave way to appreciation. Children's wards lacked playthings, the walls were devoid of pictures, and the rooms were sparsely furnished. The lack of material items, however, was more than compensated for by the rich stimuli provided family members and friends, who not only visited the chilren, but performed a variety of nursing tasks. The family centered approach also provided a sense of security for the patients. A Masai paramedic explained how the custom of polygamy ensures adherence to the 2-year postpartum sexual taboo which, in turn, facilitates prolonged breast feeding. The nurses also became acquainted with the social value of adolescent circumcision rites. These rites are illegal but still performed in many rural areas. The rites are physically painful, but they provide a mechanism for easing the transition from adolescent to adult status. The rites help young people assume measningful roles in the society and provide them with clearly specified identities. As a result, adolescent suicide is rara among the rural villagers.
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PMID:Health care in Africa. 646 42

Gangrenous stomatitis and noma as complications of measles are regularly seen in certain tropical nations. The progression of the frequently seen, simple stomatitis to oral stenosis is a serious complication requiring surgical intervention to prevent starvation.
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PMID:Oral stenosis in measles. 723 43

I-Ak- and I-Ed-transfected L fibroblasts were supertransfected with cDNA coding for hen egg lysozyme (HEL) or measles virus hemagglutinin (HA). Well-defined cell culture conditions allowed us to obtain L cells with either no detectable endogenous Ii mRNA or a high level of endogenous Ii mRNA induced by serum starvation. Cells supertransfected with mouse Ii chain gene stably expressing a high level of Ii chain were also used as APC in parallel experiments. Class II presentation of endogenously secreted HEL or an ER-retained form of HEL to the HEL-specific I-Ak-restricted 3A9 T cell hybridoma was found to be strongly enhanced in cell transfectants expressing Ii chain. Similar results were obtained with the presentation of transmembrane HA to the HA-specific I-Ed-restricted TH5.143 T cell hybridoma. These findings correlate with those obtained with the presentation of exogenous HEL and HA. In addition, as reported to be the case for exogenous antigen, expression of a large amount of endogenous HA by the APC supplants the requirement for Ii chain expression in the enhancement of antigen presentation. These data demonstrate that presentation by MHC class II molecules of a given antigen, either exogenously provided or endogenously synthesized, is controlled in a similar manner by the Ii chain.
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PMID:Invariant chain expression similarly controls presentation of endogenously synthesized and exogenous antigens by MHC class II molecules. 849 91

Recurrent famine has been a major cause of mortality in the Horn of Africa. In Ethiopia, three consecutive years of drought led to widespread loss of livestock, population displacement, and malnutrition, placing an estimated 10 million persons at risk for starvation in 2000. A large proportion of the population of the Gode district in Somali region was displaced in a search for food and food aid (CDC, unpublished data, 2000). From April through July 2000, nongovernmental organizations (NGOs) opened feeding centers in the Gode district. Because no vital statistics or public health surveillance system existed in the district, and no representative mortality or morbidity data were available, during July 2000, CDC, in collaboration with Save the Children U.S., the Office of Foreign Disaster Assistance of the U.S. Agency for International Development, and the United Nations Children's Fund (UNICEF), conducted a mortality survey. This report summarizes the results of this survey, which found persistently high levels of mortality, with measles representing an important cause of mortality in children aged <5 years and 5-14 years. Mass measles vaccination with vitamin A distribution is an important intervention during the acute phase of famines in sub-Saharan Africa.
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PMID:Mortality during a famine--Gode district, Ethiopia, July 2000. 1133 Apr 94

The impact of morbilliviruses on both human and animal populations is well documented in the history of mankind. Indeed, prior to the development of vaccines for these diseases, morbilliviruses plagued both humans and their livestock that were heavily relied upon for food and motor power within communities. Measles virus (MeV) was responsible for the death of millions of people annually across the world and those fortunate enough to escape the disease often faced starvation where their livestock had died following infection with rinderpest virus (RPV) or peste des petits ruminants virus (PPRV). Canine distemper virus has affected dog populations for centuries and in the past few decades appears to have jumped species, now causing disease in a number of non-canid species, some of which are been pushed to the brink of extinction by the virus. During the age of vaccination, the introduction and successful application of vaccines against rinderpest and measles has led to the eradication of the former and the greater control of the latter. Vaccines against PPR and canine distemper have also been generated; however, the diseases still pose a threat to susceptible species. Here we review the currently available vaccines against these four morbilliviruses and discuss the prospects for the development of new generation vaccines.
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PMID:Morbillivirus vaccines: recent successes and future hopes. 2470 52

In the nineteenth century travelling by ship became faster due to the introduction of the steam engine. Population growth, economic crises and food shortages forced millions of Italians to consider migration towards the Americas as a real opportunity. Travel conditions on ships and steamers were particularly difficult. People were crammed into dormitories where ventilation was poor, food was insufficient, hygiene was appalling and promiscuity was rife. Under such conditions, epidemics of cholera, typhus and measles were all too likely to develop, but mycobacterium tuberculosis also proliferated. The health authorities attempted to block the spread of epidemics by means of either health licenses - papers certifying good health of the crew and passengers, which had to be exhibited on arrival - or quarantine, involving the ship and all its contents, if infectious diseases were detected or suspicious deaths occurred during the ship's voyage. In this article the particularly unfortunate stories of Italian immigrants, who boarded ships and steamers, are reported. In the second half of the nineteenth century, but also in the first decades of the twentieth, millions of Italians whose aim was to reach the Americas paid a very high price. Italy did not provide acceptable living conditions for millions of farmers and town-dwellers, and migration in search of work was in many cases the only solution. Although many during their sea voyages became ill or died of starvation or infectious diseases, migration, supported by hope, continued.
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PMID:[Epidemics on the sea: migrants journeys in the nineteenth century]. 2611 Mar 4

Starvation sensitizes tumor cells to chemotherapy while protecting normal cells at the same time, a phenomenon defined as differential stress resistance. In this study, we analyzed if starvation would also increase the oncolytic potential of an oncolytic measles vaccine virus (MeV-GFP) while protecting normal cells against off-target lysis. Human colorectal carcinoma (CRC) cell lines as well as human normal colon cell lines were subjected to various starvation regimes and infected with MeV-GFP. The applied fasting regimes were either short-term (24 h pre-infection) or long-term (24 h pre- plus 96 h post-infection). Cell-killing features of (i) virotherapy, (ii) starvation, as well as (iii) the combination of both were analyzed by cell viability assays and virus growth curves. Remarkably, while long-term low-serum, standard glucose starvation potentiated the efficacy of MeV-mediated cell killing in CRC cells, it was found to be decreased in normal colon cells. Interestingly, viral replication of MeV-GFP in CRC cells was decreased in long-term-starved cells and increased after short-term low-glucose, low-serum starvation. In conclusion, starvation-based virotherapy has the potential to differentially enhance MeV-mediated oncolysis in the context of CRC cancer patients while protecting normal colon cells from unwanted off-target effects.
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PMID:Starvation-Induced Differential Virotherapy Using an Oncolytic Measles Vaccine Virus. 3128 26


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