Showing papers on "Malaria published in 1971"

Malaria and human polymorphisms.

Abstract: Malaria has probably killed more human beings than any other single disease (Garnham 1) . In 1952 Russell (2) estimated that there were about 350 million cases of malaria per year with an estimated 1 percent mortality. More recently Bruce-Chwatt (3) has estimated that 1741 million people now live in areas that were once malarious; of that numher 381 million are still subjected to endemic malaria, and 710 million inhabit areas where malaria is only partially controlled. As a leading cause of human morbidity and mortality, malaria has undoubtedly been a major agent of natural se­ lection and consequently a determinant of man's genetic evolution. Haldane (4-6) was primarily responsible for directing the attention of geneticists to the importance of infectious disease including malaria in man's recent evolution. Although man undoubtedly has had many parasites during his long history as a hunter and collector, the domestication of animals and plants about 9000 years ago increased the number and severity of parasitic infections, since it enormously increased the population density of the human species and made it one of the most available hosts for parasites. The effects of either epidemic or endemic malaria are also so disruptive to human affairs that malaria has often been considered a major cause of historical events from the declines of Greece and Rome to the failure of the Crusades and the Gallipoli campaign of World War I (Jones 7 , Hackett 8, Garnham 1). Shortt (9) has discussed the economic importance of malaria and given examples of its disastrous effects. He also points out that this disease may have prevented the settling of some areas of India. Because of its distinctive symptoms, malaria can be traced more pre­ cisely than most infectious diseases in the writings of antiquity. References on papyri of the 16th century B. C. to splenomegaly, and hieroglyphic inscriptions referring to intermittent fever seem to indicate the presence of malaria in ancient Egypt (Hoeppli 10, Garnham 1) . But the characteristic symptoms of malaria, tertian or quartan fever and an enlarged spleen, were specifically recorded in Greece by Hippocrates in the 4th century B . C. and were also known in Roman times in Italy (Boyd 1 1 , Russell 12). Pre­ Christian written records from China and India also refer to the same symptoms (Gwei-Djen & Needham 13, Hoeppli 14, Russell 10); so we know that malaria was present throughout the civilizations of antiquity.

Malaria in early childhood. An investigation of five hundred seriously ill children in whom a " clinical " diagnosis of malaria was made on admission to the Children's Emergency Room at University College Hospital, Ibadan.

Abstract: (1971). Malaria in early childhood. Annals of Tropical Medicine & Parasitology: Vol. 65, No. 1, pp. 1-20.

Determination of the Drug Sensitivity of Plasmodium falciparum

Abstract: Chloroquine-resistant infections of malaria are prevalent in many areas of Southeast Asia and South America and their importation into the United States will remain a problem during the foreseeable future. The sensitivity of Plasmodium falciparum to chloroquine and other antimalarial drugs can be determined by a simple in vitro technique. It provides an expedient method for identifying drug-resistant strains and is useful in assessing the blood schizontocidal activity of some antimalarial agents. During studies with the recently solated Vietnam (Marks) strain of P falciparum , parasites showed a marked degree of resistance to chloroquine in vivo and in vitro, but they were significantly more susceptible to amodiaquine. The findings suggest that some P falciparum infections resistant to chloroquine may respond more favorably to treatment with another 4-aminoquinoline.

New concepts in treatment of malignant tertian malaria with cerebral involvement.

Abstract: Of 140 patients with malignant tertian malaria seen during 1956 to 1967 10 died. Death was caused by cerebral malaria in all cases. Since 1968 more intensified treatment has resulted in the complete recovery of three patients and the partial recovery of one, all of whom had been in a cerebral malaria coma for various periods of time before admission and in whom a fatal outcome was expected. In these cases a polypragmatic therapeutic approach using intravenous low molecular weight dextran, besides the usual quinine and fluids, corticosteroids, heparin and urea, separately or combined, was adopted.

Experimental malaria, effects upon the immune response to different antigens.

Abstract: Hyperplasia of the reticuloendothelial system (RES) and hyperglobulinemia occur in human disease and in experimental infections with malaria [1] Despite this hyperactivity of the immune system, the antibody response to sheep erythrocytes (SRBCs) is completely suppressed in mice immunized at the height of infection with Plasmodium berghei yoelii [2] It has been hypothesized that a similar impairment of the antibody responses may occur in humans infected with malaria, and that this may contribute to the pathogenesis of Burkitt's lymphoma [2] In the only reported study of response to immunization in humans, McGregor and Barr found that a significant number of Gambian children failed to respond to tetanus toxoid during a malaria infection [3] The present study was designed to determine whether a generalized impairment of antibody responses occurs in mice infected with malaria During the period of peak parasitemia, mice infected with P b yoelii were immunized with SRBCs or bacteriophage particles, and the antibody response to these antigens and to P b yoellii was followed

Malaria and sickle-cell disease.

Abstract: SIR,-Mr. J. P. Mitchell's paper (5 June, p. 567) succeeds admirably in its declared object of seeking to clarify and simplify this variegated subject. The more conservative approach to kidney trauma has truly emerged in the last two decades; nephrectomy is rarely the method of choice in its treatment. Mr. Mitchell rightly postulates a quandary for the surgeon-the decision confronting him whether or not to operate, and whenif he does so. In addition to the more usual, there is one little-recognized type of renal injury which provokes particularly anxious deliberation both in diagnosis and in treatment. This is when a direct blow to the region causes extensive damage to the parenchyma but is unaccompanied by any cortical tear; in other words formation of a subcapsular haematoma. With no tension-avoidance allowed by any superficial rent there is clinically persisting pain and tenderness in the renal angle. There may be no haematuria. When some 48 hours have elapsed intravenous pyelography will show distortion of the caliceal pattern. It is possible that conservation may succeed and the haematoma be absorbed. But if no relief to the intrarenal tension is forthcoming then complete destruction of the organ is also feasible. This comes about by a process of autolysis which can take a span of six months; the kidney may be transformed into an inert bag of pultaceous, macerated parenchyma admixed with blood elements. Infection can readily supervene under these circumstances. The decision whether such a closed injury should be decompressed by incision in the capsule is one calling for a high degree of experience and judgement. On two occasions I have had the unhappy exnerience of removing such functionless remnants and because of that I could be biased towards intervention if I felt reasonably assured of the precise diagnosis. I also wonder if these two defunct kidneys had been left alone would they have become, after an intermediate hydrocalycosis stage, the shrunken pathological specimens like the one itemized in Mr. Mitchell's follow-up of 56 cases? Was his the final remnant of an autolytic process?-I am, etc.,

Clinical trial of malaria prophylaxis in tropical splenomegaly syndrome.

Abstract: A controlled, randomized, double-blind trial of malaria prophylaxis in tropical splenomegaly syndrome showed a significant reduction in spleen size and an improvement of anaemia and symptoms in patients treated with antimalarials compared with control subjects receiving placebo. This study confirms the observations from West Africa and provides further indirect evidence for a malarial aetiology of tropical splenomegaly syndrome.

Trimethoprim plus sulphamethoxazole compared with chloroquine in the treatment and suppression of malaria in African schoolchildren.

Abstract: (1971). Trimethoprim plus sulphamethoxazole compared with chloroquine in the treatment and suppression of malaria in African schoolchildren. Annals of Tropical Medicine & Parasitology: Vol. 65, No. 1, pp. 117-121.

C-reactive protein in Gambian Africans with special reference to P. falciparum malaria

Abstract: CRP has been studied in a Gambian African population. In acute clinical P. falciparum malaria 100% of patients had detectable CRP in the blood; it was also present in some neonates, though this bore no relation to maternal parasitaemia or parasitization of the placenta. CRP was widely distributed throughout an African village, and though there was some relationship with malarial parasitaemia the majority of infected individuals did not show CRP in the blood. Probably this was associated with the absence of clinical disease in these villagers due to the development of malaria immunity.

Serological malaria survey in the Ethiopian highlands.

Abstract: The indirect fluorescent-antibody (IFA) test was used to examine serum samples from 1,141 residents of 11 villages in north-central Ethiopia for the presence of antibodies to malaria parasites. The antigens used were Plasmodium falciparum, Plasmodium malariae, Plasmodium ovale, and Plasmodium vivax. Positive serologic responses were obtained with one or more of these antigens for 36.7% of persons living at elevations of 6,000 feet or less; whereas only 4.3% of serum specimens from persons living at elevations of 6,300 feet or higher had positive responses. Positive responses were found more often in serum from males than from females; this may be owing to the work habits of males, which exposes them to greater chance of infection. In general, serologic results correlated with parasitologic findings and suggested that P. falciparum was the most prevalent species, followed by P. ovale and P. vivax.

Chloroquine-resistant falciparum malaria among British service personnel in West Malaysia and Singapore.

Abstract: An outline is given of an investigation into the incidence of chloroquine-resistant falciparum malaria amongst British Service personnel in Far East Land Forces between 1 March 1968 and 30 June 1969. Of 72 patients with falciparum malaria investigated, 36 (50%) were shown to have chloroquine-resistant falciparum malaria: 19 cases were in 27 British servicemen (70%), 10 in 21 Gurkha soldiers (48%) and 7 in 24 Malay soldiers (29%). Resistance was of RI grading in 35 patients. 1 patient was of RII/III grading. Resistance was confirmed in 2 patients by inoculation studies. Presence of a new focus of chloroquine-resistant falciparum malaria in the State of Johore and in Trengganu was established. Other new areas with chloroquine-resistant falciparum malaria were defined throughout West Malaysia and in the Republic of Singapore. Use of chloroquine is discussed and emphasis placed upon urgent need for new anti-malarial drugs. The importance of eradication of malaria and the prevention of malaria is stressed. All medical practitioners in the United Kingdom and elsewhere should be made aware of the possibility of malaria occurring in persons returning from the Far East and being resistant to chloroquine.

Malaria. Laboratory diagnosis.

Abstract: Accidentally induced malaria as a result of blood transfusion is not uncommon in several countries and may become more frequent as the demand for blood increases. The available though incomplete records covering the period 1950-68 and based on data gathered in 35 countries gave the figure of 655 cases, of which over one half were due to P. malariae, with P. vivax, P. falciparum, and P. olale in the decreasing order of frequency.:' There is a definite relationship between the incidence of imported malaria and the number of cases due to blood transfusion."3 In the United Kingdom only eight cases of transfusion malaria have been described over the past 30 years, but probably such occurrences were more common in this country and elsewhere and not diagnosed or not reported."4