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Sample records for cerebral malaria phenomenon

  1. Cerebral malaria.

    Science.gov (United States)

    Postels, Douglas G; Birbeck, Gretchen L

    2013-01-01

    Malaria, the most significant parasitic disease of man, kills approximately one million people per year. Half of these deaths occur in those with cerebral malaria (CM). The World Health Organization (WHO) defines CM as an otherwise unexplained coma in a patient with malarial parasitemia. Worldwide, CM occurs primarily in African children and Asian adults, with the vast majority (greater than 90%) of cases occurring in children 5 years old or younger in sub-Saharan Africa. The pathophysiology of the disease is complex and involves infected erythrocyte sequestration, cerebral inflammation, and breakdown of the blood-brain barrier. A recently characterized malarial retinopathy is visual evidence of Plasmodium falciparum's pathophysiological processes occurring in the affected patient. Treatment consists of supportive care and antimalarial administration. Thus far, adjuvant therapies have not been shown to improve mortality rates or neurological outcomes in children with CM. For those who survive CM, residual neurological abnormalities are common. Epilepsy, cognitive impairment, behavioral disorders, and gross neurological deficits which include motor, sensory, and language impairments are frequent sequelae. Primary prevention strategies, including bed nets, vaccine development, and chemoprophylaxis, are in varied states of development and implementation. Continuing efforts to find successful primary prevention options and strategies to decrease neurological sequelae are needed. PMID:23829902

  2. Pathogenesis of cerebral malaria

    International Nuclear Information System (INIS)

    Full text: Cerebral Malaria (CM) is the most severe complication of malaria and a major cause of death. The mechanisms underlying human CM pathogenesis might be due to mechanical cause, as demonstrated by cytoadherence of parasitised erythrocytes pRB, or to excessive cytokine production by the host in response to Plasmodium falciparum, or a combination of the two together with neuronal injury by malaria toxins. Antibody response, genetic traits and other factors have been proposed to explain why only some episodes have life-threatening complications. The microvascular endothelial cell is a major target of inflammatory cytokines overproduced in infectious diseases. Fatal CM is associated with widespread induction of endothelial activation markers, with significant higher levels of ICAM, VCAM and E-selectin expression on vessels in the brain. 199 patients were admitted at the hospital and were classified with malaria-based neurological disfunctions, such as acute psychosis, ataxia, hallucinations, fever and convulsions, prostration or coma. On a flow chart, 65 of those patients with the most acute syndromes mentioned above, were found to have negative BSN (blood slide), compared to 124 where the BSN showed to be positive. Identically to the 10 other patients from the severe form group, also presented positive BSN. The condition of some of these two subgroup patients (15), will later evolve into a more severe form with acute neurological disfunctions attributed to the cerebral malaria. The interesting aspect in regards to the 65 patients considered as having CM, upon severe manifestations of the disease, show no or little peripheral parasitemia. This fact confirms our experimental conclusion that, in the process of pRB adhesion to the microvessels of the brain, they are sequestered by monocytes and platelets, leading to vessel rupture. This fact could be an explanation of the lower % of circulating pRB and low peripheral parasitemia. There is a relationship between

  3. Cerebral Malaria in Children: a Case Report

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    K Keshavarz

    2004-09-01

    Full Text Available Background: Malaria is an acute and chronic illness characterized by paroxysms of fever, chills, sweating, fatigue, anemia, and splenomegaly. Most malarial deaths occur in infants and young children. Plasmodium falciparum causes the most severe form of malaria and is associated with more intense parasitemia. A manifestation of severe disease most common in young children includes cerebral malaria. Mortality rate of cerebral malaria is 20 to 40%. Malaria acquired in P. falciparum areas with known chloroquine resistance or where there is any malaria hotline should generally be treated with drugs other than chloroquine. In this paper we introduce a case of cerebral malaria from Zahedan/Iran. Case report: A 13-year old girl is presented with fever, jaundice, pallor and seizure. She was treated initially with chloroquine and premaquine. During treatment she developed convulsions with decreased level of consciousness. Suspecting chloroquine resistance this was substituted by quinine. After three days, she recovered completely and blood smear was free of parasites

  4. Delayed gastric emptying time in adult cerebral falciparum malaria

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    M.K. Mohapatra , P.C. Dash , S.C. Mohapatro & R.N. Mishra

    2012-12-01

    Full Text Available Objective: We hypothesize that upper gastrointestinal symptoms in cerebral malaria are due to gastric motordysfunction. But gastric motility studies in cerebral malaria are scarce.Methods: We determined gastric emptying half-time (GET½ of liquid meals quantitatively by radio isotopescintigraphy in 25 patients of cerebral malaria and 10 healthy controls.Results: GET½ was prolonged (46.5 ± 4.8 min significantly (p <0.001 in patients of cerebral malaria comparedto healthy controls (27.6 ± 5.3 min.Conclusion: Cerebral malaria can cause prolongation of gastric emptying time of liquid foods.

  5. Pentoxifylline as an adjunct therapy in children with cerebral malaria

    OpenAIRE

    Kokwaro Gilbert; Kivaya Esther; Olola Christopher HO; Wamola Betty; Köhler Carsten; Lell Bertrand; Wypij David; Mithwani Sadik; Taylor Terrie E; Kremsner Peter G; Newton Charles RJC

    2010-01-01

    Abstract Background Pentoxifylline (PTX) affects many processes that may contribute to the pathogenesis of severe malaria and it has been shown to reduce the duration of coma in children with cerebral malaria. This pilot study was performed to assess pharmacokinetics, safety and efficacy of PTX in African children with cerebral malaria. Methods Ten children admitted to the high dependency unit of the Kilifi District Hospital in Kenya with cerebral malaria (Blantyre coma score of 2 or less) re...

  6. Magnetic Resonance Features of Cerebral Malaria

    International Nuclear Information System (INIS)

    Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm2, and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients

  7. Magnetic Resonance Features of Cerebral Malaria

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    Yadav, P.; Sharma, R.; Kumar, S.; Kumar, U. (Dept. of Radiodiagnosis and Dept. of Medicine, All India Institute of Medical Sciences, New Delhi (India))

    2008-06-15

    Background: Cerebral malaria is a major health hazard, with a high incidence of mortality. The disease is endemic in many developing countries, but with a greater increase in tourism, occasional cases may be detected in countries where the disease in not prevalent. Early diagnosis and evaluation of cerebral involvement in malaria utilizing modern imaging modalities have an impact on the treatment and clinical outcome. Purpose: To evaluate the magnetic resonance (MR) features of patients with cerebral malaria presenting with altered sensorium. Material and Methods: We present the findings in three patients with cerebral malaria presenting with altered sensorium. MR imaging using a 1.5-Tesla unit was carried out. The sequences performed were 5-mm-thick T1-weighted, T2-weighted, fluid-attenuated inversion-recovery (FLAIR), and T2-weighted gradient-echo axial sequences, and sagittal and coronal FLAIR. Diffusion-weighted imaging was performed with b values of 0 and 1000 s/mm2, and apparent diffusion coefficient (ADC) maps were obtained. Results: Focal hyperintensities in the bilateral periventricular white matter, corpus callosum, occipital subcortex, and bilateral thalami were noticed on T2-weighted and FLAIR sequences. The lesions were more marked in the splenium of the corpus callosum. No enhancement on postcontrast T1-weighted MR images was observed. There was no evidence of restricted diffusion on the diffusion-weighted sequence and ADC map. Conclusion: MR is a sensitive imaging modality, with a role in the assessment of cerebral lesions in malaria. Focal white matter and corpus callosal lesions without any restricted diffusion were the key findings in our patients

  8. Association of ADAMTS13 polymorphism with cerebral malaria

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    Kraisin Sirima

    2011-12-01

    Full Text Available Abstract Background Cerebral malaria is one of the most severe manifestations of Plasmodium falciparum malaria. The sequestration of parasitized red blood cells (PRBCs to brain microvascular endothelium has been shown to contribute to the pathophysiology of cerebral malaria. Recent studies reported increased levels of von Willebrand factor (VWF and reduced activity of VWF-cleaving protease, ADAMTS13 (a disintegrin and metalloproteinase with a thrombospondin type 1 motif, member 13, in patients with cerebral malaria. Methods Association of six single nucleotide polymorphisms (SNPs of the ADAMTS13 gene with cerebral malaria was examined in 708 Thai patients with P. falciparum malaria. Results Among six SNPs, the derived allele of a SNP located in intron 28, rs4962153-A, was significantly associated with protection against cerebral malaria when 115 cerebral malaria patients were compared with 367 mild malaria patients (Fisher's exact P-value = 0.0057; OR = 0.27; 95% CI = 0.096-0.76. Significant association was also detected between 115 cerebral malaria and 593 non-cerebral malaria (226 non-cerebral severe malaria and 367 mild malaria patients (Fisher's exact P-value = 0.012; OR = 0.30; 95% CI = 0.11-0.83. Conclusions Excessive adhesion of PRBCs to the platelet-decorated ultra-large VWF (ULVWF appears to enhance the sequestration of PRBCs to cerebral microvascular endothelium. The genetic association observed in the present study implies that the regulation of platelet-decorated ULVWF strings by ADAMTS13 may play a role in the development of cerebral malaria.

  9. A case of cerebral malaria and dengue concurrent infection

    Institute of Scientific and Technical Information of China (English)

    Anwar Alam; Md Dm

    2013-01-01

    Cerebral malaria and dengue are the common infections which cause higher mortality and morbidities in every part of the world especially in India. Concurrent infection of cerebral malaria and dengue is rare entity due to different habitat of vectors and it was reported rarely from Southeast Asia. In this case report, the authors reported a case of concurrent cerebral malaria and dengue which was recovered after eight days of admission with increase in morbidity.

  10. Retinopathy in severe malaria in Ghanaian children - overlap between fundus changes in cerebral and non-cerebral malaria

    DEFF Research Database (Denmark)

    Essuman, Vera A; Ntim-Amponsah, Christine T; Astrup, Birgitte S; Adjei, George O; Kurtzhals, Jørgen A; Ndanu, Thomas A; Goka, Bamenla

    2010-01-01

    ABSTRACT: BACKGROUND: In malaria-endemic areas, reliably establishing parasitaemia for diagnosis of malaria can be difficult. A retinopathy with some features unique to severe malaria with a predictive value on prognosis, has been described. Detection of this retinopathy could be a useful...... diagnostic tool. This study was designed to determine the diagnostic usefulness of retinopathy on ophthalmoscopy in severe malaria syndromes: Cerebral malaria (CM) and non-cerebral severe malaria (non-CM), i.e. malaria with respiratory distress (RD) and malaria with severe anaemia (SA), in Ghanaian children....... Secondly, to determine any association between retinopathy and the occurrence of convulsions in patients with CM. Methods and subjects A cross-sectional study of consecutive patients on admission with severe malaria who were assessed for retinal signs, at the Department of Child Health, Korle-Bu Teaching...

  11. Ophthalmologic identification of cerebral malaria in adults

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    Pedrosa, Catarina Areias

    2015-11-01

    Full Text Available Objective: To report the clinical presentation of malarial retinopathy in an adult, emphasizing the importance of this diagnosis for the clinical suspicion and prognosis of cerebral malaria. Methods: A 39-year-old caucasian man presented with hemolytic anemia, thrombocytopenia, acidemia and acute renal failure, developing severe encephalopathy. The diagnosis of malaria was done and after systemic stabilization, the patient noticed a central scotoma in the left eye. Ophthalmological examination revealed retinal features of malarial retinopathy. Results: At one-month follow-up, the patient had improved his systemic condition and the left eye scotoma had disappeared. Visual acuity was 20/20 in both eyes and on examination almost all lesions had regressed. Conclusion: Malarial retinopathy is a diagnostic factor and a prognosis indicator of severe infection, usually with brain involvement. The knowledge of the ophthalmological features associated with severe malaria, which is more frequent in children but can also occur in adults, becomes imperative in order to reduce the risk of neurologic sequelae and associated mortality.

  12. Human cerebral malaria and Plasmodium falciparum genotypes in Malawi

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    Milner Danny A

    2012-02-01

    Full Text Available Abstract Background Cerebral malaria, a severe form of Plasmodium falciparum infection, is an important cause of mortality in sub-Saharan African children. A Taqman 24 Single Nucleotide Polymorphisms (SNP molecular barcode assay was developed for use in laboratory parasites which estimates genotype number and identifies the predominant genotype. Methods The 24 SNP assay was used to determine predominant genotypes in blood and tissues from autopsy and clinical patients with cerebral malaria. Results Single genotypes were shared between the peripheral blood, the brain, and other tissues of cerebral malaria patients, while malaria-infected patients who died of non-malarial causes had mixed genetic signatures in tissues examined. Children with retinopathy-positive cerebral malaria had significantly less complex infections than those without retinopathy (OR = 3.7, 95% CI [1.51-9.10].The complexity of infections significantly decreased over the malaria season in retinopathy-positive patients compared to retinopathy-negative patients. Conclusions Cerebral malaria patients harbour a single or small set of predominant parasites; patients with incidental parasitaemia sustain infections involving diverse genotypes. Limited diversity in the peripheral blood of cerebral malaria patients and correlation with tissues supports peripheral blood samples as appropriate for genome-wide association studies of parasite determinants of pathogenicity.

  13. Comparison of different diagnostic techniques in Plasmodium falciparum cerebral malaria

    OpenAIRE

    Fatima Shujatullah, Abida Malik, Haris M. Khan & Ashraf Malik

    2006-01-01

    Background & objectives: Plasmodium falciparum cerebral malaria remains a major health problemin India. The efficacy of treatment of cerebral malaria lies in its early diagnosis through rapid diagnosticmethods. ParaSights-F test detects HRP-2 antigen secreted by parasitised red blood cells andquantitative buffy coat assay (QBC) is examination of buffy coat for the presence of malarial parasitestained with acridine orange. This study was performed to evaluate the effectiveness of ParaSight-F t...

  14. Lactate transport and receptor actions in cerebral malaria

    DEFF Research Database (Denmark)

    Mariga, Shelton T; Kolko, Miriam; Gjedde, Albert;

    2014-01-01

    Cerebral malaria (CM), caused by Plasmodium falciparum infection, is a prevalent neurological disorder in the tropics. Most of the patients are children, typically with intractable seizures and high mortality. Current treatment is unsatisfactory. Understanding the pathogenesis of CM is required in...... order to identify therapeutic targets. Here, we argue that cerebral energy metabolic defects are probable etiological factors in CM pathogenesis, because malaria parasites consume large amounts of glucose metabolized mostly to lactate. Monocarboxylate transporters (MCTs) mediate facilitated transfer...

  15. A study on the pathogenesis of human cerebral malaria and cerebral babesiosis

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    Masamichi Aikawa

    1992-01-01

    Full Text Available Cerebral complications are important, but poorly understood pathological features of infections caused by some species of Plasmodium and Babesia. Patients dying from P. falciparum were classified as cerebral or non-cerebral cases according to the cerebral malaria coma scale. Light microscopy revealed that cerebral microvessels of cerebral malaria patients were field with a mixture of parazited and unparazited erythrocytes, with 94% of the vessels showing parasitized red blood cell (PRBC sequestration. Some degree of PRBC sequestration was also found in non-cerebral malaria patients, but the percentage of microvessls with sequestered PRBC was only 13% Electron microscopy demonstrated knobs on the membrane of PRBC that formed focal junctions with the capillary endothelium. A number of host cell molecules such as CD36, thrombospondim (TSP and intracellular adhesion molecule I (ICAM-1 may function as endothelial cell surfacereports for P. falciparum-infected erythrocytes. Affinity labeling of CD36 and TSP to the PRBC surface showed these molecules specifically bind to the knobs. Babesia bovis infected erythrocytes procedure projections of the erythrocyte membrane that are similar to knobs. When brain tissue from B. bovis-infected cattle was examined, cerebral capillaries were packed with PRBC. Infected erythrocytes formed focal attachments with cerebral endothelial cells at the site of these knob-like projections. These findings indicate that cerebral pathology caused by B. bovis is similar to human cerebral malaria. A search for cytoadherence proteins in the endothelial cells may lead to a better understanding of the pathogenisis of cerebral babesiosis.

  16. The Platelet Count in Cerebral Malaria, Is It Useful to the Clinician?

    OpenAIRE

    Chimalizeni, Yamikani; Kawaza, Kondwani; Taylor, Terrie; Molyneux, Malcolm

    2010-01-01

    We conducted this study to determine the prognostic significance of the platelet count in children with cerebral malaria. We studied children with cerebral malaria admitted to the pediatric research ward at Queen Elizabeth Central Hospital, Malawi. We analyzed 1,811 children with cerebral malaria and compared them with 521 children with bacterial meningitis. There was a significant difference in platelet counts between children with cerebral malaria and those with meningitis. Among children w...

  17. Comparison of different diagnostic techniques in Plasmodium falciparum cerebral malaria

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    Fatima Shujatullah, Abida Malik, Haris M. Khan & Ashraf Malik

    2006-12-01

    Full Text Available Background & objectives: Plasmodium falciparum cerebral malaria remains a major health problemin India. The efficacy of treatment of cerebral malaria lies in its early diagnosis through rapid diagnosticmethods. ParaSights-F test detects HRP-2 antigen secreted by parasitised red blood cells andquantitative buffy coat assay (QBC is examination of buffy coat for the presence of malarial parasitestained with acridine orange. This study was performed to evaluate the effectiveness of ParaSight-F test and QBC assay as diagnostic methods in the patients of cerebral malaria.Methods: Fifty clinically diagnosed patients of cerebral malaria were included in the study.ParaSight-F test, QBC and conventional blood smear examination was done. Patients who were incoma and there were no obvious features of bacterial or viral etiology were investigated for cerebralmalaria by these diagnostic methods.Results: ParaSight-F test, QBC and peripheral blood smears were examined. Patients were followedupfor signs of clinical recovery. ParaSight-F test was positive in 47 patients, QBC in 46 while bloodsmear examination was positive in 28 cases.Interpretation & conclusion: Sensitivity and specificity of ParaSight-F test were found to be 96.6 and94% while QBC showed 97.8 and 100% respectively. ParaSight-F test and QBC were found to be novelmethods for diagnosis of cerebral malaria especially in the cases where diagnosis can not be made byconventional blood smear examination due to low parasitaemia. These rapid diagnostic methods helpin early therapeutic intervention.

  18. Neuroimaging findings in children with retinopathy-confirmed cerebral malaria

    International Nuclear Information System (INIS)

    Purpose: To describe brain CT findings in retinopathy-confirmed, paediatric cerebral malaria. Materials and methods: In this outcomes study of paediatric cerebral malaria, a subset of children with protracted coma during initial presentation was scanned acutely. Survivors experiencing adverse neurological outcomes also underwent a head CT. All children had ophthalmological examination to confirm the presence of the retinopathy specific for cerebral malaria. Independent interpretation of CT images was provided by two neuroradiologists. Results: Acute brain CT findings in three children included diffuse oedema with obstructive hydrocephalus (2), acute cerebral infarctions in multiple large vessel distributions with secondary oedema and herniation (1), and oedema of thalamic grey matter (1). One child who was reportedly normal prior to admission had parenchymal atrophy suggestive of pre-existing CNS injury. Among 56 survivors (9-84 months old), 15 had adverse neurologic outcomes-11/15 had a follow-up head CT, 3/15 died and 1/15 refused CT. Follow-up head CTs obtained 7-18 months after the acute infection revealed focal and multifocal lobar atrophy correlating to regions affected by focal seizures during the acute infection (5/11). Other findings were communicating hydrocephalus (2/11), vermian atrophy (1/11) and normal studies (3/11). Conclusions: The identification of pre-existing imaging abnormalities in acute cerebral malaria suggests that population-based studies are required to establish the rate and nature of incidental imaging abnormalities in Malawi. Children with focal seizures during acute cerebral malaria developed focal cortical atrophy in these regions at follow-up. Longitudinal studies are needed to further elucidate mechanisms of CNS injury and death in this common fatal disease.

  19. Neuroimaging findings in children with retinopathy-confirmed cerebral malaria

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    Potchen, Michael J. [Michigan State University, Department of Radiology, 184 Radiology Building, East Lansing, MI 48824-1303 (United States)], E-mail: mjp@rad.msu.edu; Birbeck, Gretchen L. [Michigan State University, International Neurologic and Psychiatric Epidemiology Program, 324 West Fee Hall, East Lansing, MI 48824 (United States)], E-mail: Gretchen.Birbeck@ht.msu.edu; DeMarco, J. Kevin [Michigan State University, Department of Radiology, 184 Radiology Building, East Lansing, MI 48824-1303 (United States)], E-mail: jkd@rad.msu.edu; Kampondeni, Sam D. [University of Malawi, Department of Radiology, Queen Elizabeth Central Hospital, Blantyre (Malawi)], E-mail: kamponde@msu.edu; Beare, Nicholas [St. Paul' s Eye Unit, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP (United Kingdom)], E-mail: nbeare@btinternet.com; Molyneux, Malcolm E. [Malawi-Liverpool-Wellcome Trust Clinical Research Programme, College of Medicine (Malawi); School of Tropical Medicine, University of Liverpool, Liverpool (United Kingdom)], E-mail: mmolyneux999@google.com; Taylor, Terrie E. [Michigan State University, College of Osteopathic Medicine, B309-B West Fee Hall, East Lansing, MI 48824 (United States); University of Malawi, College of Medicine, Blantyre Malaria Project, Blantyre (Malawi)], E-mail: taylort@msu.edu

    2010-04-15

    Purpose: To describe brain CT findings in retinopathy-confirmed, paediatric cerebral malaria. Materials and methods: In this outcomes study of paediatric cerebral malaria, a subset of children with protracted coma during initial presentation was scanned acutely. Survivors experiencing adverse neurological outcomes also underwent a head CT. All children had ophthalmological examination to confirm the presence of the retinopathy specific for cerebral malaria. Independent interpretation of CT images was provided by two neuroradiologists. Results: Acute brain CT findings in three children included diffuse oedema with obstructive hydrocephalus (2), acute cerebral infarctions in multiple large vessel distributions with secondary oedema and herniation (1), and oedema of thalamic grey matter (1). One child who was reportedly normal prior to admission had parenchymal atrophy suggestive of pre-existing CNS injury. Among 56 survivors (9-84 months old), 15 had adverse neurologic outcomes-11/15 had a follow-up head CT, 3/15 died and 1/15 refused CT. Follow-up head CTs obtained 7-18 months after the acute infection revealed focal and multifocal lobar atrophy correlating to regions affected by focal seizures during the acute infection (5/11). Other findings were communicating hydrocephalus (2/11), vermian atrophy (1/11) and normal studies (3/11). Conclusions: The identification of pre-existing imaging abnormalities in acute cerebral malaria suggests that population-based studies are required to establish the rate and nature of incidental imaging abnormalities in Malawi. Children with focal seizures during acute cerebral malaria developed focal cortical atrophy in these regions at follow-up. Longitudinal studies are needed to further elucidate mechanisms of CNS injury and death in this common fatal disease.

  20. The systemic pathology of cerebral malaria in African children

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    Danny Arnold Milner

    2014-08-01

    Full Text Available Pediatric cerebral malaria carries a high mortality rate in sub-Saharan Africa. We present our systematic analysis of the descriptive and quantitative histopathology of all organs sampled from a series of 103 autopsies performed between 1996 and 2010 in Blantyre, Malawi on pediatric cerebral malaria patients and control patients (without coma, or without malaria infection who were clinically well characterized prior to death. We found brain swelling in all cerebral malaria patients and the majority of controls. The histopathology in patients with sequestration of parasites in the brain demonstrated two patterns: a the classic appearance (i.e., ring hemorrhages, dense sequestration, and extra-erythrocytic pigment which was associated with evidence of systemic activation of coagulation and b the sequestration only appearance associated with shorter duration of illness and higher total burden of parasites in all organs including the spleen. Sequestration of parasites was most intense in the gastrointestinal tract in all parasitemic patients (those with cerebral malarial and those without.

  1. Brain Swelling and Death in Children with Cerebral Malaria

    Science.gov (United States)

    Seydel, Karl B.; Kampondeni, Samuel D.; Valim, Clarissa; Potchen, Michael J.; Milner, Danny A.; Muwalo, Francis W.; Birbeck, Gretchen L.; Bradley, William G.; Fox, Lindsay L.; Glover, Simon J.; Hammond, Colleen A.; Heyderman, Robert S.; Chilingulo, Cowles A.; Molyneux, Malcolm E.; Taylor, Terrie E.

    2015-01-01

    BACKGROUND Case fatality rates among African children with cerebral malaria remain in the range of 15 to 25%. The key pathogenetic processes and causes of death are unknown, but a combination of clinical observations and pathological findings suggests that increased brain volume leading to raised intracranial pressure may play a role. Magnetic resonance imaging (MRI) became available in Malawi in 2009, and we used it to investigate the role of brain swelling in the pathogenesis of fatal cerebral malaria in African children. METHODS We enrolled children who met a stringent definition of cerebral malaria (one that included the presence of retinopathy), characterized them in detail clinically, and obtained MRI scans on admission and daily thereafter while coma persisted. RESULTS Of 348 children admitted with cerebral malaria (as defined by the World Health Organization), 168 met the inclusion criteria, underwent all investigations, and were included in the analysis. A total of 25 children (15%) died, 21 of whom (84%) had evidence of severe brain swelling on MRI at admission. In contrast, evidence of severe brain swelling was seen on MRI in 39 of 143 survivors (27%). Serial MRI scans showed evidence of decreasing brain volume in the survivors who had had brain swelling initially. CONCLUSIONS Increased brain volume was seen in children who died from cerebral malaria but was uncommon in those who did not die from the disease, a finding that suggests that raised intracranial pressure may contribute to a fatal outcome. The natural history indicates that increased intracranial pressure is transient in survivors. (Funded by the National Institutes of Health and Wellcome Trust U.K.) PMID:25785970

  2. Pentoxifylline as an adjunct therapy in children with cerebral malaria

    Directory of Open Access Journals (Sweden)

    Kokwaro Gilbert

    2010-12-01

    Full Text Available Abstract Background Pentoxifylline (PTX affects many processes that may contribute to the pathogenesis of severe malaria and it has been shown to reduce the duration of coma in children with cerebral malaria. This pilot study was performed to assess pharmacokinetics, safety and efficacy of PTX in African children with cerebral malaria. Methods Ten children admitted to the high dependency unit of the Kilifi District Hospital in Kenya with cerebral malaria (Blantyre coma score of 2 or less received quinine plus a continuous infusion of 10 mg/kg/24 hours PTX for 72 hours. Five children were recruited as controls and received normal saline instead of PTX. Plasma samples were taken for PTX and tumour necrosis factor (TNF levels. Blantyre Coma Score, parasitemia, hematology and vital signs were assessed 4 hourly. Results One child (20% in the control group died, compared to four children (40% in the PTX group. This difference was not significant (p = 0.60. Laboratory parameters and clinical data were comparable between groups. TNF levels were lower in children receiving PTX. Conclusions The small sample size does not permit definitive conclusions, but the mortality rate was unexpectedly high in the PTX group.

  3. Whole blood angiopoietin-1 and -2 levels discriminate cerebral and severe (non-cerebral malaria from uncomplicated malaria

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    Tangpukdee Noppadon

    2009-12-01

    Full Text Available Abstract Background Severe and cerebral malaria are associated with endothelial activation. Angiopoietin-1 (ANG-1 and angiopoietin-2 (ANG-2 are major regulators of endothelial activation and integrity. The aim of this study was to investigate the clinical utility of whole blood angiopoietin (ANG levels as biomarkers of disease severity in Plasmodium falciparum malaria. Methods The utility of whole blood ANG levels was examined in Thai patients to distinguish cerebral (CM; n = 87 and severe (non-cerebral malaria (SM; n = 36 from uncomplicated malaria (UM; n = 70. Comparative statistics are reported using a non-parametric univariate analysis (Kruskal-Wallis test or Chi-squared test, as appropriate. Multivariate binary logistic regression was used to examine differences in whole blood protein levels between groups (UM, SM, CM, adjusting for differences due to ethnicity, age, parasitaemia and sex. Receiver operating characteristic curve analysis was used to assess the diagnostic accuracy of the ANGs in their ability to distinguish between UM, SM and CM. Cumulative organ injury scores were obtained for patients with severe disease based on the presence of acute renal failure, jaundice, severe anaemia, circulatory collapse or coma. Results ANG-1 and ANG-2 were readily detectable in whole blood. Compared to UM there were significant decreases in ANG-1 (p Conclusions These results suggest that whole blood ANG-1/2 levels are promising clinically informative biomarkers of disease severity in malarial syndromes.

  4. Plasmodium coatneyi-infected rhesus monkeys: a primate modelfor human cerebral malaria

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    Masamichi Aikawa; Brown, Arthur E.; C. Dahlem Smith; Tatsuya Tegoshi; Russell J. Howard; Thomas H. Hasler; Yoshihiro Ito; William E. Colins; H. Kyle Webster

    1992-01-01

    Although several animal models for human cerebral malaria have been proposed in the past, name have shown pathological findings that are similar to those seen in humans. In order to develop an animal model for human cerebral malaria, we studied the pathology of brains of Plasmodium coatneyi (primate malaria parasite)-infected rhesus monkeys. Our study demonstrated parazitized erythrocyte (PRBC) sequestration and cytoadherence of knobs on PRBC to endothelial cells in cerebral microvessels of t...

  5. High Plasma Erythropoietin Levels are Associated With Prolonged Coma Duration and Increased Mortality in Children With Cerebral Malaria

    OpenAIRE

    Shabani, Estela; Opoka, Robert O.; Idro, Richard; Schmidt, Robert; Park, Gregory S.; Bangirana, Paul; Vercellotti, Gregory M.; HODGES, JAMES S.; Widness, John A.; John, Chandy C.

    2014-01-01

    In children aged >18 months with cerebral malaria, elevated erythropoietin levels were associated with increased mortality, prolonged coma duration, and a lack of neuroprotection. Caution is warranted in the use of systemic erythropoietin as adjunctive therapy in cerebral malaria.

  6. Endothelial glycocalyx on brain endothelial cells is lost in experimental cerebral malaria

    DEFF Research Database (Denmark)

    Hempel, Casper; Hyttel, Poul; Kurtzhals, Jørgen Al

    2014-01-01

    We hypothesized that the glycocalyx, which is important for endothelial integrity, is lost in severe malaria. C57BL/6 mice were infected with Plasmodium berghei ANKA, resulting in cerebral malaria, or P. chabaudi AS, resulting in uncomplicated malaria. We visualized the glycocalyx with transmission...... electron microscopy and measured circulating glycosaminoglycans by dot blot and ELISA. The glycocalyx was degraded in brain vasculature in cerebral and to a lesser degree uncomplicated malaria. It was affected on both intact and apoptotic endothelial cells. Circulating glycosaminoglycan levels suggested...... that glycocalyx disruption preceded cerebral manifestations. The contribution of this loss to pathogenesis should be studied further....

  7. Concurrent gastro-intestinal nematode infection does not alter the development of experimental cerebral malaria

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    Souza, Brian; Helmby, Helena

    2008-01-01

    Concurrent helminth infections have been suggested to be associated with protection against cerebral malaria in humans, a condition characterised by systemic inflammation. Here we show that a concurrent chronic gastro-intestinal nematode infection does not alter the course of murine cerebral malaria. Mice infected with Heligmosomoides polygyrus, and co-infected with Plasmodium berghei ANKA 14 days later, developed malaria parasitemia, weight loss and anemia, at the same rate as mice without n...

  8. Caso mortal de Malaria Cerebral en la misión de Uganda Death due to cerebral malaria in Uganda

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    M.E. Presa García

    2012-03-01

    Full Text Available Las enfermedades y lesiones no de combate han sido y siguen siendo en nuestros días una amenaza muy importante para nuestras tropas. Entre ellas, las enfermedades transmitidas por vectores artrópodos ocupan un lugar importante, como es el caso del paludismo en Uganda. La prevención Sanitaria incluye una fase previa al despliegue, una fase de despliegue y otra fase posterior al despliegue. Durante nuestra misión en Uganda se ha perseguido cada una de estas fases para hacer frente a este riesgo potencialmente mortal, pero fácilmente evitable. Presentamos el caso de malaria cerebral padecido por una enfermera de nacionalidad italiana y no militar del Role 2 de Bihanga, de evolución rápida que falleció en un hospital de Nairobi.Non-combat diseases and injuries have always posed, and still do, a serious threat to our troops. Among these, arthropod-transmitted diseases are of particular relevance, as in the example of malaria in Uganda. Mission health prevention has before, during, and after deployment phases. Throughout our mission in Uganda, we have focused on each of these phases in order to tackle this deadly yet easily avoidable risk. We report the case of cerebral malaria suffered by a nurse of Italian nationality and non-military, that belong to Role 2 of Bihanga, rapidly progressive who died in a hospital in Nairobi.

  9. Long-term cognitive sequelae of cerebral malaria in Vietnam veterans.

    Science.gov (United States)

    Richardson, E D; Varney, N R; Roberts, R J; Springer, J A; Wood, P S

    1997-01-01

    The brains of fatal cases of cerebral malaria exhibit capillary occlusion, punctiform hemorrhages, and focal necrosis in subcortical white matter. Some studies have suggested that the brain pathology of survivors is similar to that of fatal cases. The purpose of this study was to investigate the hypothesis that cerebral malaria survivors would exhibit neuropsychological impairment due to the residual cerebral damage sustained from the infection. Vietnam veterans reporting a history of cerebral malaria were compared with a group of veterans with a history of combat-related injuries on standard neuropsychological tasks and on dichotic listening (DL). The cerebral malaria group performed worse on memory tasks and exhibited greater clinical impairments on DL, consistent with presumed disruption of subcortical white matter tracts. PMID:16318473

  10. Endothelin-1 Mediates Brain Microvascular Dysfunction Leading to Long-Term Cognitive Impairment in a Model of Experimental Cerebral Malaria.

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    Brandi D Freeman

    2016-03-01

    Full Text Available Plasmodium falciparum infection causes a wide spectrum of diseases, including cerebral malaria, a potentially life-threatening encephalopathy. Vasculopathy is thought to contribute to cerebral malaria pathogenesis. The vasoactive compound endothelin-1, a key participant in many inflammatory processes, likely mediates vascular and cognitive dysfunctions in cerebral malaria. We previously demonstrated that C57BL6 mice infected with P. berghei ANKA, our fatal experimental cerebral malaria model, sustained memory loss. Herein, we demonstrate that an endothelin type A receptor (ETA antagonist prevented experimental cerebral malaria-induced neurocognitive impairments and improved survival. ETA antagonism prevented blood-brain barrier disruption and cerebral vasoconstriction during experimental cerebral malaria, and reduced brain endothelial activation, diminishing brain microvascular congestion. Furthermore, exogenous endothelin-1 administration to P. berghei NK65-infected mice, a model generally regarded as a non-cerebral malaria negative control for P. berghei ANKA infection, led to experimental cerebral malaria-like memory deficits. Our data indicate that endothelin-1 is critical in the development of cerebrovascular and cognitive impairments with experimental cerebral malaria. This vasoactive peptide may thus serve as a potential target for adjunctive therapy in the management of cerebral malaria.

  11. Endothelin-1 Mediates Brain Microvascular Dysfunction Leading to Long-Term Cognitive Impairment in a Model of Experimental Cerebral Malaria.

    Science.gov (United States)

    Freeman, Brandi D; Martins, Yuri C; Akide-Ndunge, Oscar B; Bruno, Fernando P; Wang, Hua; Tanowitz, Herbert B; Spray, David C; Desruisseaux, Mahalia S

    2016-03-01

    Plasmodium falciparum infection causes a wide spectrum of diseases, including cerebral malaria, a potentially life-threatening encephalopathy. Vasculopathy is thought to contribute to cerebral malaria pathogenesis. The vasoactive compound endothelin-1, a key participant in many inflammatory processes, likely mediates vascular and cognitive dysfunctions in cerebral malaria. We previously demonstrated that C57BL6 mice infected with P. berghei ANKA, our fatal experimental cerebral malaria model, sustained memory loss. Herein, we demonstrate that an endothelin type A receptor (ETA) antagonist prevented experimental cerebral malaria-induced neurocognitive impairments and improved survival. ETA antagonism prevented blood-brain barrier disruption and cerebral vasoconstriction during experimental cerebral malaria, and reduced brain endothelial activation, diminishing brain microvascular congestion. Furthermore, exogenous endothelin-1 administration to P. berghei NK65-infected mice, a model generally regarded as a non-cerebral malaria negative control for P. berghei ANKA infection, led to experimental cerebral malaria-like memory deficits. Our data indicate that endothelin-1 is critical in the development of cerebrovascular and cognitive impairments with experimental cerebral malaria. This vasoactive peptide may thus serve as a potential target for adjunctive therapy in the management of cerebral malaria. PMID:27031954

  12. Proteomic Studies on Human and Experimental Cerebral Malaria

    KAUST Repository

    Moussa, Ehab

    2012-07-01

    Cerebral malaria (CM) is a severe neurological complication of malaria infection that results from interrelated pathologies. Despite extensive research efforts, the mechanism of the disease is not completely understood. Clinical studies, postmortem analysis, and animal models have been the main research arenas in CM. In this thesis, shotgun proteomics approach was used to further understand the pathology of human and experimental CM. The mechanism by which CM turns fatal is yet to be identified. A clinical proteomics study was conducted on pooled plasma samples from children with reversible or fatal CM from the Gambia. The results show that depletion of coagulation factors and increased levels of circulating proteasomes are associated with fatal pediatric CM. This data suggests that the ongoing coagulation during CM might be a disseminated intravascular coagulation state that eventually causes depletion of the coagulation factors leading to petechial hemorrhages. In addition, the mechanism(s) by which blood transfusion benefits CM in children was investigated. To that end, the concentration and multimerization pattern of von-willebrand factor, and the concentration of haptoglobin in the plasma of children with CM who received blood transfusions were measured. In addition to clinical studies, experimental cerebral malaria (ECM) in mice has been long used as a model for the disease. A shotgun proteomics workflow was optimized to identify the proteomic signature of the brain tissue of mice with ECM.Because of the utmost importance of membrane proteins in the pathology of the disease, sample fractionation and filter aided sample preparation were used to recover them. The proteomic signature of the brains of mice infected with P. berghei ANKA that developed neurological syndrome, mice infected with P. berghei NK56 that developed severe malaria but without neurological signs, and non-infected mice, were compared to identify CM specific proteins. Among the differentially

  13. Pathogenesis of Cerebral Malaria: New Diagnostic Tools, Biomarkers and Therapeutic Approaches

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    Praveen Kishore Sahu

    2015-10-01

    Full Text Available Cerebral malaria is a severe neuropathological complication of Plasmodium falciparum infection. It results in high mortality and post-recovery neuro-cognitive disorders in children, even after appropriate treatment with effective anti-parasitic drugs. While the complete landscape of the pathogenesis of cerebral malaria still remains to be elucidated, numerous innovative approaches have been developed in the recent years in order to improve the early detection of this neurological syndrome, and subsequently, the clinical care of affected patients. In this review, we briefly summarize the current understanding of cerebral malaria pathogenesis, compile the array of new biomarkers and tools available for diagnosis and research and describe the emerging therapeutic approaches to tackle effectively cerebral malaria.

  14. Pattern and predictors of neurological morbidities among childhood cerebral malaria survivors in central Sudan

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    Adil Mergani

    2015-01-01

    Interpretation & conclusion: Neurological sequelae are common due to childhood cerebral malaria in central Sudan. Their prediction at admission, clinical presentation and laboratory findings may guide clinical intervention and proper management that may decrease morbidity and improve CM consequences.

  15. Brain Swelling and Mannitol Therapy in Adult Cerebral Malaria: A Randomized Trial

    OpenAIRE

    Mohanty, Sanjib; Mishra, Saroj Kanti; Patnaik, Rajyabardhan; Dutt, Anil Kumar; Pradhan, Sudhir; Das, Bhabanisankar; Patnaik, Jayakrushna; Mohanty, Akshaya Kumar; Lee, Sue J.; Dondorp, Arjen M.

    2011-01-01

    Background.  Coma is a frequent presentation of severe malaria in adults and an important cause of death. The role of cerebral swelling in its pathogenesis, and the possible benefit of intravenous mannitol therapy to treat this, is uncertain. Methods.  A computed tomographic (CT) scan of the cerebrum and lumbar puncture with measurement of cerebrospinal fluid (CSF) pressure were performed on admission for 126 consecutive adult Indian patients with cerebral malaria. Patients with brain swellin...

  16. Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial

    OpenAIRE

    Byarugaba Justus S; Ndeezi Grace; Namutangula Beatrice; Tumwine James K

    2007-01-01

    Abstract Background Several reports have suggested that raised intracranial pressure (ICP) is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children...

  17. Health Care Seeking Behavior among Caregivers of Sick Children Who Had Cerebral Malaria in Northwestern Nigeria

    OpenAIRE

    Eseigbe, Edwin E.; Anyiam, Jane O.; Ogunrinde, Gboye O.; Wammanda, Robinson D.; Zoaka, Hassan A.

    2012-01-01

    Cerebral malaria is a significant cause of childhood morbidity in our region. The challenges of effective management include time and quality of treatment. The study appraised the health care seeking behavior of caregivers of sick children who developed cerebral malaria, in Zaria, northwestern Nigeria. Caregivers indentified were parents 29 (87.9%) and grandparents 4 (12.1%). Most of them were in the upper social classes. Health care options utilized before presentation at our facility were f...

  18. Plasmodium vivax cerebral malaria complicated with venous sinus thrombosis in Colombia

    Institute of Scientific and Technical Information of China (English)

    Miguel A Pinzn; Juan C Pineda; Fernando Rosso; Masaru Shinchi; Fabio Bonilla-Abada

    2013-01-01

    Complicated malaria is usually due to Plasmodium falciparum. Nevertheless, Plasmodium vivax is infrequently related with life-threatening complications. Few cases have been reported of severe Plasmodium vivax infection, and most of them from Southeast Asia and India. We report the first case of cerebral malaria due to Plasmodium vivax in Latin America, complicated with sagittal sinus thrombosis and confirmed by a molecular method.

  19. From METS to malaria: RRx-001, a multi-faceted anticancer agent with activity in cerebral malaria

    OpenAIRE

    Yalçın, Özlem; Oronsky, Bryan; Carvalho, Leonardo J. M.; Kuypers, Frans A.; Scicinski, Jan; Cabrales, Pedro

    2015-01-01

    RESEARCH Open Access From METS to malaria: RRx-001, a multi-faceted anticancer agent with activity in cerebral malaria Ozlem Yalcin1,2, Bryan Oronsky3, Leonardo J. M. Carvalho4,5, Frans A. Kuypers6, Jan Scicinski3 and Pedro Cabrales1* Abstract Background: The survival of malaria parasites, under substantial haem-induced oxidative stress in the red blood cells (RBCs) is dependent on the pentose phosphate pathway (PPP). The PPP is the only source of NADPH in the RBC, ess...

  20. Scanning electron microscopy of the neuropathology of murine cerebral malaria

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    Brenneis Christian

    2006-11-01

    Full Text Available Abstract Background The mechanisms leading to death and functional impairments due to cerebral malaria (CM are yet not fully understood. Most of the knowledge about the pathomechanisms of CM originates from studies in animal models. Though extensive histopathological studies of the murine brain during CM are existing, alterations have not been visualized by scanning electron microscopy (SEM so far. The present study investigates the neuropathological features of murine CM by applying SEM. Methods C57BL/6J mice were infected with Plasmodium berghei ANKA blood stages. When typical symptoms of CM developed perfused brains were processed for SEM or light microscopy, respectively. Results Ultrastructural hallmarks were disruption of vessel walls, parenchymal haemorrhage, leukocyte sequestration to the endothelium, and diapedesis of macrophages and lymphocytes into the Virchow-Robin space. Villous appearance of observed lymphocytes were indicative of activated state. Cerebral oedema was evidenced by enlargement of perivascular spaces. Conclusion The results of the present study corroborate the current understanding of CM pathophysiology, further support the prominent role of the local immune system in the neuropathology of CM and might expose new perspectives for further interventional studies.

  1. Reliability of the Luganda version of the Child Behaviour Checklist in measuring behavioural problems after cerebral malaria

    OpenAIRE

    Opoka Robert O; Giordani Bruno; Nakasujja Noeline; Bangirana Paul; John Chandy C; Boivin Michael J

    2009-01-01

    Abstract Background No measure of childhood behaviour has been validated in Uganda despite the documented risks to behaviour. Cerebral malaria in children poses a great risk to their behaviour, however behavioural outcomes after cerebral malaria have not been described in children. This study examined the reliability of the Luganda version of the Child Behaviour Checklist (CBCL) and described the behavioural outcomes of cerebral malaria in Ugandan children. Methods The CBCL was administered t...

  2. Genetic susceptibility to systemic lupus erythematosus protects against cerebral malaria in mice.

    Science.gov (United States)

    Waisberg, Michael; Tarasenko, Tatyana; Vickers, Brandi K; Scott, Bethany L; Willcocks, Lisa C; Molina-Cruz, Alvaro; Pierce, Matthew A; Huang, Chiung-yu; Torres-Velez, Fernando J; Smith, Kenneth G C; Barillas-Mury, Carolina; Miller, Louis H; Pierce, Susan K; Bolland, Silvia

    2011-01-18

    Plasmodium falciparum has exerted tremendous selective pressure on genes that improve survival in severe malarial infections. Systemic lupus erythematosus (SLE) is an autoimmune disease that is six to eight times more prevalent in women of African descent than in women of European descent. Here we provide evidence that a genetic susceptibility to SLE protects against cerebral malaria. Mice that are prone to SLE because of a deficiency in FcγRIIB or overexpression of Toll-like receptor 7 are protected from death caused by cerebral malaria. Protection appears to be by immune mechanisms that allow SLE-prone mice better to control their overall inflammatory responses to parasite infections. These findings suggest that the high prevalence of SLE in women of African descent living outside of Africa may result from the inheritance of genes that are beneficial in the immune control of cerebral malaria but that, in the absence of malaria, contribute to autoimmune disease. PMID:21187399

  3. Genetic susceptibility to systemic lupus erythematosus protects against cerebral malaria in mice

    Science.gov (United States)

    Waisberg, Michael; Tarasenko, Tatyana; Vickers, Brandi K.; Scott, Bethany L.; Willcocks, Lisa C.; Molina-Cruz, Alvaro; Pierce, Matthew A.; Huang, Chiung-yu; Torres-Velez, Fernando J.; Smith, Kenneth G. C.; Barillas-Mury, Carolina; Miller, Louis H.; Pierce, Susan K.; Bolland, Silvia

    2011-01-01

    Plasmodium falciparum has exerted tremendous selective pressure on genes that improve survival in severe malarial infections. Systemic lupus erythematosus (SLE) is an autoimmune disease that is six to eight times more prevalent in women of African descent than in women of European descent. Here we provide evidence that a genetic susceptibility to SLE protects against cerebral malaria. Mice that are prone to SLE because of a deficiency in FcγRIIB or overexpression of Toll-like receptor 7 are protected from death caused by cerebral malaria. Protection appears to be by immune mechanisms that allow SLE-prone mice better to control their overall inflammatory responses to parasite infections. These findings suggest that the high prevalence of SLE in women of African descent living outside of Africa may result from the inheritance of genes that are beneficial in the immune control of cerebral malaria but that, in the absence of malaria, contribute to autoimmune disease. PMID:21187399

  4. Experimental Cerebral Malaria Spreads along the Rostral Migratory Stream.

    Science.gov (United States)

    Hoffmann, Angelika; Pfeil, Johannes; Alfonso, Julieta; Kurz, Felix T; Sahm, Felix; Heiland, Sabine; Monyer, Hannah; Bendszus, Martin; Mueller, Ann-Kristin; Helluy, Xavier; Pham, Mirko

    2016-03-01

    It is poorly understood how progressive brain swelling in experimental cerebral malaria (ECM) evolves in space and over time, and whether mechanisms of inflammation or microvascular sequestration/obstruction dominate the underlying pathophysiology. We therefore monitored in the Plasmodium berghei ANKA-C57BL/6 murine ECM model, disease manifestation and progression clinically, assessed by the Rapid-Murine-Coma-and-Behavioral-Scale (RMCBS), and by high-resolution in vivo MRI, including sensitive assessment of early blood-brain-barrier-disruption (BBBD), brain edema and microvascular pathology. For histological correlation HE and immunohistochemical staining for microglia and neuroblasts were obtained. Our results demonstrate that BBBD and edema initiated in the olfactory bulb (OB) and spread along the rostral-migratory-stream (RMS) to the subventricular zone of the lateral ventricles, the dorsal-migratory-stream (DMS), and finally to the external capsule (EC) and brainstem (BS). Before clinical symptoms (mean RMCBS = 18.5±1) became evident, a slight, non-significant increase of quantitative T2 and ADC values was observed in OB+RMS. With clinical manifestation (mean RMCBS = 14.2±0.4), T2 and ADC values significantly increased along the OB+RMS (p = 0.049/p = 0.01). Severe ECM (mean RMCBS = 5±2.9) was defined by further spread into more posterior and deeper brain structures until reaching the BS (significant T2 elevation in DMS+EC+BS (p = 0.034)). Quantitative automated histological analyses confirmed microglial activation in areas of BBBD and edema. Activated microglia were closely associated with the RMS and neuroblasts within the RMS were severely misaligned with respect to their physiological linear migration pattern. Microvascular pathology and ischemic brain injury occurred only secondarily, after vasogenic edema formation and were both associated less with clinical severity and the temporal course of ECM. Altogether, we identified a distinct spatiotemporal

  5. CLINICO - HAEMATOLOGICAL PROFILE AND OUTCOME OF CEREBRAL MALARIA IN A TEACHING HOSPITAL OF SOUTH EAST RAJASTHAN

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    Gautam Lal

    2015-05-01

    Full Text Available AIM: Evaluation of Clinico - hematological profile and outcome of cerebral malaria in semi urban hospital situated in endemic area. MATERIAL AND METHODS : A cross - sectional hospital - based study was conducted from August to November, 2014 at Department of Paediatrics SRG Zanana Hospital, Jhalawar Rajasthan. Every child, except who was previously abnormal neurologically, of the age of six month to 12 years, presented with a history of fever in the last 7 days, with o r without convulsion, and/or impaired consciousness, screened for malaria by peripheral blood smear examination and rapid diagnostic test for malaria parasite. On the basis of this screening examination, these children were classified definite cerebral mal aria where the peripheral smear was positive and probable cerebral malaria where the peripheral smear was negative. If the patients presented with fever, convulsion, and/or impaired level of consciousness, they were treated with Artesunate intravenously em pirically. Patients were followed - up regularly till they regained consciousness and when, they were able to swallow, treated with oral Artisunate and single dose of Sulphadoxine and Pyrimethamine combination is also given. RESULTS: Of the3332 admissions, 8 69 (26.08% were admitted for fever. Out of these 869 febrile patients 352 patients were having other obvious clinical diagnosis for fever. In remaining 517(59.49% cases were suspected to be suffering from malaria, but all of these children who were admit ted with the diagnosis of fever, were screened for malaria and 74(08.51%were found to be positive for malaria parasite either by peripheral blood smear or rapid diagnostic test or both. Cerebral malaria developed in 37 patients. Most cases were of age gro up of 2 - 5 years, 14children had definite cerebral malaria and 9 were labelled as suspected to have probable cerebral malaria. Neurological symptoms of altered sensorium, convulsion and abnormal behaviour ranged from 35

  6. Severe neurological sequelae and behaviour problems after cerebral malaria in Ugandan children

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    Tugumisirize Joshua

    2010-04-01

    Full Text Available Abstract Background Cerebral malaria is the most severe neurological complication of falciparum malaria and a leading cause of death and neuro-disability in sub-Saharan Africa. This study aimed to describe functional deficits and behaviour problems in children who survived cerebral malaria with severe neurological sequelae and identify patterns of brain injury. Findings Records of children attending a specialist child neurology clinic in Uganda with severe neurological sequelae following cerebral malaria between January 2007 and December 2008 were examined to describe deficits in gross motor function, speech, vision and hearing, behaviour problems or epilepsy. Deficits were classified according to the time of development and whether their distribution suggested a focal or generalized injury. Any resolution during the observation period was also documented. Thirty children with probable exposure to cerebral malaria attended the clinic. Referral information was inadequate to exclude other diagnoses in 7 children and these were excluded. In the remaining 23 patients, the commonest severe deficits were spastic motor weakness (14, loss of speech (14, hearing deficit (9, behaviour problems (11, epilepsy (12, blindness (12 and severe cognitive impairment (9. Behaviour problems included hyperactivity, impulsiveness and inattentiveness as in attention deficit hyperactivity disorder (ADHD and conduct disorders with aggressive, self injurious or destructive behaviour. Two patterns were observed; a immediate onset deficits present on discharge and b late onset deficits. Some deficits e.g. blindness, resolved within 6 months while others e.g. speech, showed little improvement over the 6-months follow-up. Conclusions In addition to previously described neurological and cognitive sequelae, severe behaviour problems may follow cerebral malaria in children. The observed differences in patterns of sequelae may be due to different pathogenic mechanisms, brain

  7. Plant Hormone Salicylic Acid Produced by a Malaria Parasite Controls Host Immunity and Cerebral Malaria Outcome.

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    Ryuma Matsubara

    Full Text Available The apicomplexan parasite Toxoplasma gondii produces the plant hormone abscisic acid, but it is unclear if phytohormones are produced by the malaria parasite Plasmodium spp., the most important parasite of this phylum. Here, we report detection of salicylic acid, an immune-related phytohormone of land plants, in P. berghei ANKA and T. gondii cell lysates. However, addition of salicylic acid to P. falciparum and T. gondii culture had no effect. We transfected P. falciparum 3D7 with the nahG gene, which encodes a salicylic acid-degrading enzyme isolated from plant-infecting Pseudomonas sp., and established a salicylic acid-deficient mutant. The mutant had a significantly decreased concentration of parasite-synthesized prostaglandin E2, which potentially modulates host immunity as an adaptive evolution of Plasmodium spp. To investigate the function of salicylic acid and prostaglandin E2 on host immunity, we established P. berghei ANKA mutants expressing nahG. C57BL/6 mice infected with nahG transfectants developed enhanced cerebral malaria, as assessed by Evans blue leakage and brain histological observation. The nahG-transfectant also significantly increased the mortality rate of mice. Prostaglandin E2 reduced the brain symptoms by induction of T helper-2 cytokines. As expected, T helper-1 cytokines including interferon-γ and interleukin-2 were significantly elevated by infection with the nahG transfectant. Thus, salicylic acid of Plasmodium spp. may be a new pathogenic factor of this threatening parasite and may modulate immune function via parasite-produced prostaglandin E2.

  8. Glucagon-like peptide-1 analogue, liraglutide, in experimental cerebral malaria

    DEFF Research Database (Denmark)

    DellaValle, Brian; Hempel, Casper; Staalsoe, Trine;

    2016-01-01

    BACKGROUND: Cerebral malaria from Plasmodium falciparum infection is major cause of death in the tropics. The pathogenesis of the disease is complex and the contribution of reactive oxygen and nitrogen species (ROS/RNS) in the brain is incompletely understood. Insulinotropic glucagon-like peptide-1...... (GLP-1) mimetics have potent neuroprotective effects in animal models of neuropathology associated with ROS/RNS dysfunction. This study investigates the effect of the GLP-1 analogue, liraglutide against the clinical outcome of experimental cerebral malaria (ECM) and Plasmodium falciparum growth....... Furthermore the role of oxidative stress on ECM pathogenesis is evaluated. METHODS: ECM was induced in Plasmodium berghei ANKA-infected C57Bl/6j mice. Infected Balb/c (non-cerebral malaria) and uninfected C57Bl/6j mice were included as controls. Mice were treated twice-daily with vehicle or liraglutide (200...

  9. Cerebral malaria: insights from host-parasite protein-protein interactions

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    Bulusu Gopalakrishnan

    2010-06-01

    Full Text Available Abstract Background Cerebral malaria is a form of human malaria wherein Plasmodium falciparum-infected red blood cells adhere to the blood capillaries in the brain, potentially leading to coma and death. Interactions between parasite and host proteins are important in understanding the pathogenesis of this deadly form of malaria. It is, therefore, necessary to study available protein-protein interactions to identify lesser known interactions that could throw light on key events of cerebral malaria. Methods Sequestration, haemostasis dysfunction, systemic inflammation and neuronal damage are key processes of cerebral malaria. Key events were identified from literature as being crucial to these processes. An integrated interactome was created using available experimental and predicted datasets as well as from literature. Interactions from this interactome were filtered based on Gene Ontology and tissue-specific annotations, and further analysed for relevance to the key events. Results PfEMP1 presentation, platelet activation and astrocyte dysfunction were identified as the key events influencing the disease. 48896 host-parasite along with other host-parasite, host-host and parasite-parasite protein-protein interactions obtained from a disease-specific corpus were combined to form an integrated interactome. Filtering of the interactome resulted in five host-parasite PPI, six parasite-parasite and two host-host PPI. The analysis of these interactions revealed the potential significance of apolipoproteins and temperature/Hsp expression on efficient PfEMP1 presentation; role of MSP-1 in platelet activation; effect of parasite proteins in TGF-β regulation and the role of albumin in astrocyte dysfunction. Conclusions This work links key host-parasite, parasite-parasite and host-host protein-protein interactions to key processes of cerebral malaria and generates hypotheses for disease pathogenesis based on a filtered interaction dataset. These

  10. A Rapid Murine Coma and Behavior Scale for Quantitative Assessment of Murine Cerebral Malaria

    OpenAIRE

    Carroll, Ryan W.; Mark S Wainwright; KIM, KWANG-YOUN; Kidambi, Trilokesh; Gómez, Noé D.; Taylor, Terrie; Haldar, Kasturi

    2010-01-01

    Background Cerebral malaria (CM) is a neurological syndrome that includes coma and seizures following malaria parasite infection. The pathophysiology is not fully understood and cannot be accounted for by infection alone: patients still succumb to CM, even if the underlying parasite infection has resolved. To that effect, there is no known adjuvant therapy for CM. Current murine CM (MCM) models do not allow for rapid clinical identification of affected animals following infection. An animal m...

  11. Experimental Cerebral Malaria Develops Independently of Caspase Recruitment Domain-Containing Protein 9 Signaling

    OpenAIRE

    Julius Clemence R Hafalla; Burgold, Jan; Dorhoi, Anca; Gross, Olaf; Ruland, Jürgen; Stefan H. E. Kaufmann; Matuschewski, Kai

    2012-01-01

    The outcome of infection depends on multiple layers of immune regulation, with innate immunity playing a decisive role in shaping protection or pathogenic sequelae of acquired immunity. The contribution of pattern recognition receptors and adaptor molecules in immunity to malaria remains poorly understood. Here, we interrogate the role of the caspase recruitment domain-containing protein 9 (CARD9) signaling pathway in the development of experimental cerebral malaria (ECM) using the murine Pla...

  12. Mannitol as adjunct therapy for childhood cerebral malaria in Uganda: A randomized clinical trial

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    Byarugaba Justus S

    2007-10-01

    Full Text Available Abstract Background Several reports have suggested that raised intracranial pressure (ICP is a major contributor to death among children with cerebral malaria. Mannitol, an osmotic diuretic, effectively lowers ICP and is used to treat post-traumatic raised ICP. It is not clear whether intravenous mannitol given to children with cerebral malaria improves clinical outcome. The objective of this study was to determine the effect of mannitol as adjunct therapy on the clinical outcome of children with cerebral malaria. Methods This randomized double-blind placebo controlled clinical trial was carried out at the Emergency Paediatric ward of Mulago Hospital, Uganda's national referral and teaching hospital. One hundred and fifty six children aged 6 to 60 months with cerebral malaria were randomized to either one dose of mannitol 1 g/kg or placebo, in addition to intravenous quinine. Main outcome measures included coma recovery time; time to sit unsupported, begin oral intake; duration of hospitalization; death and adverse effects. Results Time to regain consciousness (p = 0.11, sit unsupported (p = 0.81, time to start oral intake (p = 0.13 and total coma duration (p = 0.07 were similar in both groups. There was no significant difference in the mortality between the placebo (13/80 or 16.3% and mannitol (10/76 or 13.2% groups: RR = 1.2 (CI 0.5–2.7. No adverse effects were observed after administration of mannitol. Conclusion Mannitol had no significant impact on clinical outcome of cerebral malaria. It is difficult to recommend intravenous mannitol as adjunct therapy for childhood cerebral malaria. Clinical registration number ClinicalTrials.gov ID: NCT00113854

  13. Cytokine response during non-cerebral and cerebral malaria: evidence of a failure to control inflammation as a cause of death in African adults

    Science.gov (United States)

    Mbengue, Babacar; Dagamajalu, Shobha; Fall, Mouhamadou Mansour; Loke, Mun Fai; Nguer, Cheikh Momar; Thiam, Alassane; Vadivelu, Jamuna; Dieye, Alioune

    2016-01-01

    Background. With 214 million cases and 438,000 deaths in 2015, malaria remains one of the deadliest infectious diseases in tropical countries. Several species of the protozoan Plasmodium cause malaria. However, almost all the fatalities are due to Plasmodium falciparum, a species responsible for the severest cases including cerebral malaria. Immune response to Plasmodium falciparum infection is mediated by the production of pro-inflammatory cytokines, chemokines and growth factors whose actions are crucial for the control of the parasites. Following this response, the induction of anti-inflammatory immune mediators downregulates the inflammation thus preventing its adverse effects such as damages to various organs and death. Methods. We performed a retrospective, nonprobability sampling study using clinical data and sera samples from patients, mainly adults, suffering of non-cerebral or cerebral malaria in Dakar, Sénégal. Healthy individuals residing in the same area were included as controls. We measured the serum levels of 29 biomarkers including growth factors, chemokines, inflammatory and anti-inflammatory cytokines. Results. We found an induction of both pro- and anti-inflammatory immune mediators during malaria. The levels of pro-inflammatory biomarkers were higher in the cerebral malaria than in the non-cerebral malaria patients. In contrast, the concentrations of anti-inflammatory cytokines were comparable in these two groups or lower in CM patients. Additionally, four pro-inflammatory biomarkers were significantly increased in the deceased of cerebral malaria compared to the survivors. Regarding organ damage, kidney failure was significantly associated with death in adults suffering of cerebral malaria. Conclusions. Our results suggest that a poorly controlled inflammatory response determines a bad outcome in African adults suffering of cerebral malaria.

  14. IP-10-mediated T cell homing promotes cerebral inflammation over splenic immunity to malaria infection.

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    Catherine Q Nie

    2009-04-01

    Full Text Available Plasmodium falciparum malaria causes 660 million clinical cases with over 2 million deaths each year. Acquired host immunity limits the clinical impact of malaria infection and provides protection against parasite replication. Experimental evidence indicates that cell-mediated immune responses also result in detrimental inflammation and contribute to severe disease induction. In both humans and mice, the spleen is a crucial organ involved in blood stage malaria clearance, while organ-specific disease appears to be associated with sequestration of parasitized erythrocytes in vascular beds and subsequent recruitment of inflammatory leukocytes. Using a rodent model of cerebral malaria, we have previously found that the majority of T lymphocytes in intravascular infiltrates of cerebral malaria-affected mice express the chemokine receptor CXCR3. Here we investigated the effect of IP-10 blockade in the development of experimental cerebral malaria and the induction of splenic anti-parasite immunity. We found that specific neutralization of IP-10 over the course of infection and genetic deletion of this chemokine in knockout mice reduces cerebral intravascular inflammation and is sufficient to protect P. berghei ANKA-infected mice from fatality. Furthermore, our results demonstrate that lack of IP-10 during infection significantly reduces peripheral parasitemia. The increased resistance to infection observed in the absence of IP-10-mediated cell trafficking was associated with retention and subsequent expansion of parasite-specific T cells in spleens of infected animals, which appears to be advantageous for the control of parasite burden. Thus, our results demonstrate that modulating homing of cellular immune responses to malaria is critical for reaching a balance between protective immunity and immunopathogenesis.

  15. Fatal cerebral malaria diagnosed after death in a French patient.

    Science.gov (United States)

    Alunni-Perret, Veronique; Vandenbos, Fanny; Kechkekian, Aurore; Marty, Pierre; Legros, Fabrice; Michiels, Jean François; Cardot-Leccia, Nathalie; Fortineau, Nicolas; Durant, Jacques; Quatrehomme, Gérald

    2010-09-01

    We report on the case of a French citizen who was found dead in his home, 4 days after returning from Cameroon. The patient died of imported malaria, as revealed by the postmortem investigations. Few such cases have been reported throughout the world. This article reviews deaths due to malaria diagnosed at the time of autopsy in France between 1995 and 2005. We conclude that the nonspecific symptoms of malaria can lead to a misdiagnosis and the need for a forensic expert to intervene at the scene of death, which usually occurs in the home. We will remind forensic pathologists of the clinical, biologic, and forensic aspects of this infectious disease. In particular, the uses of microbiologic analyses, the QBC malaria test and the Core malaria Pan/Pv/pf test as well as brain tissue histology will be reviewed. PMID:20508488

  16. Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report.

    Science.gov (United States)

    Çizmeci, Elif Ayşe; Kelebek Girgin, Nermin; Ceylan, Ilkay; Tuncel, Tekin; Alver, Oktay; Akalin, Emin Halis

    2016-01-01

    Malaria is a parasitic disease that is starting to be encountered in intensive care units (ICU) worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alveolar oedema. We present the case of a 25-yr old male patient who presented to the Emergency Department of Uludag University in Bursa, Turkey in the winter of 2014 with complaints of fever for three days. His medical history revealed a 14-month stay in Tanzania. Staining of blood smears revealed characteristic gametocytes in accordance with P. falciparum infection. The day after admission, he had an epileptic seizure after which his Glasgow Coma Scale was 6, so he was intubated and transferred to the ICU. A computerized tomography scan revealed findings of cerebral oedema. Intravenous mannitol was administered for 6 days. Intravenous artemisinin was continued for 10 days. Due to refractory fevers, anti-malarial treatment was switched to quinine and doxycycline on the 14th day and on the 16th day the fevers ceased. This case emphasizes that cerebral malaria should be suspected in cases of seizures accompanying malaria, and treatment should be initiated in the ICU. Furthermore, resistance of P. falciparum to artemisinin should be in mind when a response to therapy is lacking. PMID:27095978

  17. Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report

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    Elif Ayşe ÇİZMECİ

    2016-03-01

    Full Text Available Malaria is a parasitic disease that is starting to be encountered in intensive care units (ICU worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alveolar oedema. We present the case of a 25-yr old male patient who presented to the Emergency Department of Uludag University in Bursa, Turkey in the winter of 2014 with complaints of fe­ver for three days. His medical history revealed a 14-month stay in Tanzania. Staining of blood smears revealed characteristic gametocytes in accordance with P. falciparum infection. The day after admission, he had an epileptic seizure after which his Glasgow Coma Scale was 6, so he was intubated and transferred to the ICU. A computerized tomography scan revealed findings of cerebral oedema. Intravenous mannitol was administered for 6 days. Intravenous artemisinin was continued for 10 days. Due to refractory fevers, anti-malarial treatment was switched to quinine and doxycycline on the 14th day and on the 16th day the fe­vers ceased. This case emphasizes that cerebral malaria should be suspected in cases of seizures accompanying malaria, and treatment should be initiated in the ICU. Furthermore, resistance of P. falciparum to artemisinin should be in mind when a response to therapy is lacking.

  18. Cerebral Malaria Treated with Artemisinin in the Intensive Care Unit: A Case Report

    Science.gov (United States)

    ÇİZMECİ, Elif Ayşe; KELEBEK GİRGİN, Nermin; CEYLAN, Ilkay; TUNCEL, Tekin; ALVER, Oktay; AKALIN, Emin Halis

    2016-01-01

    Malaria is a parasitic disease that is starting to be encountered in intensive care units (ICU) worldwide, owing to increasing globalisation. Severe malaria caused by Plasmodium falciparum, is characterised by cerebral malaria, acute renal failure, hypoglycaemia, severe anaemia, splenomegaly and alveolar oedema. We present the case of a 25-yr old male patient who presented to the Emergency Department of Uludag University in Bursa, Turkey in the winter of 2014 with complaints of fever for three days. His medical history revealed a 14-month stay in Tanzania. Staining of blood smears revealed characteristic gametocytes in accordance with P. falciparum infection. The day after admission, he had an epileptic seizure after which his Glasgow Coma Scale was 6, so he was intubated and transferred to the ICU. A computerized tomography scan revealed findings of cerebral oedema. Intravenous mannitol was administered for 6 days. Intravenous artemisinin was continued for 10 days. Due to refractory fevers, anti-malarial treatment was switched to quinine and doxycycline on the 14th day and on the 16th day the fevers ceased. This case emphasizes that cerebral malaria should be suspected in cases of seizures accompanying malaria, and treatment should be initiated in the ICU. Furthermore, resistance of P. falciparum to artemisinin should be in mind when a response to therapy is lacking. PMID:27095978

  19. Differences in gene transcriptomic pattern of Plasmodium falciparum in children with cerebral malaria and asymptomatic carriers

    DEFF Research Database (Denmark)

    Almelli, Talleh; Nuel, Grégory; Bischoff, Emmanuel;

    2014-01-01

    , transcriptional factor proteins, proteins implicated in protein transport, as well as Plasmodium conserved and hypothetical proteins. Interestingly, UPs A1, A2, A3 and UPs B1 of var genes were predominantly found in cerebral malaria-associated isolates and those containing architectural domains of DC4, DC5, DC13...

  20. Polymorphisms in the RNASE3 gene are associated with susceptibility to cerebral malaria in Ghanaian children

    DEFF Research Database (Denmark)

    Adu, Bright; Dodoo, Daniel; Adukpo, Selorme;

    2011-01-01

    Cerebral malaria (CM) is the most severe outcome of Plasmodium falciparum infection and a major cause of death in children from 2 to 4 years of age. A hospital based study in Ghana showed that P. falciparum induces eosinophilia and found a significantly higher serum level of eosinophil cationic...

  1. Comparison of chloroquine with artesunate in the treatment of cerebral malaria in Ghanaian children

    DEFF Research Database (Denmark)

    Goka, B Q; Adabayeri, V; Ofori-Adjei, E;

    2001-01-01

    .8), between the two groups. The results suggest that syrup chloroquine and intramuscular/oral artesunate currently give comparable clinical responses in the treatment of cerebral malaria in Ghana. Possible reasons for this are discussed, and suggestions are made for future antimalarial drug policy....

  2. Multivariate modelling with 1H NMR of pleural effusion in murine cerebral malaria

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    Ghosh Soumita

    2011-11-01

    Full Text Available Abstract Background Cerebral malaria is a clinical manifestation of Plasmodium falciparum infection. Although brain damage is the predominant pathophysiological complication of cerebral malaria (CM, respiratory distress, acute lung injury, hydrothorax/pleural effusion are also observed in several cases. Immunological parameters have been assessed in pleural fluid in murine models; however there are no reports of characterization of metabolites present in pleural effusion. Methods 1H NMR of the sera and the pleural effusion of cerebral malaria infected mice were analyzed using principal component analysis, orthogonal partial least square analysis, multiway principal component analysis, and multivariate curve resolution. Results It has been observed that there was 100% occurrence of pleural effusion (PE in the mice affected with CM, as opposed to those are non-cerebral and succumbing to hyperparasitaemia (NCM/HP. An analysis of 1H NMR and SDS-PAGE profile of PE and serum samples of each of the CM mice exhibited a similar profile in terms of constituents. Multivariate analysis on these two classes of biofluids was performed and significant differences were detected in concentrations of metabolites. Glucose, creatine and glutamine contents were high in the PE and lipids being high in the sera. Multivariate curve resolution between sera and pleural effusion showed that changes in PE co-varied with that of serum in CM mice. The increase of glucose in PE is negatively correlated to the glucose in serum in CM as obtained from the result of multiway principal component analysis. Conclusions This study reports for the first time, the characterization of metabolites in pleural effusion formed during murine cerebral malaria. The study indicates that the origin of PE metabolites in murine CM may be the serum. The loss of the components like glucose, glutamine and creatine into the PE may worsen the situation of patients, in conjunction with the enhanced

  3. CNS hypoxia is more pronounced in murine cerebral than noncerebral malaria and is reversed by erythropoietin

    DEFF Research Database (Denmark)

    Hempel, Casper; Combes, Valery; Hunt, Nicholas Henry; Kurtzhals, Jørgen Anders Lindholm; Grau, Georges Emile Raymond

    2011-01-01

    , and two models of malaria without neurologic signs, P. berghei K173 in CBA mice and P. berghei ANKA in BALB/c mice. Hypoxia was demonstrated in brain sections using intravenous pimonidazole and staining with hypoxia-inducible factor-1a-specific antibody. Cytopathic hypoxia was studied using poly (ADP......Cerebral malaria (CM) is associated with high mortality and risk of sequelae, and development of adjunct therapies is hampered by limited knowledge of its pathogenesis. To assess the role of cerebral hypoxia, we used two experimental models of CM, Plasmodium berghei ANKA in CBA and C57BL/6 mice......-ribose) polymerase-1 (PARP-1) gene knockout mice. The effect of erythropoietin, an oxygen-sensitive cytokine that mediates protection against CM, on cerebral hypoxia was studied in C57BL/6 mice. Numerous hypoxic foci of neurons and glial cells were observed in mice with CM. Substantially fewer and smaller foci were...

  4. Pathogenesis of Cerebral Malaria: Recent Experimental Data and Possible Applications for Humans

    Science.gov (United States)

    Lou, Jinning; Lucas, Ralf; Grau, Georges E.

    2001-01-01

    Malaria still is a major public health problem, partly because the pathogenesis of its major complication, cerebral malaria, remains incompletely understood. Experimental models represent useful tools to better understand the mechanisms of this syndrome. Here, data generated by several models are reviewed both in vivo and in vitro; we propose that some pathogenic mechanisms, drawn from data obtained from experiments in a mouse model, may be instrumental in humans. In particular, tumor necrosis factor (TNF) receptor 2 is involved in this syndrome, implying that the transmembrane form of TNF may be more important than the soluble form of the cytokine. It has also been shown that in addition to differences in immune responsiveness between genetically resistant and susceptible mice, there are marked differences at the level of the target cell of the lesion, namely, the brain endothelial cell. In murine cerebral malaria, a paradoxical role of platelets has been proposed. Indeed, platelets appear to be pathogenic rather than protective in inflammatory conditions because they can potentiate the deleterious effects of TNF. More recently, it has been shown that interactions among platelets, leukocytes, and endothelial cells have phenotypic and functional consequences for the endothelial cells. A better understanding of these complex interactions leading to vascular injury will help improve the outcome of cerebral malaria. PMID:11585786

  5. Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

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    Resmi Premji

    2016-01-01

    Full Text Available Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated.

  6. Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus

    Science.gov (United States)

    Premji, Resmi; Roopnarinesingh, Nira; Cohen, Joshua; Sen, Sabyasachi

    2016-01-01

    Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated.

  7. Cerebral Malaria: An Unusual Cause of Central Diabetes Insipidus.

    Science.gov (United States)

    Premji, Resmi; Roopnarinesingh, Nira; Cohen, Joshua; Sen, Sabyasachi

    2016-01-01

    Central diabetes insipidus is an uncommon feature of malaria. A previously healthy 72-year-old man presented with fever, rigors, and altered mental status after a recent trip to Liberia, a country known for endemic falciparum malaria. Investigations confirmed plasmodium falciparum parasitemia. Within one week after admission, the serum sodium rose to 166 mEq/L and the urine output increased to 7 liters/day. Other labs were notable for a high serum osmolality, low urine osmolality, and low urine specific gravity. The hypernatremia did not respond to hypotonic fluids. Diabetes insipidus was suspected and parenteral desmopressin was started with a prompt decrease in urinary output and improvement in mental status. Additional testing showed normal anterior pituitary hormones. The desmopressin was eventually tapered off with complete resolution of symptoms. Central diabetes insipidus occurred likely as a result of obstruction of the neurohypophyseal microvasculature. Other endocrinopathies that have been reported with malaria include hyponatremia, adrenal insufficiency, hypothyroidism, hypocalcemia, hypophosphatemia, hyper-, and hypoglycemia, but none manifested in our patient. Though diabetes insipidus is a rare complication of malaria, clinicians need to be aware of this manifestation, as failure to do so may lead to fatality particularly if the patient is dehydrated. PMID:27242936

  8. Spectral reflectance of the ocular fundus as a diagnostic marker for cerebral malaria

    Science.gov (United States)

    Liu, Xun; Rice, David A.; Khoobehi, Bahram

    2012-03-01

    The challenge of correctly identifying malaria infection continues to impede our efforts to control this disease. Recent studies report highly specific retinal changes in severe malaria patients; these retinal changes may represent a very useful diagnostic indicator for this disease. To further explore the ocular manifestations of malaria, we used hyperspectral imaging to study retinal changes caused by Plasmodium berghei ANKA parasitization in a mouse model. We collected the spectral reflectance of the ocular fundus from hyperspectral images of the mouse eye. The blood oxygen sensitive spectral region was normalized for variances in illumination, and used to calculate relative values that correspond to oxygenated hemoglobin levels. Oxygen hemoglobin levels are markedly lower in parasitized mice, indicating that hemoglobin digestion by P. berghei may be detected using spectral reflectance. Furthermore, the ocular reflectance of parasitized mice was abnormally elevated between 660nm and 750nm, suggesting fluorescence in this region. While the source of this fluorescence is not yet clear, its presence correlates strongly with P. Berghei parasitization, and may indicate the presence of hemozoin deposits in the retinal vasculature. The pathology of severe malaria still presents many questions for clinicians and scientists, and our understanding of cerebral malaria has been generally confined to clinical observation and postmortem examination. As the retina represents a portion of the central nervous system that can be easily examined noninvasively, our technique may provide the basis for an automated tool to detect and examine severe malaria via retinal changes.

  9. Investigation of Hydrogen Sulfide Gas as a Treatment against P. falciparum, Murine Cerebral Malaria, and the Importance of Thiolation State in the Development of Cerebral Malaria

    DEFF Research Database (Denmark)

    Dellavalle, Brian; Staalsoe, Trine; Kurtzhals, Jørgen Anders; Hempel, Casper

    2013-01-01

    Cerebral malaria (CM) is a potentially fatal cerebrovascular disease of complex pathogenesis caused by Plasmodium falciparum. Hydrogen sulfide (HS) is a physiological gas, similar to nitric oxide and carbon monoxide, involved in cellular metabolism, vascular tension, inflammation, and cell death....... HS treatment has shown promising results as a therapy for cardio- and neuro- pathology. This study investigates the effects of fast (NaHS) and slow (GYY4137) HS-releasing drugs on the growth and metabolism of P. falciparum and the development of P. berghei ANKA CM. Moreover, we investigate the role...

  10. Vascular dysfunction as a target for adjuvant therapy in cerebral malaria

    Directory of Open Access Journals (Sweden)

    Leonardo José de Moura Carvalho

    2014-08-01

    Full Text Available Cerebral malaria (CM is a life-threatening complication of Plasmodium falciparum malaria that continues to be a major global health problem. Brain vascular dysfunction is a main factor underlying the pathogenesis of CM and can be a target for the development of adjuvant therapies for the disease. Vascular occlusion by parasitised red blood cells and vasoconstriction/vascular dysfunction results in impaired cerebral blood flow, ischaemia, hypoxia, acidosis and death. In this review, we discuss the mechanisms of vascular dysfunction in CM and the roles of low nitric oxide bioavailability, high levels of endothelin-1 and dysfunction of the angiopoietin-Tie2 axis. We also discuss the usefulness and relevance of the murine experimental model of CM by Plasmodium berghei ANKA to identify mechanisms of disease and to screen potential therapeutic interventions.

  11. A new hypothesis on the manifestation of cerebral malaria: the secret is in the liver

    OpenAIRE

    Martins, Yuri C; Daniel-Ribeiro, Claudio Tadeu

    2013-01-01

    Despite the abundance of information on cerebral malaria (CM), the pathogenesis of this disease is not completely understood. At present, two nonexclusive dominant hypotheses exist to explain how the neurological syndrome manifests: the sequestration (or mechanical) hypothesis and the inflammatory hypothesis. The sequestration hypothesis states that sequestration of P. falciparum-parasitized red blood cells (pRBCs) to brain capillary endothelia causes obstruction of capillary blood flow follo...

  12. CLINICO - HAEMATOLOGICAL PROFILE AND OUTCOME OF CEREBRAL MALARIA IN A TEACHING HOSPITAL OF SOUTH EAST RAJASTHAN

    OpenAIRE

    Gautam Lal; Rajendra Kumar

    2015-01-01

    AIM: Evaluation of Clinico - hematological profile and outcome of cerebral malaria in semi urban hospital situated in endemic area. MATERIAL AND METHODS : A cross - sectional hospital - based study was conducted from August to November, 2014 at Department of Paediatrics SRG Zanana Hospital, Jhalawar Rajasthan. Every child, except who was previously abnormal neurologically, of the age of six month to 12 years, presented with a history of fever in...

  13. Glatiramer acetate reduces the risk for experimental cerebral malaria: a pilot study

    OpenAIRE

    Helbok Raimund; Broessner Gregor; Dietmann Anelia; Burger Christoph; Part Andrea; Lackner Peter; Reindl Markus; Schmutzhard Erich; Beer Ronny

    2009-01-01

    Abstract Background Cerebral malaria (CM) is associated with high mortality and morbidity caused by a high rate of transient or persistent neurological sequelae. Studies on immunomodulatory and neuroprotective drugs as ancillary treatment in murine CM indicate promising potential. The current study was conducted to evaluate the efficacy of glatiramer acetate (GA), an immunomodulatory drug approved for the treatment of relapsing remitting multiple sclerosis, in preventing the death of C57Bl/6J...

  14. Genetic susceptibility to systemic lupus erythematosus protects against cerebral malaria in mice

    OpenAIRE

    Waisberg, Michael; Tarasenko, Tatyana; Brandi K Vickers; Scott, Bethany L.; Willcocks, Lisa C.; Molina-Cruz, Alvaro; Pierce, Matthew A.; Huang, Chiung-Yu; Torres-Velez, Fernando J.; Smith, Kenneth G.C.; Barillas-Mury, Carolina; Miller, Louis H.; Pierce, Susan K.; Bolland, Silvia

    2010-01-01

    Plasmodium falciparum has exerted tremendous selective pressure on genes that improve survival in severe malarial infections. Systemic lupus erythematosus (SLE) is an autoimmune disease that is six to eight times more prevalent in women of African descent than in women of European descent. Here we provide evidence that a genetic susceptibility to SLE protects against cerebral malaria. Mice that are prone to SLE because of a deficiency in FcγRIIB or overexpression of Toll-like receptor 7 are p...

  15. Decorticate, decerebrate and opisthotonic posturing and seizures in Kenyan children with cerebral malaria

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    Ogutu Bernhards

    2005-12-01

    Full Text Available Abstract Background Abnormal motor posturing is often observed in children with cerebral malaria, but the aetiology and pathogenesis is poorly understood. This study examined the risk factors and outcome of posturing in Kenyan children with cerebral malaria. Methods Records of children admitted to Kilifi district hospital with cerebral malaria from January, 1999 through December, 2001 were reviewed for posturing occurring on or after admission. The clinical characteristics, features of raised intracranial pressure, number of seizures and biochemical changes in patients that developed posturing was compared to patients who did not. Results Of the 417 children with complete records, 163 (39.1% had posturing: 85 on admission and 78 after admission to hospital. Decorticate posturing occurred in 80, decerebrate in 61 and opisthotonic posturing in 22 patients. Posturing was associated with age ≥ 3 years (48.1 vs 35.8%, p = 0.01 and features of raised intracranial pressure on funduscopy (adjusted OR 2.1 95%CI 1.2–3.7, p = 0.009 but not other markers of severity of disease. Unlike decorticate posturing, decerebrate (adjusted OR 1.9 95%CI 1.0–3.5 and opisthotonic posturing (adjusted OR 2.9 95%CI 1.0–8.1 were, in addition, independently associated with recurrence of seizures after admission. Opisthotonus was also associated with severe metabolic acidosis (OR 4.2 95%CI 3.2–5.6, p Conclusion Abnormal motor posturing is a common feature of cerebral malaria in children. It is associated with features of raised intracranial pressure and recurrence of seizures, although intracranial hypertension may be the primary cause.

  16. Protection against cerebral malaria by the low-molecular-weight thiol pantethine.

    Science.gov (United States)

    Penet, Marie-France; Abou-Hamdan, Mhamad; Coltel, Nicolas; Cornille, Emilie; Grau, Georges E; de Reggi, Max; Gharib, Bouchra

    2008-01-29

    We report that administration of the low-molecular-weight thiol pantethine prevented the cerebral syndrome in Plasmodium berghei ANKA-infected mice. The protection was associated with an impairment of the host response to the infection, with in particular a decrease of circulating microparticles and preservation of the blood-brain barrier integrity. Parasite development was unaffected. Pantethine modulated one of the early steps of the inflammation-coagulation cascade, i.e., the transbilayer translocation of phosphatidylserine at the cell surface that we demonstrated on red blood cells and platelets. In this, pantethine mimicked the inactivation of the ATP-binding-cassette transporter A1 (ABCA1), which also prevents the cerebral syndrome in this malaria model. However, pantethine acts through a different pathway, because ABCA1 activity was unaffected by the treatment. The mechanisms of pantethine action were investigated, using the intact molecule and its constituents. The disulfide group (oxidized form) is necessary to lower the platelet response to activation by thrombin and collagen. Thio-sensitive mechanisms are also involved in the impairment of microparticle release by TNF-activated endothelial cells. In isolated cells, the effects were obtained by cystamine that lacks the pantothenic moiety of the molecule; however, the complete molecule is necessary to protect against cerebral malaria. Pantethine is well tolerated, and it has already been administered in other contexts to man with limited side effects. Therefore, trials of pantethine treatment in adjunctive therapy for severe malaria are warranted. PMID:18195363

  17. Expression of the domain cassette 8 Plasmodium falciparum erythrocyte membrane protein 1 is associated with cerebral malaria in Benin.

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    Gwladys I Bertin

    Full Text Available BACKGROUND: Plasmodium falciparum erythrocyte membrane protein-1 (PfEMP-1 is a highly polymorphic adherence receptor expressed on the surface of infected erythrocytes. Based on sequence homology PfEMP-1 variants have been grouped into three major groups A-C, the highly conserved VAR2CSA variants, and semi-conserved types defined by tandem runs of specific domains ("domain cassettes" (DC. The PfEMP-1 type expressed determines the adherence phenotype, and is associated with clinical outcome of infection. METHODS: Parasite isolates from Beninese children or women presenting with, respectively, CM or PAM were collected along with samples from patients with uncomplicated malaria (UM. We assessed the transcript level of var genes by RT-qPCR and the expression of PfEMP-1 proteins by LC-MS/MS. RESULTS: Var genes encoding DC8 and Group A PfEMP-1 were transcribed more often and at higher levels in cerebral malaria vs. uncomplicated malaria patients. LC-MS/MS identified peptides from group A, DC8 PfEMP-1 more frequently in cerebral malaria than in uncomplicated malaria and pregnancy-associated malaria samples. CONCLUSION: This is the first study to show association between PfEMP-1 subtype and disease outcome by direct analysis of parasites proteome. The results corroborate that group A and specifically the PfEMP-1 types DC8 are universally associated with cerebral malaria. This is a crucial observation for promoting studies on malaria pathogenesis.

  18. Significant association of KIR2DL3-HLA-C1 combination with cerebral malaria and implications for co-evolution of KIR and HLA.

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    Kouyuki Hirayasu

    Full Text Available Cerebral malaria is a major, life-threatening complication of Plasmodium falciparum malaria, and has very high mortality rate. In murine malaria models, natural killer (NK cell responses have been shown to play a crucial role in the pathogenesis of cerebral malaria. To investigate the role of NK cells in the developmental process of human cerebral malaria, we conducted a case-control study examining genotypes for killer immunoglobulin-like receptors (KIR and their human leukocyte antigen (HLA class I ligands in 477 malaria patients. We found that the combination of KIR2DL3 and its cognate HLA-C1 ligand was significantly associated with the development of cerebral malaria when compared with non-cerebral malaria (odds ratio 3.14, 95% confidence interval 1.52-6.48, P = 0.00079, corrected P = 0.02. In contrast, no other KIR-HLA pairs showed a significant association with cerebral malaria, suggesting that the NK cell repertoire shaped by the KIR2DL3-HLA-C1 interaction shows certain functional responses that facilitate development of cerebral malaria. Furthermore, the frequency of the KIR2DL3-HLA-C1 combination was found to be significantly lower in malaria high-endemic populations. These results suggest that natural selection has reduced the frequency of the KIR2DL3-HLA-C1 combination in malaria high-endemic populations because of the propensity of interaction between KIR2DL3 and C1 to favor development of cerebral malaria. Our findings provide one possible explanation for KIR-HLA co-evolution driven by a microbial pathogen, and its effect on the global distribution of malaria, KIR and HLA.

  19. Marked Elevation in Plasma Osteoprotegerin Constitutes an Early and Consistent Feature of Cerebral Malaria

    Science.gov (United States)

    O’Regan, Niamh; Moxon, Chris; Gegenbauer, Kristina; O’Sullivan, Jamie M.; Chion, Alain; Smith, Owen P.; Preston, Roger J. S.; Brophy, Teresa M.; Craig, Alister G.

    2016-01-01

    Summary Adherence of infected erythrocytes to vascular endothelium causes acute endothelial cell (EC) activation during Plasmodium falciparum infection. Consequently, proteins stored in Weibel-Palade (WP) bodies within EC are secreted into the plasma. Osteoprotegerin (OPG) binds to VWF and consequently is stored within WP bodies. Given the critical role of EC activation in the pathogenesis of severe malaria, we investigated plasma OPG levels in children with P. falciparum malaria. At presentation, plasma OPG levels were significantly elevated in children with cerebral malaria (CM) compared to healthy controls (means 16.0 vs 0.8 ng/ml; p<0.01). Importantly, OPG levels were also significantly higher in children with CM who had a fatal outcome, compared to children with CM who survived. Finally, in children with CM, plasma OPG levels correlated with other established prognostic indices (including plasma lactate levels and peripheral parasite density). To further investigate the relationship between severe malaria and OPG, we utilised a murine model of experimental CM in which C57BL/6J mice were infected with P. berghei ANKA. Interestingly, plasma OPG levels were increased 4.6 fold within 24 hours following P. berghei inoculation. This early marked elevation in OPG levels was observed before any objective clinical signs were apparent, and preceded the development of peripheral blood parasitaemia. As the mice became increasingly unwell, plasma OPG levels progressively increased. Collectively, these data suggest that OPG constitutes a novel biomarker with prognostic significance in patients with severe malaria. In addition, further studies are required to determine whether OPG plays a role in modulating malaria pathogenesis. PMID:26766771

  20. Evidences of the association among epidemic of malaria buds in Colombia and the phenomenon El Nino - oscillation of the south

    International Nuclear Information System (INIS)

    The El Nino-Southern Oscillation (ENSO) phenomenon is the main forcing mechanism of climatic variability in tropical South America from seasons to decades. Colombia experience below normal dry periods and above normal air temperatures during the warm phase of ENSO (El Nino), and the converse for the cold phase (La Nina). We analyze records of the annual parasitary incidence (A.P.I) index of malaria in Colombia (Plasmodium vivax and Plasmodium falciparum) for the 1959-1994 period we conclude that: (1) during the occurrence of the El Nino event there is a remarkable increase in the number of cases of malaria in Colombia, with a correlation coefficient of 0.62 (statistically significant at the 95% level) between the malaria 8eries and the sea surface temperature series at the nino-4 region (5 degrades N-5 degrades S, 160 degrades E-150 degrades O); and (2) there is an increasing trend in the number of cases for the aforementioned period these statistically related correlations and modeling results may be used for developing health early warning systems (hews) of climate conditions conducive to outbreaks, facilitating early, environmentally-sound public health interventions to control and mitigate the incidence of diseases related with climate variability

  1. Histamine H(3 receptor-mediated signaling protects mice from cerebral malaria.

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    Walid Beghdadi

    Full Text Available BACKGROUND: Histamine is a biogenic amine that has been shown to contribute to several pathological conditions, such as allergic conditions, experimental encephalomyelitis, and malaria. In humans, as well as in murine models of malaria, increased plasma levels of histamine are associated with severity of infection. We reported recently that histamine plays a critical role in the pathogenesis of experimental cerebral malaria (CM in mice infected with Plasmodium berghei ANKA. Histamine exerts its biological effects through four different receptors designated H1R, H2R, H3R, and H4R. PRINCIPAL FINDINGS: In the present work, we explored the role of histamine signaling via the histamine H3 receptor (H3R in the pathogenesis of murine CM. We observed that the lack of H3R expression (H3R(-/- mice accelerates the onset of CM and this was correlated with enhanced brain pathology and earlier and more pronounced loss of blood brain barrier integrity than in wild type mice. Additionally tele-methylhistamine, the major histamine metabolite in the brain, that was initially present at a higher level in the brain of H3R(-/- mice was depleted more quickly post-infection in H3R(-/- mice as compared to wild-type counterparts. CONCLUSIONS: Our data suggest that histamine regulation through the H3R in the brain suppresses the development of CM. Thus modulating histamine signaling in the central nervous system, in combination with standard therapies, may represent a novel strategy to reduce the risk of progression to cerebral malaria.

  2. Recombinant human erythropoietin increases survival and reduces neuronal apoptosis in a murine model of cerebral malaria

    DEFF Research Database (Denmark)

    Wiese, Lothar; Hempel, Casper; Penkowa, Milena;

    2008-01-01

    BACKGROUND: Cerebral malaria (CM) is an acute encephalopathy with increased pro-inflammatory cytokines, sequestration of parasitized erythrocytes and localized ischaemia. In children CM induces cognitive impairment in about 10% of the survivors. Erythropoietin (Epo) has - besides of its well known...... with recombinant human Epo (rhEpo; 50-5000 U/kg/OD, i.p.) at different time points. The effect on survival was measured. Brain pathology was investigated by TUNEL (Terminal deoxynucleotidyl transferase (TdT)-mediated deoxyuridine triphosphate (dUTP)-digoxigenin nick end labelling), as a marker of...

  3. Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased calpain and caspase activity and can be reduced by erythropoietin treatment

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    Casper eHempel

    2014-06-01

    Full Text Available The pathogenesis of cerebral malaria includes compromised microvascular perfusion, increased inflammation, cytoadhesion and endothelial activation. These events cause blood-brain barrier disruption and neuropathology and can be associated with the vascular endothelial growth factor (VEGF signalling pathway. We studied this pathway in mice infected with Plasmodium berghei ANKA causing murine cerebral malaria with or without the use of erythropoietin as adjunct therapy. ELISA and western blotting was used for quantification of VEGF and relevant proteins in brain and plasma. Cerebral malaria increased levels of VEGF in brain and plasma and decreased plasma levels of soluble VEGF receptor 2. Erythropoietin treatment normalised VEGF receptor 2 levels and reduced brain VEGF levels. Hypoxia-inducible factor (HIF-1α was significantly upregulated whereas cerebral HIF-2α and erythropoietin levels remained unchanged. Furthermore, we noticed increased caspase-3 and calpain activity in terminally ill mice, as measured by protease-specific cleavage of α-spectrin and p35. In conclusion, we detected increased cerebral and systemic VEGF as well as HIF-1α, which in the brain were reduced to normal in erythropoietin-treated mice. Also caspase and calpain activity was reduced markedly in erythropoietin-treated mice.

  4. Perivascular Arrest of CD8+ T Cells Is a Signature of Experimental Cerebral Malaria.

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    Tovah N Shaw

    Full Text Available There is significant evidence that brain-infiltrating CD8+ T cells play a central role in the development of experimental cerebral malaria (ECM during Plasmodium berghei ANKA infection of C57BL/6 mice. However, the mechanisms through which they mediate their pathogenic activity during malaria infection remain poorly understood. Utilizing intravital two-photon microscopy combined with detailed ex vivo flow cytometric analysis, we show that brain-infiltrating T cells accumulate within the perivascular spaces of brains of mice infected with both ECM-inducing (P. berghei ANKA and non-inducing (P. berghei NK65 infections. However, perivascular T cells displayed an arrested behavior specifically during P. berghei ANKA infection, despite the brain-accumulating CD8+ T cells exhibiting comparable activation phenotypes during both infections. We observed T cells forming long-term cognate interactions with CX3CR1-bearing antigen presenting cells within the brains during P. berghei ANKA infection, but abrogation of this interaction by targeted depletion of the APC cells failed to prevent ECM development. Pathogenic CD8+ T cells were found to colocalize with rare apoptotic cells expressing CD31, a marker of endothelial cells, within the brain during ECM. However, cellular apoptosis was a rare event and did not result in loss of cerebral vasculature or correspond with the extensive disruption to its integrity observed during ECM. In summary, our data show that the arrest of T cells in the perivascular compartments of the brain is a unique signature of ECM-inducing malaria infection and implies an important role for this event in the development of the ECM-syndrome.

  5. Simultaneous administration of vitamin A and DTP vaccine modulates the immune response in a murine cerebral malaria model

    DEFF Research Database (Denmark)

    Hein-Kristensen, L; Jørgensen, M J; Ravn, H;

    2010-01-01

    -tetanus-pertussis (DTP) vaccine may increase mortality from non-targeted diseases. We investigated the non-targeted effect of pretreatment with VAS and DTP vaccine in a murine model of experimental cerebral malaria. Our a priori hypothesis was that VAS/DTP would aggravate the infection. We found that the effect of VAS...

  6. A functional polymorphism in the IL1B gene promoter, IL1B -31C>T, is not associated with cerebral malaria in Thailand

    OpenAIRE

    Tangpukdee Noppadon; Hananantachai Hathairad; Patarapotikul Jintana; Doi Akihiro; Naka Izumi; Ohashi Jun; Looareesuwan Sornchai; Tokunaga Katsushi

    2005-01-01

    Abstract Background IL-1β and IL-1RA levels are higher in the serum of cerebral malaria patients than in patients with mild malaria. Recently, the level of IL1B expression was reported to be influenced by a polymorphism in the promoter of IL1, IL1B -31C>T. Methods To examine whether polymorphisms in IL1B and IL1RA influence the susceptibility to cerebral malaria, IL1B -31C>T, IL1B 3953C>T, and IL1RA variable number of tandem repeat (VNTR) were analysed in 312 Thai patients with malaria (109 c...

  7. Reliability of the Luganda version of the Child Behaviour Checklist in measuring behavioural problems after cerebral malaria

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    Opoka Robert O

    2009-12-01

    Full Text Available Abstract Background No measure of childhood behaviour has been validated in Uganda despite the documented risks to behaviour. Cerebral malaria in children poses a great risk to their behaviour, however behavioural outcomes after cerebral malaria have not been described in children. This study examined the reliability of the Luganda version of the Child Behaviour Checklist (CBCL and described the behavioural outcomes of cerebral malaria in Ugandan children. Methods The CBCL was administered to parents of 64 children aged 7 to 16 years participating in a trial to improve cognitive functioning after cerebral malaria. These children were assigned to the treatment or control group. The CBCL parent ratings were completed for the children at baseline and nine weeks later. The CBCL was translated into Luganda, a local language, prior to its use. Baseline scores were used to calculate internal consistency using Cronbach Alpha. Correlations between the first and second scores of the control group were used to determine test-retest reliability. Multicultural norms for the CBCL were used to identify children with behavioural problems of clinical significance. Results The test-retest reliability and internal consistency of the Internalising scales were 0.64 and 0.66 respectively; 0.74 and 0.78 for the Externalising scale and 0.67 and 0.83 for Total Problems. Withdrawn/Depressed (15.6%, Thought Problems (12.5%, Aggressive Behaviour (9.4% and Oppositional Defiant Behaviour (9.4% were the commonly reported problems. Conclusion The Luganda version of the CBCL is a fairly reliable measure of behavioural problems in Ugandan children. Depressive and thought problems are likely behavioural outcomes of cerebral malaria in children. Further work in children with psychiatric diagnoses is required to test its validity in a clinical setting.

  8. Malaria.

    Science.gov (United States)

    Dupasquier, Isabelle

    1989-01-01

    Malaria, the greatest pandemia in the world, claims an estimated one million lives each year in Africa alone. While it may still be said that for the most part malaria is found in what is known as the world's poverty belt, cases are now frequently diagnosed in western countries. Due to resistant strains of malaria which have developed because of…

  9. A rapid murine coma and behavior scale for quantitative assessment of murine cerebral malaria.

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    Ryan W Carroll

    Full Text Available BACKGROUND: Cerebral malaria (CM is a neurological syndrome that includes coma and seizures following malaria parasite infection. The pathophysiology is not fully understood and cannot be accounted for by infection alone: patients still succumb to CM, even if the underlying parasite infection has resolved. To that effect, there is no known adjuvant therapy for CM. Current murine CM (MCM models do not allow for rapid clinical identification of affected animals following infection. An animal model that more closely mimics the clinical features of human CM would be helpful in elucidating potential mechanisms of disease pathogenesis and evaluating new adjuvant therapies. METHODOLOGY/PRINCIPAL FINDINGS: A quantitative, rapid murine coma and behavior scale (RMCBS comprised of 10 parameters was developed to assess MCM manifested in C57BL/6 mice infected with Plasmodium berghei ANKA (PbA. Using this method a single mouse can be completely assessed within 3 minutes. The RMCBS enables the operator to follow the evolution of the clinical syndrome, validated here by correlations with intracerebral hemorrhages. It provides a tool by which subjects can be identified as symptomatic prior to the initiation of trial treatment. CONCLUSIONS/SIGNIFICANCE: Since the RMCBS enables an operator to rapidly follow the course of disease, label a subject as affected or not, and correlate the level of illness with neuropathologic injury, it can ultimately be used to guide the initiation of treatment after the onset of cerebral disease (thus emulating the situation in the field. The RMCBS is a tool by which an adjuvant therapy can be objectively assessed.

  10. Inhibition of endothelial activation: a new way to treat cerebral malaria?

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    2005-09-01

    Full Text Available BACKGROUND: Malaria is still a major public health problem, partly because the pathogenesis of its major complication, cerebral malaria (CM, remains incompletely understood. However tumor necrosis factor (TNF is thought to play a key role in the development of this neurological syndrome, as well as lymphotoxin alpha (LT. METHODS AND FINDINGS: Using an in vitro model of CM based on human brain-derived endothelial cells (HBEC-5i, we demonstrate the anti-inflammatory effect of LMP-420, a 2-NH2-6-Cl-9-[(5-dihydroxyboryl-pentyl] purine that is a transcriptional inhibitor of TNF. When added before or concomitantly to TNF, LMP-420 inhibits endothelial cell (EC activation, i.e., the up-regulation of both ICAM-1 and VCAM-1 on HBEC-5i surfaces. Subsequently, LMP-420 abolishes the cytoadherence of ICAM-1-specific Plasmodium falciparum-parasitized red blood cells on these EC. Identical but weaker effects are observed when LMP-420 is added with LT. LMP-420 also causes a dramatic reduction of HBEC-5i vesiculation induced by TNF or LT stimulation, as assessed by microparticle release. CONCLUSION: These data provide evidence for a strong in vitro anti-inflammatory effect of LMP-420 and suggest that targeting host cell pathogenic mechanisms might provide a new therapeutic approach to improving the outcome of CM patients.

  11. Cerebrospinal fluid and serum biomarkers of cerebral malaria mortality in Ghanaian children

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    Wiredu Edwin K

    2007-11-01

    Full Text Available Abstract Background Plasmodium falciparum can cause a diffuse encephalopathy known as cerebral malaria (CM, a major contributor to malaria associated mortality. Despite treatment, mortality due to CM can be as high as 30% while 10% of survivors of the disease may experience short- and long-term neurological complications. The pathogenesis of CM and other forms of severe malaria is multi-factorial and appear to involve cytokine and chemokine homeostasis, inflammation and vascular injury/repair. Identification of prognostic markers that can predict CM severity will enable development of better intervention. Methods Postmortem serum and cerebrospinal fluid (CSF samples were obtained within 2–4 hours of death in Ghanaian children dying of CM, severe malarial anemia (SMA, and non-malarial (NM causes. Serum and CSF levels of 36 different biomarkers (IL-1β, IL-1ra, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12 (p70, IL-13, IL-15, IL-17, Eotaxin, FGF basic protein, CRP, G-CSF, GM-CSF, IFN-γ, TNF-α, IP-10, MCP-1 (MCAF, MIP-1α, MIP-1β, RANTES, SDF-1α, CXCL11 (I-TAC, Fas-ligand [Fas-L], soluble Fas [sFas], sTNF-R1 (p55, sTNF-R2 (p75, MMP-9, TGF-β1, PDGF bb and VEGF were measured and the results compared between the 3 groups. Results After Bonferroni adjustment for other biomarkers, IP-10 was the only serum biomarker independently associated with CM mortality when compared to SMA and NM deaths. Eight CSF biomarkers (IL-1ra, IL-8, IP-10, PDGFbb, MIP-1β, Fas-L, sTNF-R1, and sTNF-R2 were significantly elevated in CM mortality group when compared to SMA and NM deaths. Additionally, CSF IP-10/PDGFbb median ratio was statistically significantly higher in the CM group compared to SMA and NM groups. Conclusion The parasite-induced local cerebral dysregulation in the production of IP-10, 1L-8, MIP-1β, PDGFbb, IL-1ra, Fas-L, sTNF-R1, and sTNF-R2 may be involved in CM neuropathology, and their immunoassay may have potential utility in predicting

  12. Production, fate and pathogenicity of plasma microparticles in murine cerebral malaria.

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    Fatima El-Assaad

    2014-03-01

    Full Text Available In patients with cerebral malaria (CM, higher levels of cell-specific microparticles (MP correlate with the presence of neurological symptoms. MP are submicron plasma membrane-derived vesicles that express antigens of their cell of origin and phosphatidylserine (PS on their surface, facilitating their role in coagulation, inflammation and cell adhesion. In this study, the in vivo production, fate and pathogenicity of cell-specific MP during Plasmodium berghei infection of mice were evaluated. Using annexin V, a PS ligand, and flow cytometry, analysis of platelet-free plasma from infected mice with cerebral involvement showed a peak of MP levels at the time of the neurological onset. Phenotypic analyses showed that MP from infected mice were predominantly of platelet, endothelial and erythrocytic origins. To determine the in vivo fate of MP, we adoptively transferred fluorescently labelled MP from mice with CM into healthy or infected recipient mice. MP were quickly cleared following intravenous injection, but microscopic examination revealed arrested MP lining the endothelium of brain vessels of infected, but not healthy, recipient mice. To determine the pathogenicity of MP, we transferred MP from activated endothelial cells into healthy recipient mice and this induced CM-like brain and lung pathology. This study supports a pathogenic role for MP in the aggravation of the neurological lesion and suggests a causal relationship between MP and the development of CM.

  13. Malaria

    Science.gov (United States)

    ... and Prevention (CDC) web site for information about travel health concerns for international locations before you go. Prevention ... in the evening, when mosquitoes are typically more active. Medicine is also ... malaria? If you plan to travel to a country where malaria is common, you' ...

  14. Self-reactivities to the non-erythroid alpha spectrin correlate with cerebral malaria in Gabonese children.

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    Vincent Guiyedi

    Full Text Available BACKGROUND: Hypergammaglobulinemia and polyclonal B-cell activation commonly occur in Plasmodium sp. infections. Some of the antibodies produced recognize self-components and are correlated with disease severity in P. falciparum malaria. However, it is not known whether some self-reactive antibodies produced during P. falciparum infection contribute to the events leading to cerebral malaria (CM. We show here a correlation between self-antibody responses to a human brain protein and high levels of circulating TNF alpha (TNFalpha, with the manifestation of CM in Gabonese children. METHODOLOGY: To study the role of self-reactive antibodies associated to the development of P. falciparum cerebral malaria, we used a combination of quantitative immunoblotting and multivariate analysis to analyse correlation between the reactivity of circulating IgG with a human brain protein extract and TNFalpha concentrations in cohorts of uninfected controls (UI and P. falciparum-infected Gabonese children developing uncomplicated malaria (UM, severe non-cerebral malaria (SNCM, or CM. RESULTS/CONCLUSION: The repertoire of brain antigens recognized by plasma IgGs was more diverse in infected than in UI individuals. Anti-brain reactivity was significantly higher in the CM group than in the UM and SNCM groups. IgG self-reactivity to brain antigens was also correlated with plasma IgG levels and age. We found that 90% of CM patients displayed reactivity to a high-molecular mass band containing the spectrin non-erythroid alpha chain. Reactivity with this band was correlated with high TNFalpha concentrations in CM patients. These results strongly suggest that an antibody response to brain antigens induced by P. falciparum infection may be associated with pathogenic mechanisms in patients developing CM.

  15. Transdermal Glyceryl Trinitrate as an Effective Adjunctive Treatment with Artemether for Late-Stage Experimental Cerebral Malaria

    OpenAIRE

    Orjuela-Sánchez, Pamela; Ong, Peng Kai; Zanini, Graziela M.; Melchior, Benoît; Martins, Yuri C.; Meays, Diana; Frangos, John A.; Carvalho, Leonardo J. M.

    2013-01-01

    Cerebral malaria (CM) is associated with low nitric oxide (NO) bioavailability, cerebrovascular constriction, occlusion, and hypoperfusion. Administration of exogenous NO partially prevents the neurological syndrome and associated vascular pathology in an experimental CM (ECM) mouse model. In this study, we evaluated the effects of transdermal glyceryl trinitrate in preventing ECM and, in combination with artemether, rescuing late-stage ECM mice from mortality. The glyceryl trinitrate and/or ...

  16. Reduction of Experimental Cerebral Malaria and Its Related Proinflammatory Responses by the Novel Liposome-Based β-Methasone Nanodrug

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    Jintao Guo

    2014-01-01

    Full Text Available Cerebral malaria (CM is a severe complication of and a leading cause of death due to Plasmodium falciparum infection. CM is likely the result of interrelated events, including mechanical obstruction due to parasite sequestration in the microvasculature, and upregulation of Th1 immune responses. In parallel, blood-brain-barrier (BBB breakdown and damage or death of microglia, astrocytes, and neurons occurs. We found that a novel formulation of a liposome-encapsulated glucocorticosteroid, β-methasone hemisuccinate (nSSL-BMS, prevents experimental cerebral malaria (ECM in a murine model and creates a survival time-window, enabling administration of an antiplasmodial drug before severe anemia develops. nSSL-BMS treatment leads to lower levels of cerebral inflammation, expressed by altered levels of corresponding cytokines and chemokines. The results indicate the role of integrated immune responses in ECM induction and show that the new steroidal nanodrug nSSL-BMS reverses the balance between the Th1 and Th2 responses in malaria-infected mice so that the proinflammatory processes leading to ECM are prevented. Overall, because of the immunopathological nature of CM, combined immunomodulator/antiplasmodial treatment should be considered for prevention/treatment of human CM and long-term cognitive damage.

  17. Differential kinetics of plasma procalcitonin levels in cerebral malaria in urban Senegalese patients according to disease outcome

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    Babacar Mbengue

    2011-11-01

    Full Text Available P. falciparum malaria continues as the serial killer of over a million lives yearly, mainly for children in sub-Saharan Africa. For severe malaria, we are still on the quest for a prognostic marker of fatal outcome. We analysed the association between serum levels of Procalcitonin (PCT, a marker of septic inflammation, and clinical outcome in Senegalese patients admitted with confirmed cerebral malaria in the intensive care facility of Hopital Principal. A total of 98 patients living in the hypoendemic urban area of Dakar, Senegal, were enrolled during transmission seasons. Levels of PCT were compared between surviving vs the 26.5 % fatal cases in blood samples of the 3 days following hospitalisation. Mean PCT levels were elevated in patients with active infection, with a large range of values (0.1 to 280 nanog per mL, significantly higher on day 0 in fatal cases than in surviving (53.6 vs 27.3; P=0.01. No exact individual threshold level could indicate occurrence of fatality, however mortality could be most accurately predicted by PCT level above 69 nanog per ML and there was a very clear different profile of evolution of PCT levels on the 3 days of observation decreasing early from day 1 in surviving patients (P<10–3, contrary to fatal cases. These results indicate that PCT kinetic rather than intrinsic level could be of use to predict a reduced risk of fatality in patient with cerebral malaria and could serve as potential predicting marker for severe malaria.

  18. Study on the phenomenon of insulin resistance (IR) in patients with acute cerebral infarction

    International Nuclear Information System (INIS)

    Objective: To investigate the presence of insulin resistance (IR) in patients with cerebral infarction and the indication for insulin therapy. Methods: Fasting blood glucose (FPG) (with biochemistry), fasting serum insulin (FINS) and cortisol (with RIA) levels were measured in 50 patients with cerebral infarction and 80 controls. Insulin sensitivity index (ISI) was calculated and correlation with the score of neurologic impairment as well as the size of lesion was studied. Results: FPG, FINS and cortisol levels in the patients were significantly higher than those in the controls (P<0.001 ) while the ISI was significantly lower (P <0.001 ) than that in the controls. Levels of there parameters were significantly higher in patients with moderate-severe lesions than those in patients with only mild lesion (P<0.001, P<0.01, P<0.05 respectively). ISI was negatively correlated to the size of infarction (r=-0.313, P<0.05) and also to the score of neurologic impairment (r=-0.317, P<0.05). The mortality and morbidity in the moderate severe group were naturally higher than those in the mild group. Conclusion: Insulin resistance does exist during the acute stage of cerebral infarction. Degree of hyperinsulinaemia and severity of the resistance are related to the course and prognosis of the disease process. Insulin therapy should be considered in those patients with hyperglycemia. (authors)

  19. Real-time imaging reveals the dynamics of leukocyte behaviour during experimental cerebral malaria pathogenesis.

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    Saparna Pai

    2014-07-01

    Full Text Available During experimental cerebral malaria (ECM mice develop a lethal neuropathological syndrome associated with microcirculatory dysfunction and intravascular leukocyte sequestration. The precise spatio-temporal context in which the intravascular immune response unfolds is incompletely understood. We developed a 2-photon intravital microscopy (2P-IVM-based brain-imaging model to monitor the real-time behaviour of leukocytes directly within the brain vasculature during ECM. Ly6C(hi monocytes, but not neutrophils, started to accumulate in the blood vessels of Plasmodium berghei ANKA (PbA-infected MacGreen mice, in which myeloid cells express GFP, one to two days prior to the onset of the neurological signs (NS. A decrease in the rolling speed of monocytes, a measure of endothelial cell activation, was associated with progressive worsening of clinical symptoms. Adoptive transfer experiments with defined immune cell subsets in recombinase activating gene (RAG-1-deficient mice showed that these changes were mediated by Plasmodium-specific CD8(+ T lymphocytes. A critical number of CD8(+ T effectors was required to induce disease and monocyte adherence to the vasculature. Depletion of monocytes at the onset of disease symptoms resulted in decreased lymphocyte accumulation, suggesting reciprocal effects of monocytes and T cells on their recruitment within the brain. Together, our studies define the real-time kinetics of leukocyte behaviour in the central nervous system during ECM, and reveal a significant role for Plasmodium-specific CD8(+ T lymphocytes in regulating vascular pathology in this disease.

  20. Recombinant human erythropoietin increases survival and reduces neuronal apoptosis in a murine model of cerebral malaria

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    Hempel Casper

    2008-01-01

    Full Text Available Abstract Background Cerebral malaria (CM is an acute encephalopathy with increased pro-inflammatory cytokines, sequestration of parasitized erythrocytes and localized ischaemia. In children CM induces cognitive impairment in about 10% of the survivors. Erythropoietin (Epo has – besides of its well known haematopoietic properties – significant anti-inflammatory, antioxidant and anti-apoptotic effects in various brain disorders. The neurobiological responses to exogenously injected Epo during murine CM were examined. Methods Female C57BL/6j mice (4–6 weeks, infected with Plasmodium berghei ANKA, were treated with recombinant human Epo (rhEpo; 50–5000 U/kg/OD, i.p. at different time points. The effect on survival was measured. Brain pathology was investigated by TUNEL (Terminal deoxynucleotidyl transferase (TdT-mediated deoxyuridine triphosphate (dUTP-digoxigenin nick end labelling, as a marker of apoptosis. Gene expression in brain tissue was measured by real time PCR. Results Treatment with rhEpo increased survival in mice with CM in a dose- and time-dependent manner and reduced apoptotic cell death of neurons as well as the expression of pro-inflammatory cytokines in the brain. This neuroprotective effect appeared to be independent of the haematopoietic effect. Conclusion These results and its excellent safety profile in humans makes rhEpo a potential candidate for adjunct treatment of CM.

  1. Glatiramer acetate reduces the risk for experimental cerebral malaria: a pilot study

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    Helbok Raimund

    2009-02-01

    Full Text Available Abstract Background Cerebral malaria (CM is associated with high mortality and morbidity caused by a high rate of transient or persistent neurological sequelae. Studies on immunomodulatory and neuroprotective drugs as ancillary treatment in murine CM indicate promising potential. The current study was conducted to evaluate the efficacy of glatiramer acetate (GA, an immunomodulatory drug approved for the treatment of relapsing remitting multiple sclerosis, in preventing the death of C57Bl/6J mice infected with Plasmodium berghei ANKA. Methods and Results GA treatment led to a statistically significant lower risk for developing CM (57.7% versus 84.6% in treated animals. The drug had no effect on the course of parasitaemia. The mechanism of action seems to be an immunomodulatory effect since lower IFN-gamma levels were observed in treated animals in the early course of the disease (day 4 post-infection which also led to a lower number of brain sequestered leukocytes in treated animals. No direct neuro-protective effect such as an inhibition of apoptosis or reduction of micro-bleedings in the brain was found. Conclusion These findings support the important role of the host immune response in the pathophysiology of murine CM and might lead to the development of new adjunctive treatment strategies.

  2. Suppressor of cytokine signaling 2 modulates the immune response profile and development of experimental cerebral malaria.

    Science.gov (United States)

    Brant, Fatima; Miranda, Aline S; Esper, Lisia; Gualdrón-López, Melisa; Cisalpino, Daniel; de Souza, Danielle da Gloria; Rachid, Milene Alvarenga; Tanowitz, Herbert B; Teixeira, Mauro Martins; Teixeira, Antônio Lucio; Machado, Fabiana Simão

    2016-05-01

    Plasmodium falciparum infection results in severe malaria in humans, affecting various organs, including the liver, spleen and brain, and resulting in high morbidity and mortality. The Plasmodium berghei ANKA (PbA) infection in mice closely recapitulates many aspects of human cerebral malaria (CM); thus, this model has been used to investigate the pathogenesis of CM. Suppressor of cytokine signaling 2 (SOCS2), an intracellular protein induced by cytokines and hormones, modulates the immune response, neural development, neurogenesis and neurotrophic pathways. However, the role of SOCS2 during CM remains unknown. SOCS2 knockout (SOCS2(-/-)) mice infected with PbA show an initial resistance to infection with reduced parasitemia and production of TNF, TGF-β, IL-12 and IL-17 in the brain. Interestingly, in the late phase of infection, SOCS2(-/-) mice display increased parasitemia and reduced Treg cell infiltration, associated with enhanced levels of Th1 and Th17 cells and related cytokines IL-17, IL-6, and TGF-β in the brain. A significant reduction in protective neurotrophic factors, such as glial cell line-derived neurotrophic factor (GDNF) and brain-derived neurotrophic factor (BDNF), was also observed. Moreover, the molecular alterations in the brain of infected SOCS2(-/-) mice were associated with anxiety-related behaviors and cognition impairment. Mechanistically, these results revealed enhanced nitric oxide (NO) production in PbA-infected SOCS2(-/-) mice, and the inhibition of NO synthesis through l-NAME led to a marked decrease in survival, the disruption of parasitemia control and more pronounced anxiety-like behavior. Treatment with l-NAME also shifted the levels of Th1, Th7 and Treg cells in the brains of infected SOCS2(-/-) mice to the background levels observed in infected WT, with remarkable exception of increased CD8(+)IFN(+) T cells and inflammatory monocytes. These results indicate that SOCS2 plays a dual role during PbA infection, being detrimental

  3. Caring for children with cerebral malaria: insights gleaned from 20 years on a research ward in Malawi.

    Science.gov (United States)

    Taylor, Terrie E

    2009-04-01

    Clinicians treating patients with severe malaria in endemic areas confront a variety of challenges inherent to resource-poor settings, but it is possible to provide excellent care. The basic requirements, in addition to a thorough clinical examination of the patient, include assessing parasitaemia; determining anaemia (via haematocrit or haemoglobin); estimating blood glucose and lactate concentrations; establishing and maintaining i.v. access; measuring oxygen saturation and providing supplemental oxygen when necessary; grouping, cross-matching and transfusing blood. This paper provides practical information on determining the Blantyre Coma Score, collecting cerebrospinal fluid and measuring the opening pressure, and administering controlled volumes of i.v. fluids. Included is a narrative protocol describing the approach to patients with cerebral malaria used on the research ward at the Queen Elizabeth Central Hospital in Blantyre, Malawi. PMID:19128813

  4. Artemether and Artesunate Show the Highest Efficacies in Rescuing Mice with Late-Stage Cerebral Malaria and Rapidly Decrease Leukocyte Accumulation in the Brain▿

    OpenAIRE

    Clemmer, L.; Martins, Y. C.; Zanini, G. M.; Frangos, J. A.; Carvalho, L. J. M.

    2011-01-01

    The murine model of cerebral malaria (ECM) caused by Plasmodium berghei ANKA (PbA) infection in susceptible mice has been extensively used for studies of pathogenesis and identification of potential targets for human CM therapeutics. However, the model has been seldom explored to evaluate adjunctive therapies for this malaria complication. A first step toward this goal is to define a treatment protocol with an effective antimalarial drug able to rescue mice presenting late-stage ECM. We evalu...

  5. Specific depletion of Ly6C(hi inflammatory monocytes prevents immunopathology in experimental cerebral malaria.

    Directory of Open Access Journals (Sweden)

    Beatrix Schumak

    Full Text Available Plasmodium berghei ANKA (PbA infection of C57BL/6 mice leads to experimental cerebral malaria (ECM that is commonly associated with serious T cell mediated damage. In other parasitic infection models, inflammatory monocytes have been shown to regulate Th1 responses but their role in ECM remains poorly defined, whereas neutrophils are reported to contribute to ECM immune pathology. Making use of the recent development of specific monoclonal antibodies (mAb, we depleted in vivo Ly6C(hi inflammatory monocytes (by anti-CCR2, Ly6G+ neutrophils (by anti-Ly6G or both cell types (by anti-Gr1 during infection with Ovalbumin-transgenic PbA parasites (PbTg. Notably, the application of anti-Gr1 or anti-CCR2 but not anti-Ly6G antibodies into PbTg-infected mice prevented ECM development. In addition, depletion of Ly6C(hi inflammatory monocytes but not neutrophils led to decreased IFNγ levels and IFNγ+CD8+ T effector cells in the brain. Importantly, anti-CCR2 mAb injection did not prevent the generation of PbTg-specific T cell responses in the periphery, whereas anti-Gr1 mAb injection strongly diminished T cell frequencies and CTL responses. In conclusion, the specific depletion of Ly6C(hi inflammatory monocytes attenuated brain inflammation and immune cell recruitment to the CNS, which prevented ECM following Plasmodium infection, pointing out a substantial role of Ly6C+ monocytes in ECM inflammatory processes.

  6. Cannabidiol increases survival and promotes rescue of cognitive function in a murine model of cerebral malaria.

    Science.gov (United States)

    Campos, A C; Brant, F; Miranda, A S; Machado, F S; Teixeira, A L

    2015-03-19

    Cerebral malaria (CM) is a severe complication resulting from Plasmodium falciparum infection that might cause permanent neurological deficits. Cannabidiol (CBD) is a nonpsychotomimetic compound of Cannabis sativa with neuroprotective properties. In the present work, we evaluated the effects of CBD in a murine model of CM. Female mice were infected with Plasmodium berghei ANKA (PbA) and treated with CBD (30mg/kg/day - 3 or 7days i.p.) or vehicle. On 5th day-post-infection (dpi), at the peak of the disease), animals were treated with single or repeated doses of Artesunate, an antimalarial drug. All groups were tested for memory impairment (Novel Object Recognition or Morris Water Maze) and anxiety-like behaviors (Open field or elevated plus maze test) in different stages of the disease (at the peak or after the complete clearance of the disease). Th1/Th2 cytokines and neurotrophins (brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF)) were measured in the prefrontal cortex and hippocampus of experimental groups. PbA-infected mice displayed memory deficits and exhibited increase in anxiety-like behaviors on the 5dpi or after the clearance of the parasitemia, effects prevented by CBD treatment. On 5dpi, TNF-α and IL-6 increased in the hippocampus, while only IL-6 increased in the prefrontal cortex. CBD treatment resulted in an increase in BDNF expression in the hippocampus and decreased levels of proinflammatory cytokines in the hippocampus (TNF-α) and prefrontal cortex (IL-6). Our results indicate that CBD exhibits neuroprotective effects in CM model and might be useful as an adjunctive therapy to prevent neurological symptoms following this disease. PMID:25595981

  7. From METS to malaria: RRx-001, a multi-faceted anticancer agent with activity in cerebral malaria

    OpenAIRE

    Yalçın, Özlem; Oronsky, Bryan; Carvalho, Leonardo J. M.; Kuypers, Frans A.; Scicinski, Jan; Cabrales, Pedro

    2015-01-01

    Background: The survival of malaria parasites, under substantial haem-induced oxidative stress in the red blood cells (RBCs) is dependent on the pentose phosphate pathway (PPP). The PPP is the only source of NADPH in the RBC, essential for the production of reduced glutathione (GSH) and for protection from oxidative stress. Glucose-6-phosphate dehydrogenase (G6PD) deficiency, therefore, increases the vulnerability of erythrocytes to oxidative stress. In Plasmodium, G6PD is combined with the s...

  8. The plant-based immunomodulator curcumin as a potential candidate for the development of an adjunctive therapy for cerebral malaria

    Directory of Open Access Journals (Sweden)

    Taramelli Donatella

    2011-03-01

    Full Text Available Abstract The clinical manifestations of cerebral malaria (CM are well correlated with underlying major pathophysiological events occurring during an acute malaria infection, the most important of which, is the adherence of parasitized erythrocytes to endothelial cells ultimately leading to sequestration and obstruction of brain capillaries. The consequent reduction in blood flow, leads to cerebral hypoxia, localized inflammation and release of neurotoxic molecules and inflammatory cytokines by the endothelium. The pharmacological regulation of these immunopathological processes by immunomodulatory molecules may potentially benefit the management of this severe complication. Adjunctive therapy of CM patients with an appropriate immunomodulatory compound possessing even moderate anti-malarial activity with the capacity to down regulate excess production of proinflammatory cytokines and expression of adhesion molecules, could potentially reverse cytoadherence, improve survival and prevent neurological sequelae. Current major drug discovery programmes are mainly focused on novel parasite targets and mechanisms of action. However, the discovery of compounds targeting the host remains a largely unexplored but attractive area of drug discovery research for the treatment of CM. This review discusses the properties of the plant immune-modifier curcumin and its potential as an adjunctive therapy for the management of this complication.

  9. Erythropoietin Levels Increase during Cerebral Malaria and Correlate with Heme, Interleukin-10 and Tumor Necrosis Factor-Alpha in India

    Science.gov (United States)

    Dalko, Esther; Tchitchek, Nicolas; Pays, Laurent; Herbert, Fabien; Cazenave, Pierre-André; Ravindran, Balachandran; Sharma, Shobhona; Nataf, Serge; Das, Bidyut; Pied, Sylviane

    2016-01-01

    Cerebral malaria (CM) caused by Plasmodium falciparum parasites often leads to the death of infected patients or to persisting neurological sequelae despite anti-parasitic treatments. Erythropoietin (EPO) was recently suggested as a potential adjunctive treatment for CM. However diverging results were obtained in patients from Sub-Saharan countries infected with P. falciparum. In this study, we measured EPO levels in the plasma of well-defined groups of P. falciparum-infected patients, from the state of Odisha in India, with mild malaria (MM), CM, or severe non-CM (NCM). EPO levels were then correlated with biological parameters, including parasite biomass, heme, tumor necrosis factor (TNF)-α, interleukin (IL)-10, interferon gamma-induced protein (IP)-10, and monocyte chemoattractant protein (MCP)-1 plasma concentrations by Spearman’s rank and multiple correlation analyses. We found a significant increase in EPO levels with malaria severity degree, and more specifically during fatal CM. In addition, EPO levels were also found correlated positively with heme, TNF-α, IL-10, IP-10 and MCP-1 during CM. We also found a significant multivariate correlation between EPO, TNF-α, IL-10, IP-10 MCP-1 and heme, suggesting an association of EPO with a network of immune factors in CM patients. The contradictory levels of circulating EPO reported in CM patients in India when compared to Africa highlights the need for the optimization of adjunctive treatments according to the targeted population. PMID:27441662

  10. Endothelium-based biomarkers are associated with cerebral malaria in Malawian children: a retrospective case-control study.

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    Andrea L Conroy

    Full Text Available BACKGROUND: Differentiating cerebral malaria (CM from other causes of serious illness in African children is problematic, owing to the non-specific nature of the clinical presentation and the high prevalence of incidental parasitaemia. CM is associated with endothelial activation. In this study we tested the hypothesis that endothelium-derived biomarkers are associated with the pathophysiology of severe malaria and may help identify children with CM. METHODS AND FINDINGS: Plasma samples were tested from children recruited with uncomplicated malaria (UM; n = 32, cerebral malaria with retinopathy (CM-R; n = 38, clinically defined CM without retinopathy (CM-N; n = 29, or non-malaria febrile illness with decreased consciousness (CNS; n = 24. Admission levels of angiopoietin-2 (Ang-2, Ang-1, soluble Tie-2 (sTie-2, von Willebrand factor (VWF, its propeptide (VWFpp, vascular endothelial growth factor (VEGF, soluble ICAM-1 (sICAM-1 and interferon-inducible protein 10 (IP-10 were measured by ELISA. Children with CM-R had significantly higher median levels of Ang-2, Ang-2:Ang-1, sTie-2, VWFpp and sICAM-1 compared to children with CM-N. Children with CM-R had significantly lower median levels of Ang-1 and higher median concentrations of Ang-2:Ang-1, sTie-2, VWF, VWFpp, VEGF and sICAM-1 compared to UM, and significantly lower median levels of Ang-1 and higher median levels of Ang-2, Ang-2:Ang-1, VWF and VWFpp compared to children with fever and altered consciousness due to other causes. Ang-1 was the best discriminator between UM and CM-R and between CNS and CM-R (areas under the ROC curve of 0.96 and 0.93, respectively. A comparison of biomarker levels in CM-R between admission and recovery showed uniform increases in Ang-1 levels, suggesting this biomarker may have utility in monitoring clinical response. CONCLUSIONS: These results suggest that endothelial proteins are informative biomarkers of malarial disease severity. These results

  11. Complement factors C1q, C3 and C5 in brain and serum of mice with cerebral malaria

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    Helbok Raimund

    2008-10-01

    Full Text Available Abstract Background The patho-mechanisms leading to brain damage due to cerebral malaria (CM are yet not fully understood. Immune-mediated and ischaemic mechanisms have been implicated. The role of complement factors C1q, C3 and C5 for the pathogenesis of CM were investigated in this study. Methods C57BL/6J mice were infected with Plasmodium berghei ANKA blood stages. The clinical severity of the disease was assessed by a battery of 40 standardized tests for evaluating neurological functions in mice. Brain homogenates and sera of mice with CM, infected animals without CM and non-infected control animals were analyzed for C1q, C3 and C5 up-regulation by Western blotting. Results Densitometric analysis of Western blots of brain homogenates yielded statistically significant differences in the levels of C1q and C5 in the analyzed groups. Correlation analysis showed a statistically significant association of C1q and C5 levels with the clinical severity of the disease. More severely affected animals showed higher levels of C1q and C5. No differences in complement levels were observed between frontal and caudal parts of the brain. Densitometric analysis of Western blot of sera yielded statistically lower levels of C1q in infected animals without CM compared to animals of the control group. Conclusion The current study provides direct evidence for up-regulation of complement factors C1q and C5 in the brains of animals with CM. Local complement up-regulation is a possible mechanism for brain damage in experimental cerebral malaria.

  12. Low plasma concentrations of interleukin 10 in severe malarial anaemia compared with cerebral and uncomplicated malaria

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Adabayeri, V; Goka, B Q;

    1998-01-01

    BACKGROUND: Severe anaemia is a major complication of malaria but little is known about its pathogenesis. Experimental models have implicated tumour necrosis factor (TNF) in induction of bone-marrow suppression and eythrophagocytosis. Conversely, interleukin 10 (IL-10), which mediates feed-back r...

  13. Both functional LTbeta receptor and TNF receptor 2 are required for the development of experimental cerebral malaria.

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    Dieudonnée Togbe

    Full Text Available BACKGROUND: TNF-related lymphotoxin alpha (LTalpha is essential for the development of Plasmodium berghei ANKA (PbA-induced experimental cerebral malaria (ECM. The pathway involved has been attributed to TNFR2. Here we show a second arm of LTalpha-signaling essential for ECM development through LTbeta-R, receptor of LTalpha1beta2 heterotrimer. METHODOLOGY/PRINCIPAL FINDINGS: LTbetaR deficient mice did not develop the neurological signs seen in PbA induced ECM but died at three weeks with high parasitaemia and severe anemia like LTalphabeta deficient mice. Resistance of LTalphabeta or LTbetaR deficient mice correlated with unaltered cerebral microcirculation and absence of ischemia, as documented by magnetic resonance imaging and angiography, associated with lack of microvascular obstruction, while wild-type mice developed distinct microvascular pathology. Recruitment and activation of perforin(+ CD8(+ T cells, and their ICAM-1 expression were clearly attenuated in the brain of resistant mice. An essential contribution of LIGHT, another LTbetaR ligand, could be excluded, as LIGHT deficient mice rapidly succumbed to ECM. CONCLUSIONS/SIGNIFICANCE: LTbetaR expressed on radioresistant resident stromal, probably endothelial cells, rather than hematopoietic cells, are essential for the development of ECM, as assessed by hematopoietic reconstitution experiment. Therefore, the data suggest that both functional LTbetaR and TNFR2 signaling are required and non-redundant for the development of microvascular pathology resulting in fatal ECM.

  14. Protection against cerebral malaria by the low-molecular-weight thiol pantethine

    OpenAIRE

    Penet, Marie-France; Abou-Hamdan, Mhamad; Coltel, Nicolas; Cornille, Emilie; Grau, Georges E.; de Reggi, Max; Gharib, Bouchra

    2008-01-01

    We report that administration of the low-molecular-weight thiol pantethine prevented the cerebral syndrome in Plasmodium berghei ANKA-infected mice. The protection was associated with an impairment of the host response to the infection, with in particular a decrease of circulating microparticles and preservation of the blood–brain barrier integrity. Parasite development was unaffected. Pantethine modulated one of the early steps of the inflammation–coagulation cascade, i.e., the transbilayer ...

  15. The Effect of Annona Muricata Leaves Towards Blood Levels of Cxcl9 and Lymphoblast (Study in Cerebral Malaria Phase of Swiss Mice

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    Mohamed M.Y. Gadalla

    2015-09-01

    Full Text Available Cerebral malaria (CM forms part of the spectrum of severe malaria, with a case fatality rate ranging from 15% in adults in southeast Asia to 8.5% in children in Africa. A.Muricata was used to cure Malaria in traditional medicine. The research will examine the effect of it in the chemokine (C-X-C motif receptor 3 (CXCR3 binding chemokines, including chemokine (C-X-C motif ligand 4 (CXCL4, CXCL9. The intervented mice group were infected then the it’s spleen were cultured , incubation 72 hours and then analyzed the result. The CXCL9 level of PbA-infected mice treated with A. muricata are lower than group of infected mice without treatment. Lymphoblast level of PbA-infected mice treated with A. Muricata are higher than group of infected mice without treatment. A. Muricata treatment cure in the CM in the mice and may be a potential treatment in human CM.Cerebral malaria (CM adalah keadaan infeksi malaria yang berat dengan tingkat kefatalan dari 15% di Asia tenggara dan 8% di Afrika. A. Muricata secara tradisional dipakai mengobati CM. Riset ini meneliti pengaruh A. Muricata pada ikatan chemokine (C-X-C motif reseptor 3 (CXCR3termasuk chemokine (C-X-C motif ligand 4 (CXCL4 dan CXCL9. Kelompok mice intervensi diinfeksi dan limfanya di culture dalam inkubator 72 jam untuk dianalisis. Kadar PbA CXCL9 pada mencit intervensi yang diberi A. Muricata lebih rendah dari pada kontrol. Kadar PbA limfoblast intervensi lebihtinggi dari pada kontrol. A. Muricata memperbaiki CM pada mencit dan berpotensi sebagai pengobat pada CM manusia.

  16. Platelets alter gene expression profile in human brain endothelial cells in an in vitro model of cerebral malaria.

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    Mathieu Barbier

    Full Text Available Platelet adhesion to the brain microvasculature has been associated with cerebral malaria (CM in humans, suggesting that platelets play a role in the pathogenesis of this syndrome. In vitro co-cultures have shown that platelets can act as a bridge between Plasmodium falciparum-infected red blood cells (pRBC and human brain microvascular endothelial cells (HBEC and potentiate HBEC apoptosis. Using cDNA microarray technology, we analyzed transcriptional changes of HBEC in response to platelets in the presence or the absence of tumor necrosis factor (TNF and pRBC, which have been reported to alter gene expression in endothelial cells. Using a rigorous statistical approach with multiple test corrections, we showed a significant effect of platelets on gene expression in HBEC. We also detected a strong effect of TNF, whereas there was no transcriptional change induced specifically by pRBC. Nevertheless, a global ANOVA and a two-way ANOVA suggested that pRBC acted in interaction with platelets and TNF to alter gene expression in HBEC. The expression of selected genes was validated by RT-qPCR. The analysis of gene functional annotation indicated that platelets induce the expression of genes involved in inflammation and apoptosis, such as genes involved in chemokine-, TREM1-, cytokine-, IL10-, TGFβ-, death-receptor-, and apoptosis-signaling. Overall, our results support the hypothesis that platelets play a pathogenic role in CM.

  17. Protection from Experimental Cerebral Malaria with a Single Dose of Radiation-Attenuated, Blood-Stage Plasmodium berghei Parasites

    OpenAIRE

    Gerald, Noel J.; Majam, Victoria; Mahajan, Babita; Kozakai, Yukiko; Kumar, Sanjai

    2011-01-01

    Background Whole malaria parasites are highly effective in inducing immunity against malaria. Due to the limited success of subunit based vaccines in clinical studies, there has been a renewed interest in whole parasite-based malaria vaccines. Apart from attenuated sporozoites, there have also been efforts to use live asexual stage parasites as vaccine immunogens. Methodology and Results We used radiation exposure to attenuate the highly virulent asexual blood stages of the murine malaria par...

  18. IL-33-mediated protection against experimental cerebral malaria is linked to induction of type 2 innate lymphoid cells, M2 macrophages and regulatory T cells.

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    Anne-Gaelle Besnard

    2015-02-01

    Full Text Available Cerebral malaria (CM is a complex parasitic disease caused by Plasmodium sp. Failure to establish an appropriate balance between pro- and anti-inflammatory immune responses is believed to contribute to the development of cerebral pathology. Using the blood-stage PbA (Plasmodium berghei ANKA model of infection, we show here that administration of the pro-Th2 cytokine, IL-33, prevents the development of experimental cerebral malaria (ECM in C57BL/6 mice and reduces the production of inflammatory mediators IFN-γ, IL-12 and TNF-α. IL-33 drives the expansion of type-2 innate lymphoid cells (ILC2 that produce Type-2 cytokines (IL-4, IL-5 and IL-13, leading to the polarization of the anti-inflammatory M2 macrophages, which in turn expand Foxp3 regulatory T cells (Tregs. PbA-infected mice adoptively transferred with ILC2 have elevated frequency of M2 and Tregs and are protected from ECM. Importantly, IL-33-treated mice deleted of Tregs (DEREG mice are no longer able to resist ECM. Our data therefore provide evidence that IL-33 can prevent the development of ECM by orchestrating a protective immune response via ILC2, M2 macrophages and Tregs.

  19. Erythropoietin treatment alleviates ultrastructural myelin changes induced by murine cerebral malaria

    DEFF Research Database (Denmark)

    Hempel, Casper; Hyttel, Poul; Staalsø, Trine;

    2012-01-01

    , adjunctive therapy, which is not available at present. Previously, erythropoietin (EPO) was reported to significantly improve the survival and outcome in a murine CM model. The study objectives were to assess myelin thickness and ultrastructural morphology in the corpus callosum in murine CM and to adress...... for electron microscopy. Myelin sheaths in the corpus callosum were analysed with transmission electron microscopy and stereology. RESULTS: The infection caused clinical CM, which was counteracted by EPO. The total number of myelinated axons was identical in the four groups and mice with CM did not......, perivascular oedemas and intracerebral haemorrhages. CONCLUSIONS: EPO treatment reduced clinical signs of CM and reduced cerebral pathology. Murine CM does not reduce the general thickness of myelin sheaths in the corpus callosum....

  20. Increased concentrations of interleukin-6 and interleukin-1 receptor antagonist and decreased concentrations of beta-2-glycoprotein I in Gambian children with cerebral malaria

    DEFF Research Database (Denmark)

    Jakobsen, P H; McKay, V; Morris-Jones, S D; McGuire, W; van Hensbroek, M B; Meisner, S; Bendtzen, K; Schousboe, I; Bygbjerg, I C; Greenwood, B M

    1994-01-01

    To investigate the pathogenic versus the protective role of cytokines and toxin-binding factors in Plasmodium falciparum infections, we measured the concentrations of tumor necrosis factor alpha, interleukin-1 alpha (IL-1 alpha), IL-1 beta, IL-1 receptor antagonist, and IL-6, as well as soluble...... concentrations of anti-PI antibodies and the PI-binding serum protein beta-2-glycoprotein I. We found increased concentrations of IL-6, sIL-6R, IL-1ra, and some immunoglobulin M antibodies against PI in children with cerebral malaria, but those who died had decreased concentrations of beta-2-glycoprotein I. We...

  1. Study of the asymmetry phenomenon of cerebral medullary in MRI%脑回的不对称性MRI研究

    Institute of Scientific and Technical Information of China (English)

    贾彤彤

    2012-01-01

    目的 探讨脑结构MRI扫描图像的不对称性及其意义.方法 采用1.5T MRI仪对47名志愿者进行脑组织冠状面断层扫描,对各脑回的面积进行测量,比较左右侧各结构面积差异,并比较不同优势半球脑回结构的面积差异.结果 冠状面MRI扫描图像上,左右侧大脑额上回、额中回、额下回面积无明显差异,右侧颞上回面积大于左侧颞上回面积(P<0.05),不同优势半球额上回、额中回、额下回面积无明显差异,优势半球颞上回面积大于非优势半球颞上回面积(P<0.05).结论 大脑脑回在冠状面上结构存在着不对称现象,可能与其功能或某些脑部疾病的解剖学基础有关,揭示大脑空间结构的不均匀性.%Objective To Investigate the asymmetry of cerebral medullary substance In MRI scanlng image. Methods 47 volunteer were selected and taken scanning with 1.5T MRI in coronal plane, ihe area of cerebral convolution were measured, and were contrasted between left side and right side, between dominant hemisphere and no dominant hemisphere. Results In MRI Image of coronal plane, area of gyms frontalis superior, gyms frontalis medius, gyrus frontalis inferior was Identical between left side and right side, area of gyrus temporalis superior In right side was bigger than In left side (P < 0.05), area of gyrus frontalis superior, gyrus frontalis medius, gyrus frontalis Inferior was Identical between dominant hemisphere and no dominant hemisphere, area of gyrus temporalis superior In right was bigger In dominant hemisphere than In no dominant hemisphere (P < 0.05). Conclusion Image of cerebral convolution is asymmetry In coronal plane, which maybe Is anatomical foundation of function and disease In para encephalica .

  2. Neurological manifestations of malaria

    Directory of Open Access Journals (Sweden)

    Gustavo C. Román

    1992-03-01

    Full Text Available The involvement of the nervous system in malaria is reviewed in this paper. Cerebral malaria, the acute encephalopathy which complicates exclusively the infection by Plasmodium falciparum commonly affects children and adolescents in hyperendemic areas. Plugging of cerebral capillaries and venules by clumped, parasitized red cells causing sludging in the capillary circulation is one hypothesis to explain its pathogenesis. The other is a humoral hypothesis which proposes nonspecific, immune-mediated, inflammatory responses with release of vasoactive substances capable of producing endothelial damage and alterations of permeability. Cerebral malaria has a mortality rate up to 50%, and also a considerable longterm morbidity, particularly in children. Hypoglycemia, largely in patients treated with quinine, may complicate the cerebral symptomatology. Other central nervous manifestations of malaria include intracranial hemorrhage, cerebral arterial occlusion, and transient extrapyramidal and neuropsychiiatric manifestations. A self-limiting, isolated cerebellar ataxia, presumably caused by immunological mechanisms, in patients recovering from falciparum malaria has been recognized in Sri Lanka. Malaria is a common cause of febrile seizures in the tropics, and it also contributes to the development of epilepsy in later life. Several reports of spinal cord and peripheral nerve involvement are also available. A transient muscle paralysis resembling periodic paralysis during febrile episodes of malaria has been described in some patients. The pathogenesis of these neurological manifestations remains unexplored, but offers excellent perspectives for research at a clinical as well as experimental level.

  3. Pharmacologic inhibition of CXCL10 in combination with anti-malarial therapy eliminates mortality associated with murine model of cerebral malaria.

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    Nana O Wilson

    Full Text Available Despite appropriate anti-malarial treatment, cerebral malaria (CM-associated mortalities remain as high as 30%. Thus, adjunctive therapies are urgently needed to prevent or reduce such mortalities. Overproduction of CXCL10 in a subset of CM patients has been shown to be tightly associated with fatal human CM. Mice with deleted CXCL10 gene are partially protected against experimental cerebral malaria (ECM mortality indicating the importance of CXCL10 in the pathogenesis of CM. However, the direct effect of increased CXCL10 production on brain cells is unknown. We assessed apoptotic effects of CXCL10 on human brain microvascular endothelial cells (HBVECs and neuroglia cells in vitro. We tested the hypothesis that reducing overexpression of CXCL10 with a synthetic drug during CM pathogenesis will increase survival and reduce mortality. We utilized atorvastatin, a widely used synthetic blood cholesterol-lowering drug that specifically targets and reduces plasma CXCL10 levels in humans, to determine the effects of atorvastatin and artemether combination therapy on murine ECM outcome. We assessed effects of atorvastatin treatment on immune determinants of severity, survival, and parasitemia in ECM mice receiving a combination therapy from onset of ECM (day 6 through 9 post-infection and compared results with controls. The results indicate that CXCL10 induces apoptosis in HBVECs and neuroglia cells in a dose-dependent manner suggesting that increased levels of CXCL10 in CM patients may play a role in vasculopathy, neuropathogenesis, and brain injury during CM pathogenesis. Treatment of ECM in mice with atorvastatin significantly reduced systemic and brain inflammation by reducing the levels of the anti-angiogenic and apoptotic factor (CXCL10 and increasing angiogenic factor (VEGF production. Treatment with a combination of atorvastatin and artemether improved survival (100% when compared with artemether monotherapy (70%, p<0.05. Thus, adjunctively

  4. Managing malaria in the intensive care unit

    OpenAIRE

    Marks, M; Gupta-Wright, A.; Doherty, JF; Singer, M; Walker, D.

    2014-01-01

    The number of people travelling to malaria-endemic countries continues to increase, and malaria remains the commonest cause of serious imported infection in non-endemic areas. Severe malaria, mostly caused by Plasmodium falciparum, often requires intensive care unit (ICU) admission and can be complicated by cerebral malaria, respiratory distress, acute kidney injury, bleeding complications, and co-infection. The mortality from imported malaria remains significant. This article reviews the man...

  5. Systemic and cerebral vascular endothelial growth factor levels increase in murine cerebral malaria along with increased Calpain and caspase activity and can be reduced by erythropoietin treatment

    DEFF Research Database (Denmark)

    Hempel, Casper; Hoyer, Nils; Kildemoes, Anna;

    2014-01-01

    . Furthermore, we noticed increased caspase-3 and calpain activity in terminally ill mice, as measured by protease-specific cleavage of α-spectrin and p35. In conclusion, we detected increased cerebral and systemic VEGF as well as HIF-1α, which in the brain were reduced to normal in EPO-treated mice. Also...

  6. CD4+ natural regulatory T cells prevent experimental cerebral malaria via CTLA-4 when expanded in vivo.

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    Ashraful Haque

    Full Text Available Studies in malaria patients indicate that higher frequencies of peripheral blood CD4(+ Foxp3(+ CD25(+ regulatory T (Treg cells correlate with increased blood parasitemia. This observation implies that Treg cells impair pathogen clearance and thus may be detrimental to the host during infection. In C57BL/6 mice infected with Plasmodium berghei ANKA, depletion of Foxp3(+ cells did not improve parasite control or disease outcome. In contrast, elevating frequencies of natural Treg cells in vivo using IL-2/anti-IL-2 complexes resulted in complete protection against severe disease. This protection was entirely dependent upon Foxp3(+ cells and resulted in lower parasite biomass, impaired antigen-specific CD4(+ T and CD8(+ T cell responses that would normally promote parasite tissue sequestration in this model, and reduced recruitment of conventional T cells to the brain. Furthermore, Foxp3(+ cell-mediated protection was dependent upon CTLA-4 but not IL-10. These data show that T cell-mediated parasite tissue sequestration can be reduced by regulatory T cells in a mouse model of malaria, thereby limiting malaria-induced immune pathology.

  7. Malaria Research

    Science.gov (United States)

    ... Content Marketing Share this: Main Content Area Malaria Research NIAID Role in Malaria Research Basic Biology Prevention ... Labs​ Malaria Research Program Services for Researchers Featured Research Ancient Immune Mechanism Identified That Controls Malaria in ...

  8. Relapsing malaria infection acquired in Kenya.

    OpenAIRE

    Patterson, J E; Bia, F. J.; Miller, K.; McPhedran, P.

    1987-01-01

    An American physician-traveler to East Africa presented with manifestations of cerebral malaria and was treated with intravenous quinidine for chloroquine-resistant falciparum malaria. He later relapsed with Plasmodium ovale infection, despite previous primaquine therapy. Treatment of chloroquine-resistant malaria is discussed. The difficulty in diagnosing P. ovale infections and the predominance of this malaria species over P. vivax in East Africa are reviewed. Images FIG. 1 FIG. 2 FIG. 3

  9. Brain mitochondrial function in a murine model of cerebral malaria and the therapeutic effects of rhEPO

    DEFF Research Database (Denmark)

    Karlsson, Michael; Hempel, Casper; Sjövall, Fredrik;

    2013-01-01

    connection between disease severity and mitochondrial respiratory function. Treatment with rhEPO similarly had no effect on respiratory function. Thus cerebral metabolic dysfunction in CM does not seem to be directly linked to altered mitochondrial respiratory capacity as analyzed in brain homogenates ex...... cellular respiration of mitochondria. Recombinant human erythropoietin (rhEPO) is a promising new therapy that has been shown to reduce mortality in a mouse model of CM. In order to further elucidate the metabolic dysfunction in CM the objective of the present study was to assess brain mitochondrial...... respiratory function in CM with and without rhEPO treatment. The P. berghei ANKA - C57BL/6 murine model of CM was used. Mitochondrial respiration was analyzed in brain homogenates using high-resolution respirometry and a multiple substrate and inhibitor protocol. The animals were divided into four groups...

  10. Autopsy findings in severe malaria – a case report

    OpenAIRE

    Dedi Afandi; Budi Sampurna; Inge Sutanto; J. W. Marwoto; Nurjati Chairani; Sutisna Himawan; Rawina W; Ivan Riyanto

    2008-01-01

    Severe malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology. (Med J Indones 2008; 17: 210-5)Keywords: Plasmodium falciparum, cerebral malaria, black wate...

  11. Autopsy findings in severe malaria – a case report

    Directory of Open Access Journals (Sweden)

    Dedi Afandi

    2008-09-01

    Full Text Available Severe malaria, caused by Plasmodium falciparum infection, has a high mortality rate and is the main cause of death in malaria. Since clinical autopsy is unpopular in Indonesia, autopsy examination in malaria cases is rarely done. We reported a forty three year old woman from non endemic area that was dead because of severe malaria. Diagnosis was concluded from autopsy, histopathology, and toxicology. (Med J Indones 2008; 17: 210-5Keywords: Plasmodium falciparum, cerebral malaria, black water fever

  12. Clinical pattern of severe Plasmodium falciparum malaria in Sudan in an area characterized by seasonal and unstable malaria transmission

    DEFF Research Database (Denmark)

    Giha, H A; Elghazali, G; A-Elgadir, T M E;

    2005-01-01

    A hospital-based study was carried out in Gedarif town, eastern Sudan, an area of markedly unstable malaria transmission. Among the 2488 diagnosed malaria patients, 4.4% fulfilled the WHO criteria for severe malaria, and seven died of cerebral malaria. The predominant complication was severe...... malarial anemia (45.4%), followed by convulsions (21%), cerebral malaria (16. 4%) and hypotension (11.8%). Severe malaria was recognized in all age groups, but 44.5% of patients were aged 2 to 4 years. The mean ages of patients with severe anemia (5.6 years) and convulsions (5.9 years) were significantly...... lower than the mean ages of patients with cerebral malaria (14.1 years) or hypotension (35.2 years). Patients with convulsions and cerebral malaria had significantly higher mean parasite count (69972 and 56110 parasites/microL, respectively) than patients with severe anemia (24637 parasites/microL) or...

  13. Malaria and stroke: case report

    Directory of Open Access Journals (Sweden)

    LEOPOLDINO JOSÉ FÁBIO SANTOS

    1999-01-01

    Full Text Available Malaria is a parasitic disease with high prevalence in several regions of the world. Infestation by Plasmodium faciparum can, in some cases, affect the central nervous system producing encephalitis resulting in death or neurological sequelae. The mechanisms involved in the pathophysiology of the cerebral lesion are not totally clear and there are currently two theories (mechanical and humoral concerning this. We report a case of malaria with an atypical evolution, with a stroke lesion in the territory of the middle cerebral artery, with no association with encephalitis. We conclude that the mechanical theory is the one applicable to this patient.

  14. Malaria: toxins, cytokines and disease

    DEFF Research Database (Denmark)

    Jakobsen, P H; Bate, C A; Taverne, J;

    1995-01-01

    In this review the old concept of severe malaria as a toxic disease is re-examined in the light of recent discoveries in the field of cytokines. Animal studies suggest that the induction of TNF by parasite-derived molecules may be partly responsible for cerebral malaria and anemia, while...... hypoglycaemia may be due to direct effects of similar molecules on glucose metabolism. These molecules appear to be phospholipids and we suggest that when fully characterized they might form the basis of antitoxic therapy for malaria....

  15. Reversible suppression of bone marrow response to erythropoietin in Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Rodrigues, O; Addae, M;

    1997-01-01

    To study the importance of bone marrow inhibition in the pathogenesis of malarial anaemia, haematological and parasitological parameters were followed in patients with acute malaria. Three patient categories were studied, severe malarial anaemia (SA), cerebral malaria (CM) and uncomplicated malar...

  16. Raynaud's phenomenon

    DEFF Research Database (Denmark)

    Nielsen, S L; Christensen, N J; Olsen, N;

    1980-01-01

    forearm venous concentration of noradrenaline was lower and adrenaline concentration higher in the sympathectomized patients than in the other groups (p less than 0,05). Noradrenaline showed a significant increase during body cooling in normals and primary Raynaud's (p less than 0,05). There was no...... significant correlation between the vasoconstrictor response to cooling of a finger and the noradrenaline concentration probably due to the fact that skin vasoconstriction impeded release of noradrenaline from the skin. The relapse of Raynaud's phenomenon after surgically sufficient sympathectomy could not be...

  17. Analysis about treatment of children cerebral malaria with artemether unitied Quinimax%蒿甲醚联合Quinimax治疗小儿脑型疟疾33例分析

    Institute of Scientific and Technical Information of China (English)

    陈智; 欧维琳

    2009-01-01

    目的 探讨蒿甲醚联合Quinimax治疗小儿脑型疟疾的临床疗效.方法 将65例小儿脑型疟疾患儿随机分成治疗组和对照组,治疗组33例给予蒿甲醚联合Quinimax,对照组32例单用Quinimax治疗.结果 治疗组退热时间24h,对照组48h,差异有统计学意义(P<0.01);治疗组治愈率93.9%,对照组71.8%,差异有统计学意义(P<0.05);治疗组无1例发生不良反应,对照组不良反应发生率为31.25%;两组病死率和并发症差异无统计学意义.结论 蒿甲醚联合Quinimax治疗小儿脑型疟疾退热效果快,治愈率高,不良反应少.%Objective To evaluate the therapeutic effect of Artemether unitied Quinimax in 33 children cerebral malaria treatment. Methods 65 children cerebral malaria are divided into 2 random groups, one is treatment group, another is control group. The patients in treatment group is cured by artemether unitied Quinimax, another is cured by Quinimax. Results The antithermic time in treatment group is 24 hours, in control group is 48 hours. Their difference is statistics significance(P<0.01);The cure rate is 93.9% in treatment group, in control is 71.8%, their difference is statistics significance(P<0.05). In treatment group without patient occurred untoward effect,in control group the rate of untoward effect is 31.25%. The difference isn't statis-tics significance of mofiality and complication for 2 groups. Conclusion The antithermic time is fast in treating children cerebral maralia with artemether unitied Quinimax,and the cure rate is better,and untoward effect is lack.

  18. Raynaud's phenomenon.

    Science.gov (United States)

    Hughes, Michael; Herrick, Ariane L

    2016-02-01

    Raynaud's phenomenon (RP) is a major cause of pain and disability in patients with autoimmune connective tissue diseases (CTDs), particularly systemic sclerosis (SSc). The clinician must perform a comprehensive clinical assessment in patients with RP to differentiate between primary (idiopathic) and secondary RP, in particular (for rheumatologists), secondary to an autoimmune CTD, as both the prognosis and treatment may differ significantly. Key investigations are nailfold capillaroscopy and testing for autoantibodies (in particular, those associated with SSc). Patients with RP and either abnormal nailfold capillaroscopy or an SSc-specific antibody (and especially with both) have a high risk of transitioning to an autoimmune CTD. Both nailfold capillaroscopy and autoantibody specificity may help the clinician in predicting organ-based complications. The management of CTD-associated RP requires a multifaceted approach to treatment, including patient education and conservative ('non-drug') measures. Patients with CTD-associated RP often require pharmacological treatment, which in the first instance is usually a calcium channel blocker, although other agents can be used. There is an increasing tendency to use phosphodiesterase type 5 inhibitors early in the treatment of CTD-associated RP. Oral therapies are commonly associated with side effects (often due to systemic vasodilation) that may result in failure of dose escalation and/or permanent discontinuation. Intravenous prostanoid therapy and surgery (e.g., botulinum toxin injection and digital sympathectomy) can be considered in severe RP. Patients with CTD-associated RP can develop a number of ischaemic digital complications (primarily ulcers and critical ischaemia), which may be associated with significant tissue loss. Future research is required to increase the understanding of the pathogenesis and natural history of RP (to drive therapeutic advances), and to explore/develop drug therapies, including those that

  19. The recent malaria situation in Chittagong, Bangladesh.

    Science.gov (United States)

    Hussain, S M B; Rahman, M M; Ahmed, Z; Siddique, M M

    2003-01-01

    This is a retrospective study on 7,005 cases of malaria treated in a base hospital during the period 1998 to 2001. The aim of the study is to analyze the patterns, complications and mortality rates of malaria and its response to standard anti-malarial drugs. Diagnosis of malaria was made from identification of parasites on Giemsa stained thick and thin blood slides among the febrile cases and the clinical (unspecified) malaria was diagnosed as per WHO criteria. Malaria cases accounted for 136.17 per thousand-hospital admissions. Out of 7,005 malaria cases, 54.22% were falciparum, 26.18% were vivax and 12.02% were mixed infections. The most common complications of falciparum malaria were cerebral malaria (2.80%), malarial hepatitis (1.55%), acute pneumonia and/or pulmonary edema (0.22%), acute renal failure (0.13%), algid malaria (0.13%) and black water fever (0.06%). Most of the cases (66.98%) responded (S-response) well to chloroquine. Among the rest, 11.99% required quinine, 9.79% required artemether and 0.08% required both mefloquine and artemether. The total mortality rate was 0.30% but it was 9.25% and 6.17% among complicated malaria and cerebral malaria cases, respectively. Prognosis appeared better on early recognition of complications and initiation of prompt, effective treatment and adequate nursing care. Most mortality was due to complicated falciparum malaria and the emergence of drug resistance. PMID:19238662

  20. Malaria (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Malaria KidsHealth > For Parents > Malaria Print A A A ... Prevention Diagnosis and Treatment en español Malaria About Malaria Malaria is a common infection in hot, tropical ...

  1. Eradicating malaria.

    Science.gov (United States)

    Breman, Joel G

    2009-01-01

    The renewed interest in malaria research and control is based on the intolerable toll this disease takes on young children and pregnant women in Africa and other vulnerable populations; 150 to 300 children die each hour from malaria amounting to 1 to 2 million deaths yearly. Malaria-induced neurologic impairment, anemia, hypoglycemia, and low birth weight imperil normal development and survival. Resistance of Plasmodium falciparum to drugs and Anopheles mosquitoes to insecticides has stimulated discovery and development of artemisinin-based combination treatments (ACTs) and other drugs, long-lasting insecticide-treated bednets (with synthetic pyrethroids) and a search for non-toxic, long-lasting, affordable insecticides for indoor residual spraying (IRS). Malaria vaccine development and testing are progressing rapidly and a recombinant protein (RTS,S/AS02A) directed against the circumsporozoite protein is soon to be in Phase 3 trials. Support for malaria control, research, and advocacy through the Global Fund for HIV/AIDS, Tuberculosis and Malaria, the U.S. President's Malaria Initiative, the Bill & Melinda Gates Foundation, WHO and other organizations is resulting in decreasing morbidity and mortality in many malarious countries. Sustainability of effective programs through training and institution strengthening will be the key to malaria elimination coupled with improved surveillance and targeted research. PMID:19544698

  2. Malaria Matters

    Centers for Disease Control (CDC) Podcasts

    2008-04-18

    This podcast gives an overview of malaria, including prevention and treatment, and what CDC is doing to help control and prevent malaria globally.  Created: 4/18/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 4/18/2008.

  3. Transient alien limb phenomenon in right frontoparietal infarction

    OpenAIRE

    Panda Samhita

    2010-01-01

    Alien limb phenomenon is associated with different neurological disorders, such as stroke and corticobasal degeneration. It is usually caused by involvement of the corpus callosum, with or without the frontal regions. Rarely, it can result from insult in the posterior cerebral artery territory. Alien limb phenomenon is generally persistent. Here, an unusual case of transient alien hand phenomenon is reported.

  4. Transient alien limb phenomenon in right frontoparietal infarction

    Directory of Open Access Journals (Sweden)

    Panda Samhita

    2010-01-01

    Full Text Available Alien limb phenomenon is associated with different neurological disorders, such as stroke and corticobasal degeneration. It is usually caused by involvement of the corpus callosum, with or without the frontal regions. Rarely, it can result from insult in the posterior cerebral artery territory. Alien limb phenomenon is generally persistent. Here, an unusual case of transient alien hand phenomenon is reported.

  5. Orgasm Induced Seizures: A Rare Phenomenon.

    Science.gov (United States)

    Chaukimath, S P; Patil, P S

    2015-01-01

    A variety of stimuli can cause reflex seizures, Some triggers include light, music and cognitive phenomenon. There are case reports however where the phenomenon of sexual activity has been a trigger for epileptic seizures. Most of these cases reported are in women so far, and were found to be localized to right cerebral hemisphere. We report a case of a 36-year-old male with orgasm-induced seizures, with other atypical features compared to majority of previous reports. PMID:27057393

  6. Malaria and Travelers

    Science.gov (United States)

    ... a CDC Malaria Branch clinician. malaria@cdc.gov Malaria and Travelers Recommend on Facebook Tweet Share Compartir ... may be at risk for infection. Determine if malaria transmission occurs at the destinations Obtain a detailed ...

  7. Malaria Treatment (United States)

    Science.gov (United States)

    ... Malaria Branch clinician. malaria@cdc.gov Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version of Parts 1-3 ...

  8. STUDY OF RENAL FAILURE IN MALARIA

    Directory of Open Access Journals (Sweden)

    Girish Pamappa

    2016-01-01

    Full Text Available Renal failure is a serious complication of malaria, with a mortality of 14 to 33%. In view of the significant morbidity and mortality due to acute renal failure in malaria, there is need to identify patients at an early stage and to intensify care given to reduce morbidity and mortality. AIMS  To evaluate the clinical profile of Acute Renal Failure (ARF in malaria.  To evaluate the factors associated with adverse outcome, relation of severity of renal impairment on final outcome in patients with ARF due to malaria. MATERIAL AND METHODS This study was conducted at a tertiary care hospital over a period of 12 months. STUDY DESIGN  Type of study: Prospective Analytical, Observational Study.  Sample Size: 50 patients admitted to ICU, Kidney Unit, and the Medicine Wards with Malaria and ARF. Inclusion Criteria Clinically screened patients with evidence of malarial parasites in the blood smears or by antigen detection with clinical features or biochemical evidence of acute renal failure. Exclusion Criteria  Presence of any disease or condition leading to ARF or affecting the outcome of malarial ARF.  Other causes of Fever, Jaundice and Oliguria, like Leptospirosis, Dengue. METHODOLOGY Fifty patients who fulfilled the inclusion criteria were interrogated with regards to the complaints, clinical signs. Blood tests were sent on admission. Details were recorded as per the clinical proforma. The patients were followed until their discharge/death. RESULTS Oliguria was present in only 30% of patients. 30% of patients received haemodialysis. The mortality was 12% for severe renal failure. On Univariate analysis, Acidosis and Cerebral malaria were highly significant predictors of mortality. Other significant predictors were Renal failure, Oliguria, Shock, DIC, Hyperparasitemia, Leukocytosis (TLC. On Multivariate analysis, Oliguria, Cerebral malaria, Acidosis, Shock and two or more complications were the independent predictors of mortality

  9. What Is Raynaud's Phenomenon?

    Science.gov (United States)

    ... Phenomenon PDF Version Size: 59 KB November 2014 What Is Raynaud’s Phenomenon? Fast Facts: An Easy-to- ... use tools that vibrate, such as a jackhammer. What Are the Symptoms of Raynaud’s Phenomenon? The body ...

  10. Malaria vaccine.

    Science.gov (United States)

    1994-05-01

    Some have argued that the vaccine against malaria developed by Manuel Pattaroyo, a Colombian scientist, is being tested prematurely in humans and that it is unlikely to be successful. While the Pattaroyo vaccine has been shown to confer protection against the relatively mild malaria found in Colombia, doubts exist over whether it will be effective in Africa. Encouraging first results, however, are emerging from field tests in Tanzania. The vaccine triggered a strong new immune response, even in individuals previously exposed to malaria. Additional steps must be taken to establish its impact upon mortality and morbidity. Five major trials are underway around the world. The creator estimates that the first ever effective malaria vaccine could be available for widespread use within five years and he has no intention of securing a patent for the discovery. In another development, malaria specialists from 35 African countries convened at an international workshop in Zimbabwe to compare notes. Participants disparaged financial outlays for the fight against malaria equivalent to 2% of total AIDS funding as insufficient; noted intercountry differences in prevention, diagnosis, and treatment; and found information exchange between anglophone and francophone doctors to be generally poor. PMID:12287671

  11. Studying Different Clinical Syndromes Of Paediatric Severe Malaria Using Plasma Proteomics

    KAUST Repository

    Ramaprasad, Abhinay

    2012-08-01

    Background- Severe Plasmodium falciparum malaria remains one of the major causes of childhood morbidity and mortality in Africa. Severe malaria manifests itself as three main clinical syndromes-impaired consciousness (cerebral malaria), respiratory distress and severe malarial anaemia. Cerebral malaria and respiratory distress are major contributors to malaria mortality but their pathophysiology remains unclear. Motivation/Objectives- Most children with severe malaria die within the first 24 hours of admission to a hospital because of their pathophysiological conditions. Thus, along with anti-malarial drugs, various adjuvant therapies such as fluid bolus (for hypovolaemia) and anticonvulsants (for seizures) are given to alleviate the sick child’s condition. But these therapies can sometimes have adverse effects. Hence, a clear understanding of severe malaria pathophysiology is essential for making an informed decision regarding adjuvant therapies. Methodology- We used mass spectrometry-based shotgun proteomics to study plasma samples from Gambian children with severe malaria. We compared the proteomic profiles of different severe malaria syndromes and generated hypotheses regarding the underlying disease mechanisms. Results/Conclusions- The main challenges of studying the severe malaria syndromes using proteomics were the high complexity and variability among the samples. We hypothesized that hepatic injury and nitric oxide play roles in the pathophysiology of cerebral malaria and respiratory distress.

  12. Profile of acute severe malaria with hepatopathy

    Directory of Open Access Journals (Sweden)

    Aminul Khan

    2014-10-01

    Full Text Available Background: The single most dreaded complication in severe malaria is cerebral malaria, but extracerebral serious complications are becoming frequent in endemic areas, which include hepatic dysfunctions with jaundice. Materials and Methods: This prospective case series study was undertaken to observe the clinical profile in 81cases of complicated malaria presenting with jaundice out of 344 hospitalized patients diagnosed with acute severe malaria. Liver function tests were assessed and the patients were followed up to 4 weeks. Results: 85% cases with jaundice had Plasmodium falciparum (Pf infection. Significant findings included a predominantly hemolytic jaundice (mean bilirubin 7.6 mg%, unconjugated 4.83 mg%, conjugated 2.79 mg%, raised ALT > AST (mean 101.2 vs.74.7 iu and a mean prothrombin time of 3 sec > control. Acute renal failure was common (77%. No residual hepatic dysfunctions were detected in survivors on follow-up. Mortality was 10%, mostly due to delayed diagnosis and associated serious co-morbid conditions. Conclusion: Differentiating fulminant viral hepatitis with multi-organ failure and early treatment of associated complications are crucial to reduce mortality in malaria presenting with jaundice. Hemolytic jaundice with mild and relatively early reversibility of hepatocellular dysfunction usually points towards complicated Pf malaria. Histologically, there is mild hepatic derangement. Acute renal failure is commonly associated. Vivax malaria can also cause hepatic dysfunctions. Mere presence of jaundice does not increase mortality compared to those without jaundice

  13. Kompliceret malaria

    DEFF Research Database (Denmark)

    Rønn, A M; Bygbjerg, Ib Christian; Jacobsen, E

    1989-01-01

    An increasing number of cases of malaria, imported to Denmark, are caused by Plasmodium falciparum and severe and complicated cases are more often seen. In the Department of Infectious Diseases, Rigshospitalet, 23 out of 32 cases, hospitalized from 1.1-30.6.1988, i.e. 72%, were caused by P...

  14. Cerebral Hypoxia

    Science.gov (United States)

    ... Enhancing Diversity Find People About NINDS NINDS Cerebral Hypoxia Information Page Synonym(s): Hypoxia, Anoxia Table of Contents ( ... Trials Organizations Publicaciones en Español What is Cerebral Hypoxia? Cerebral hypoxia refers to a condition in which ...

  15. Translation as a psycholinguistic phenomenon.

    Science.gov (United States)

    Zasyekin, Serhiy

    2010-06-01

    The article sketches the outlines of a theoretical framework for the analysis of translation of literary texts, viewed as psycho-semiotic phenomenon and based on evaluation of earlier attempts in this direction, and on the results of a psycholinguistic empirical study of translations. Central to this framework is the recent insight that the human cerebral hemisphere functional asymmetry somehow plays a role in structuring the fictional text by its author and in its processing by the interpreter. It is argued that the texts of modernism and post-modernism contain information blocks describing a character's perception of events in altered states of consciousness. This model helps to explain how a translator's inappropriate linguistic choice may influence the target language reader's aesthetic reaction. PMID:19894118

  16. [Current malaria situation in Turkmenistan].

    Science.gov (United States)

    Amangel'diev, K A

    2001-01-01

    from tertian malaria, which is the most dangerous from the epidemiological point of view since the main vectors in Turkmenistan, are highly susceptible to P. vivax infection. The particular dangerous phenomenon is the higher incidence of imported tertian malaria in rural areas where sick people and those who carry the parasite come into close contact with highly susceptible vectors. Thus, the risk that new malaria outbreaks will occur and the disease will become reestablished in the country is very high. It is also influenced by major changes in water use in the country, which have aggravated the mosquito situation. In the area around the Karakum canal and river basins, 17 large reservoirs have been constructed, with very extensive filtration ponds around them, which have become breeding ground's for malaria mosquitoes. There are 1219 water areas without any economic significance in the country, covering a total area of 1054 ha, which require regular treatment with insecticides. With assistance from the WHO European Regional Office, Dr. Guido Sabatinelli in particular, Turkmenistan has developed a plan for preventive malaria control measures for 1999-2001, which has been approved in a decree issued by the Ministry of Health and Medical Industry. The material support received has made it possible to provide large-scale prophylaxis for people who suffered from malaria in 1997-1999, seasonal treatment for people living near the active foci of the disease and interseasonal prophylaxis for people visiting these areas. Seasonal treatment with Dellaguil was made in 4,590 people living in the active foci of malaria infection, and 2,281 fixed-term military personnel belonging to the units stationed in the active foci of malaria infection. In all foci of infection, every person with malaria or carrying the parasite underwent epidemiological investigation and all cases were entered in health clinic records. In 1999, four seminars were held to train 75 specialists from all

  17. Acute cerebellar ataxia: A neurological manifestation in malaria

    Directory of Open Access Journals (Sweden)

    Peddametla Shravan Kumar

    2014-01-01

    Full Text Available Malaria is a vector-borne disease transmitted by the bite of an infected female anopheles mosquito presents with varied clinical manifestations. Neurological manifestations include headaches, confusion, convulsions, hemiplegia, ataxia, cerebral palsy, cortical blindness, and Guillain-Barre syndrome (GBS. We are presenting a case report of acute cerebellar ataxia in a 20-year-old male patient who presented with fever and positive for Plasmodium vivax and Plasmodium falciparum malaria antibodies.

  18. Rapid reemergence of T cells into peripheral circulation following treatment of severe and uncomplicated Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Hviid, L; Kurtzhals, J A; Goka, B Q;

    1997-01-01

    Frequencies and absolute numbers of peripheral T-cell subsets were monitored closely following acute Plasmodium falciparum malaria in 22 Ghanaian children from an area of hyperendemicity for seasonal malaria transmission. The children presented with cerebral or uncomplicated malaria (CM or UM, re...

  19. Nanotechnology applied to the treatment of malaria.

    Science.gov (United States)

    Santos-Magalhães, Nereide Stela; Mosqueira, Vanessa Carla Furtado

    2010-03-18

    Despite the fact that we live in an era of advanced technology and innovation, infectious diseases, like malaria, continue to be one of the greatest health challenges worldwide. The main drawbacks of conventional malaria chemotherapy are the development of multiple drug resistance and the non-specific targeting to intracellular parasites, resulting in high dose requirements and subsequent intolerable toxicity. Nanosized carriers have been receiving special attention with the aim of minimizing the side effects of drug therapy, such as poor bioavailability and the selectivity of drugs. Several nanosized delivery systems have already proved their effectiveness in animal models for the treatment and prophylaxis of malaria. A number of strategies to deliver antimalarials using nanocarriers and the mechanisms that facilitate their targeting to Plasmodium spp.-infected cells are discussed in this review. Taking into account the peculiarities of malaria parasites, the focus is placed particularly on lipid-based (e.g., liposomes, solid lipid nanoparticles and nano and microemulsions) and polymer-based nanocarriers (nanocapsules and nanospheres). This review emphasizes the main requirements for developing new nanotechnology-based carriers as a promising choice in malaria treatment, especially in the case of severe cerebral malaria. PMID:19914313

  20. The Impact of Genetic Susceptibility to Systemic Lupus Erythematosus on Placental Malaria in Mice

    OpenAIRE

    Waisberg, Michael; Lin, Christina K.; Huang, Chiung-Yu; Pena, Mirna; Orandle, Marlene; Bolland, Silvia; Pierce, Susan K.

    2013-01-01

    Severe malaria, including cerebral malaria (CM) and placental malaria (PM), have been recognized to have many of the features of uncontrolled inflammation. We recently showed that in mice genetic susceptibility to the lethal inflammatory autoimmune disease, systemic lupus erythematosus (SLE), conferred resistance to CM. Protection appeared to be mediated by immune mechanisms that allowed SLE-prone mice, prior to the onset of overt SLE symptoms, to better control their inflammatory response to...

  1. Renal failure in malaria

    OpenAIRE

    B.S. Das

    2008-01-01

    Acute renal failure (ARF) is seen mostly in Plasmodium falciparum infection, but P. vivax and P. malariae can occasionally contribute for renal impairment. Malarial ARF is commonly found in non-immune adults and older children with falciparum malaria. Occurance of ARF in severe falciparum malaria is quite common in southeast Asia and Indian subcontinent where intensity of malaria transmission is usually low with occasional microfoci of intense transmission. Since precise mechanism of malaria...

  2. Prophylaxis of Malaria

    OpenAIRE

    Schwartz, Eli

    2012-01-01

    Malaria prevention in travelers to endemic areas remains dependent principally on chemoprophylaxis. Although malaria chemoprophylaxis refers to all malaria species, a distinction should be drawn between falciparum malaria prophylaxis and the prophylaxis of the relapsing malaria species (vivax & ovale). While the emergence of drug resistant strains, as well as the costs and adverse reactions to medications, complicate falciparum prophylaxis use, there are virtually no drugs available for vivax...

  3. Malaria zoonoses.

    Science.gov (United States)

    Baird, J Kevin

    2009-09-01

    The genus Plasmodium includes many species that naturally cause malaria among apes and monkeys. The 2004 discovery of people infected by Plasmodium knowlesi in Malaysian Borneo alerted to the potential for non-human species of plasmodia to cause human morbidity and mortality. Subsequent work revealed what appears to be a surprisingly high risk of infection and relatively severe disease, including among travelers to Southeast Asia. The biology and medicine of this zoonosis is reviewed here, along with an examination of the spectrum of Plasmodium species that may cause infection of humans. PMID:19747661

  4. Tuberculoma cerebral Cerebral tuberculoma

    OpenAIRE

    ELIZABETH CLARA BARROSO; TÂNIA REGINA BRÍGIDO DE OLIVEIRA; ANA MARIA DANTAS DO AMARAL; VALÉRIA GÓES FERREIRA PINHEIRO; ANA LÚCIA DE OLIVEIRA SOUSA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  5. The Lazarus phenomenon.

    Science.gov (United States)

    Sahni, Vaibhav

    2016-08-01

    The Lazarus phenomenon or the unassisted return of spontaneous circulation after cardiac arrest is a grossly underreported phenomenon in medical literature which essentially implies the 'resurrection' of an individual after cardiac arrest. Although there have been a handful of such cases reported, the clinical incidence and significance may be underestimated. Because of the presumed infrequency of this condition, there are no studies specifically researching Lazarus phenomenon in scientific literature. This review intends to systematically present current and past knowledge on this rare but definitive phenomenon. Research databases namely Google Scholar, Science Direct, Medline and PubMed were utilized. Only articles which identified cases where the return of spontaneous circulation occurred after cessation of Cardiopulmonary Resuscitation (CPR), and review articles on the entity were included. The mentioned databases were searched using the terms 'Lazarus phenomenon', 'cardiopulmonary resuscitation' and 'return of spontaneous circulation'. A literature review was synthesised based on articles meeting the eligibility criteria to better understand the phenomenon of return of spontaneous circulation. PMID:27540490

  6. Clinical Profile and Outcome of Complicated Plasmodium falciparum Malaria

    Directory of Open Access Journals (Sweden)

    Virendra C patil

    2012-01-01

    Full Text Available Context: Complicated Plasmodium falciparum Malaria is a syndrome and a disease of protean, clinical manifestations including jaundice, ARF, ARDS and multi-organ failure. Aims: The objectives of the present study are to study clinical features, complications and factors affecting outcome of patients with complicated P. falciparum Malaria. Settings and Design: This retrospective descriptive study was conducted at tertiary care centre in western Maharashtra from January 2010 to December 2010. Methods and Material: Total 73 patients with complicated P. falciparum malaria who presented with fever having positive trophozoites of P. falciparum in blood smear were included. SPSS (version-10 software was used for all statistical calculations. Results: A total 73 patients had complicated P. falciparum malaria with 52 were males and 21 were female patients. Total 9 (12.32 % patients were presented with shock as a presenting feature. Four (5.47 % patients had hypoglycaemia at the time of admission. Total 43 (58.90 % patients had jaundice, 37 (50.68 % had anaemia, 28 (38.35 % had cerebral malaria, 7 (9.58 % had acute renal failure, 5 (6.84 % had ARDS and 5 (6.84 % had thrombocytopenia. Total 46 patients had single complication in the form of cerebral malaria 14 (19.17 %, jaundice 15 (20.54 % and anaemia 16 (21.91 %. Total 14 patients had two complications in the form of jaundice with ARF 02 (2.73 % with one (50 % death and jaundice with anaemia 12 (16.43 %. Total 9 (12.32 % patients had three complications in the form of cerebral malaria with jaundice with anaemia with 3 deaths (33.33 %. Total 5 (6.84 % patients had multiple complications in the form of cerebral malaria with ARF with ARDS with thrombocytopenia with 4 (80 % death. Case fatality rate was 10.95 %. The case fatality rate with ARDS was 80 % (4/5, with ARF was 57.14 % (4/7 and with cerebral malaria it was 25 % (7/28. Case fatality rate was highest in patients with pulmonary complication (ARDS

  7. Cerebral Palsy

    Science.gov (United States)

    Cerebral palsy is a group of disorders that affect a person's ability to move and to maintain balance ... do not get worse over time. People with cerebral palsy may have difficulty walking. They may also have ...

  8. Cerebral hemodynamics in moyamoya disease

    International Nuclear Information System (INIS)

    Rebuild-up phenomenon, an electroencephalographic pathological finding in moyamoya disease, was evaluated in the context of dynamic changes in cerebral circulation after hyperventilation. Sequential functional angiography after hyperventilation, measurement of cerebral blood flow (CBF) by the outflow method, and Kr-81m single photon emission tomography were employed for clarification of the sequential dynamic changes in cerebral circulation after hyperventilation. In most cases there was a persistent decrease in CBF even after arterial carbon dioxide tension (PaCO2) had been normalized, which suggests that the response of the cerebral circulation to the changes in PaCO2 is delayed. Moreover, this feature was most prominent in the superficial layer of the cerebrum. For the most part, coincidence and synchronization were documented between rebuild-up and the delayed response of the cerebral circulation. These findings indicate that the delayed CBF response to hyperventilation contributes pathogenetically to rebuild-up in moyamoya disease. (author)

  9. Concurrent dengue and malaria in an area in Kolkata

    Institute of Scientific and Technical Information of China (English)

    Amiya Kumar Hati; Indranil Bhattacharjee; Hiranmoy Mukherjee; Bhaswati Bandyopadhayay; Deban Bandyopadhyay; Rajyasree De; Goutam Chandra

    2012-01-01

    ABSTRACT Objective:To establish the nature and extent of dual dengue and malaria infections in an endemic area through a longitudinal study.Methods: A prospective study was conducted from August2005to December2010to document the nature and extent of concurrent dengue and malaria infections in an area in central Kolkata, endemic both for dengue and malaria.Results:Of2 971 suspected cases of dengue fever, in605 (20.36%)persons dengue infection was detected, of whom46 (7.60%, 46/605)patients (40 and6suffered from secondary and primary dengue fever respectively) were simultaneously suffering from malaria (28 and18 were infected with Plasmodium vivax (P.vivax) andPlasmodium falciparum (P. falciparum) respectively, such dual infections of dengue and malaria were detected in all the years of the study period, except 2007, indicating intense transmission of both dengue and malaria in the study area, and the phenomenon was not an isolated one, the rate of concomitant infections ranged from25% in2009 to4.9% in 2005. Out of total population surveyed,1.54% (46/2 971)had concurrent dengue and malaria infection.Conclusions: These findings added a new dimension in diagnosis, treatment, epidemiology and control of dengue and malaria. The possible risk of concurrent dengue and malaria infections should always be kept in mind in endemic areas for early diagnosis employing modern technology and prompt and effective treatment to avoid serious complications.

  10. The Lazarus phenomenon

    Science.gov (United States)

    2016-01-01

    The Lazarus phenomenon or the unassisted return of spontaneous circulation after cardiac arrest is a grossly underreported phenomenon in medical literature which essentially implies the ‘resurrection’ of an individual after cardiac arrest. Although there have been a handful of such cases reported, the clinical incidence and significance may be underestimated. Because of the presumed infrequency of this condition, there are no studies specifically researching Lazarus phenomenon in scientific literature. This review intends to systematically present current and past knowledge on this rare but definitive phenomenon. Research databases namely Google Scholar, Science Direct, Medline and PubMed were utilized. Only articles which identified cases where the return of spontaneous circulation occurred after cessation of Cardiopulmonary Resuscitation (CPR), and review articles on the entity were included. The mentioned databases were searched using the terms ‘Lazarus phenomenon’, ‘cardiopulmonary resuscitation’ and ‘return of spontaneous circulation’. A literature review was synthesised based on articles meeting the eligibility criteria to better understand the phenomenon of return of spontaneous circulation.

  11. Cerebral Atrophy

    Science.gov (United States)

    ... Alzheimer’s disease, Pick’s disease, and fronto-temporal dementia cerebral palsy , in which lesions (damaged areas) may impair motor ... lead to cerebral atrophy. NIH Patient Recruitment for Cerebral Atrophy Clinical Trials ... by: Office of Communications and Public Liaison National Institute of Neurological Disorders ...

  12. Vaccines Against Malaria

    OpenAIRE

    Ouattara, Amed; Laurens, Matthew B.

    2014-01-01

    No licensed malaria vaccine currently exists; however, final phase 3 testing results of a leading candidate vaccine are forthcoming. Continued challenges to malaria vaccine developers include genetically diverse strains found in nature and establishment of a vaccine correlate of protection.

  13. Haptoglobin 1-1 is associated with susceptibility to severe Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Quaye, I K; Ekuban, F A; Goka, B Q;

    2000-01-01

    The haptoglobin (Hp) phenotypes were determined by polyacrylamide-gel electrophoresis in plasma samples obtained in 1997 from 113 Plasmodium falciparum malaria patients (aged 1-12 years) with strictly defined cerebral malaria, severe malarial anaemia, or uncomplicated malaria and 42 age......). No significant difference in frequency of Hp0 was observed between patients and controls. Among the malaria patients, the Hp1-1 phenotype was significantly more prevalent among patients with the complications of cerebral malaria and severe anaemia compared to patients with uncomplicated disease......, whereas the reverse was seen with respect to Hp2-1 and Hp2-2. Our data suggest that the Hp1-1 phenotype is associated with susceptibility to P. falciparum malaria in general, and to the development of severe disease in particular....

  14. Sri Lanka Malaria Maps

    OpenAIRE

    Hoek Wim; Gunawardena Dissanayake M; Briët Olivier JT; Amerasinghe Felix P

    2003-01-01

    Abstract Background Despite a relatively good national case reporting system in Sri Lanka, detailed maps of malaria distribution have not been publicly available. Methods In this study, monthly records over the period 1995 – 2000 of microscopically confirmed malaria parasite positive blood film readings, at sub-district spatial resolution, were used to produce maps of malaria distribution across the island. Also, annual malaria trends at district resolution were displayed for the period 1995 ...

  15. Malaria og graviditet

    DEFF Research Database (Denmark)

    Hoffmann, A L; Rønn, A M; Langhoff-Roos, J;

    1992-01-01

    protection against malaria and insect repellents. As a rule, malaria is treated with chloroquine. In cases of Falciparum malaria in whom chloroquine resistance is suspected, treatment with mefloquine may be employed although this should only be employed in cases of dire necessity in pregnant patients during...

  16. Mask Phenomenon in Communication

    Institute of Scientific and Technical Information of China (English)

    郎丽璇

    2013-01-01

    People sometimes wear masks. Abusive expression may be used to convey love while polite words can be exchanged among enemies. This essay describes and discusses this special phenomenon in communication and analyzes the elements that con-tribute to the success of a mask communication.

  17. What Is Raynaud's Phenomenon?

    Science.gov (United States)

    ... is most common in:  Women.  People living in cold places. The secondary form tends to start after age 35 to 40. ... may be more likely to get the secondary form:  Workers who are around ... Phenomenon? The body saves heat when it is cold by slowing the supply of blood to the ...

  18. Distinct patterns of cytokine regulation in discrete clinical forms of Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Akanmori, B D; Kurtzhals, J A; Goka, B Q;

    2000-01-01

    The pathogenesis of two of the most severe complications of Plasmodium falciparum malaria, cerebral malaria (CM) and severe malarial anaemia (SA) both appear to involve dysregulation of the immune system. We have measured plasma levels of TNF and its two receptors in Ghanaian children with strict...

  19. Molecular architecture of a complex between an adhesion protein from the malaria parasite and intracellular adhesion molecule 1

    DEFF Research Database (Denmark)

    Brown, Alan; Turner, Louise; Christoffersen, Stig;

    2013-01-01

    The adhesion of Plasmodium falciparum-infected erythrocytes to human tissues or endothelium is central to the pathology caused by the parasite during malaria. It contributes to the avoidance of parasite clearance by the spleen and to the specific pathologies of cerebral and placental malaria. The...

  20. Dendritic cell function and antigen presentation in malaria.

    Science.gov (United States)

    Cockburn, Ian A; Zavala, Fidel

    2016-06-01

    Due to the diverse roles T cells play in protection against malaria as well as pathogenesis it is critical to know which cells present antigen and the nature of the antigens they present. During pre-erythrocytic stages of infection, cutting-edge imaging studies have shown how Plasmodium antigens are presented during both the priming and effector phases of the protective CD8+ T cell response. During blood stages, pathology is in part due to the loss of DC function and the action of pathogenic T cells in the brain. Recently endothelial cells presenting malaria antigen to cognate T cells have emerged as critical players in malaria pathogenesis. Manipulating these processes may inform both vaccine design and the development of therapies for cerebral malaria. PMID:26845735

  1. Synchronization: The ratchet phenomenon

    International Nuclear Information System (INIS)

    In this paper some simple models of coupled oscillators are defined. They are used as tools to analyze properties of synchronization domains. It is possible to get the general organization of these domains (generally known as tongues), particularly when the coupling or the forcing signal is 'square'. At large forcing a phenomenon, very similar to the ratchet wheel mechanism, takes place and many synchronization domains disappear. Generally the tongue associated with the relative winding number 1/1 becomes predominant and only tongues with relative winding number p/q < 1 remain. This phenomenon is rather general and appears in many real situations. It is related with motion and transport in physical and biological sciences.

  2. The Laurent phenomenon

    OpenAIRE

    Fomin, Sergey; Zelevinsky, Andrei

    2001-01-01

    A composition of birational maps given by Laurent polynomials need not be given by Laurent polynomials; however, sometimes---quite unexpectedly---it does. We suggest a unified treatment of this phenomenon, which covers a large class of applications. In particular, we settle in the affirmative a conjecture of D.Gale and R.Robinson on integrality of generalized Somos sequences, and prove the Laurent property for several multidimensional recurrences, confirming conjectures by J.Propp, N.Elkies, ...

  3. [Lazarus phenomenon: spontaneous resuscitation].

    Science.gov (United States)

    Casielles García, J L; González Latorre, M V; Fernández Amigo, N; Guerra Vélz, A; Cotta Galán, M; Bravo Capaz, E; de las Mulas Béjar, M

    2004-01-01

    A 94-year-old woman undergoing surgery for simple repair of a duodenal perforation experienced a sudden massive hemorrhage (1500 mL) when the duodenum was separated from adjacent structures. Hemodynamic stability was re-established when fluids were replaced. After the abdominal wall was closed, increased amplitude of the QRS wave was observed and heart rate slowed until there was no pulse. Electromechanical dissociation (EMD) was diagnosed and cardiopulmonary resuscitation was started. When EMD persisted after 40 minutes, resuscitative measures were stopped and the ventilator was disconnected, though orotracheal intubation and arterial and electrocardiographic monitoring were maintained. After 2 or 3 minutes, heart rhythm restarted spontaneously and arterial pressure waves reappeared on the monitor. The patient progressed well for 72 hours, after which she developed septic shock and multiorgan failure, dying 18 days later. The Lazarus phenomenon may be more common than the medical literature would indicate, possibly because a large gap in our understanding of the pathophysiology of the phenomenon underlies anecdotes about "miracles". As we wait for adequate international consensus on a protocol for monitoring the withdrawal of resuscitative measures, we should act prudently before definitively certifying death. The case we report occurred during a surgical intervention in which the patient had received general anesthesia. We believe that the causes that might explain the Lazarus phenomenon are quite different in that context than they would be in a nonsurgical setting, such that it would be useful to create a national database to keep a record of such intraoperative events. PMID:15495638

  4. Severe childhood malaria syndromes defined by plasma proteome profiles.

    Directory of Open Access Journals (Sweden)

    Florence Burté

    Full Text Available BACKGROUND: Cerebral malaria (CM and severe malarial anemia (SMA are the most serious life-threatening clinical syndromes of Plasmodium falciparum infection in childhood. Therefore it is important to understand the pathology underlying the development of CM and SMA, as opposed to uncomplicated malaria (UM. Different host responses to infection are likely to be reflected in plasma proteome-patterns that associate with clinical status and therefore provide indicators of the pathogenesis of these syndromes. METHODS AND FINDINGS: Plasma and comprehensive clinical data for discovery and validation cohorts were obtained as part of a prospective case-control study of severe childhood malaria at the main tertiary hospital of the city of Ibadan, an urban and densely populated holoendemic malaria area in Nigeria. A total of 946 children participated in this study. Plasma was subjected to high-throughput proteomic profiling. Statistical pattern-recognition methods were used to find proteome-patterns that defined disease groups. Plasma proteome-patterns accurately distinguished children with CM and with SMA from those with UM, and from healthy or severely ill malaria-negative children. CONCLUSIONS: We report that an accurate definition of the major childhood malaria syndromes can be achieved using plasma proteome-patterns. Our proteomic data can be exploited to understand the pathogenesis of the different childhood severe malaria syndromes.

  5. Pathophysiological Mechanisms in Gaseous Therapies for Severe Malaria.

    Science.gov (United States)

    Kayano, Ana Carolina A V; Dos-Santos, João Conrado K; Bastos, Marcele F; Carvalho, Leonardo J; Aliberti, Júlio; Costa, Fabio T M

    2016-04-01

    Over 200 million people worldwide suffer from malaria every year, a disease that causes 584,000 deaths annually. In recent years, significant improvements have been achieved on the treatment of severe malaria, with intravenous artesunate proving superior to quinine. However, mortality remains high, at 8% in children and 15% in adults in clinical trials, and even worse in the case of cerebral malaria (18% and 30%, respectively). Moreover, some individuals who do not succumb to severe malaria present long-term cognitive deficits. These observations indicate that strategies focused only on parasite killing fail to prevent neurological complications and deaths associated with severe malaria, possibly because clinical complications are associated in part with a cerebrovascular dysfunction. Consequently, different adjunctive therapies aimed at modulating malaria pathophysiological processes are currently being tested. However, none of these therapies has shown unequivocal evidence in improving patient clinical status. Recently, key studies have shown that gaseous therapies based mainly on nitric oxide (NO), carbon monoxide (CO), and hyperbaric (pressurized) oxygen (HBO) alter vascular endothelium dysfunction and modulate the host immune response to infection. Considering gaseous administration as a promising adjunctive treatment against severe malaria cases, we review here the pathophysiological mechanisms and the immunological aspects of such therapies. PMID:26831465

  6. Acute cerebral vascular accident associated with hyperperfusion

    International Nuclear Information System (INIS)

    Cerebral radionuclide angiography can demonstrate decreased or normal radioactivity in the affected region during the arterial phase in patients who have sustained a cerebral vascular accident and thus enhances the diagnostic specificity of the static brain image. In an occasional patient, however, a seemingly paradoxical pattern of regional hyperperfusion with a return to normal or subnormal perfusion following the acute phase has been observed. This phenomenon, called luxury perfusion, has been defined using intra-arterial 133Xe for semiquantitative cerebral blood flow measurements and should be kept in mind as a potentially misleading cerebral imaging pattern

  7. Tuberculoma cerebral Cerebral tuberculoma

    Directory of Open Access Journals (Sweden)

    ELIZABETH CLARA BARROSO

    2002-01-01

    Full Text Available Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa 5-15% das formas extrapulmonares e é reconhecida como de alta letalidade. Apresentação tumoral como a relatada é rara, particularmente em imunocompetentes. Quando tratada, pode ter bom prognóstico e deve entrar sempre no diagnóstico diferencial de massas cerebrais.It is reported a case of a previously healthy man with seizures of sudden onset. A contrast head computerized tomogram (CT showed a right frontoparietal expanding lesion suggesting to be metastatic. No prior disease was found on investigation. The histologic exam of the brain revealed tuberculoma. The seizures were controlled with Hidantoin 300 mg/day and antituberculosis chemotherapy for 18 months. Central nervous system tuberculosis (5-15% of the extrapulmonary forms is highly lethal. The case reported herein is specially rare in immunocompetent patients. It may have good prognosis and should be considered in the differential diagnosis of brain tumours.

  8. Frequently Asked Questions (FAQs) about Malaria

    Science.gov (United States)

    ... Where Malaria Occurs Eradication The Disease What is malaria? Malaria is a serious and sometimes fatal disease ... and poverty. Top of Page How People Get Malaria (Transmission) How is malaria transmitted? Usually, people get ...

  9. Sri Lanka Malaria Maps

    Directory of Open Access Journals (Sweden)

    van der Hoek Wim

    2003-07-01

    Full Text Available Abstract Background Despite a relatively good national case reporting system in Sri Lanka, detailed maps of malaria distribution have not been publicly available. Methods In this study, monthly records over the period 1995 – 2000 of microscopically confirmed malaria parasite positive blood film readings, at sub-district spatial resolution, were used to produce maps of malaria distribution across the island. Also, annual malaria trends at district resolution were displayed for the period 1995 – 2002. Results The maps show that Plasmodium vivax malaria incidence has a marked variation in distribution over the island. The incidence of Plasmodium falciparum malaria follows a similar spatial pattern but is generally much lower than that of P. vivax. In the north, malaria shows one seasonal peak in the beginning of the year, whereas towards the south a second peak around June is more pronounced. Conclusion This paper provides the first publicly available maps of both P. vivax and P. falciparum malaria incidence distribution on the island of Sri Lanka at sub-district resolution, which may be useful to health professionals, travellers and travel medicine professionals in their assessment of malaria risk in Sri Lanka. As incidence of malaria changes over time, regular updates of these maps are necessary.

  10. The Void Phenomenon Revisited

    CERN Document Server

    Giovanelli, Riccardo

    2009-01-01

    The Void Phenomenon consists in the apparent discrepancy between the number of observed dwarf halos in cosmic voids and that expected from CDM simulations. We approach the problem considering the challenging prospects of detecting field dwarf systems with halo masses < 10^9 solar, via their possible HI emission. A brief review of recent work is followed by preliminary results from the ALFALFA survey, which suggest the possibility, but not yet the proof, that such objects may have been already detected towards the outskirts of the Local Group.

  11. Kasabach-Merritt phenomenon

    International Nuclear Information System (INIS)

    An association between a vascular lesion and a life threatening coagulopathy is called Kasabach-Merritt phenomenon (KMP). It includes thrombocytopenia, microangiopathic hemolytic anemia, and disseminated intravascular coagulopathy. We can not overstate the need for excellent and careful screening. Treatment modalities of KMP have included medication, radiation, embolization and surgery. Corticosteroids have traditionally been the mainstay of treatment. We report a 4-months-old girl with an extensive vascular lesion involving the left parotid, submandibular, and parapharyngeal regions, and with KMP. We treated her with a mega dose of corticosteroids. Her coagulopathy resolved, and her vascular lesion improved. (author)

  12. Cerebral Palsy

    Science.gov (United States)

    ... 1 • 2 • 3 For Teens For Kids For Parents MORE ON THIS TOPIC Cerebral Palsy: Keith's Story Physical Therapy I Have Cerebral Palsy. Can I Babysit? Body Image and Self-Esteem Contact Us Print Resources Send to a friend ...

  13. Determinants of variant surface antigen antibody response in severe Plasmodium falciparum malaria in an area of low and unstable malaria transmission

    DEFF Research Database (Denmark)

    A-Elgadir, T M E; Theander, T G; Elghazali, G; Nielsen, M A; A-Elbasit, I E; Adam, I; Troye-Blomberg, M; Elbashir, M I; Giha, H A

    2006-01-01

    study was conducted in Eastern Sudan, an area of seasonal and unstable malaria transmission. Parasites and plasma were obtained from patients with different clinical grades of malaria, and flow cytometry was used for analysis of VSA antibody (Ab) response. We found that individuals recognized a broader......The variant surface antigens (VSA) of infected erythrocytes are important pathogenic markers, a set of variants (VSA(SM)), were assumed to be associated with severe malaria (SM), while SM constitutes clinically diverse forms, such as, severe malarial anemia (SMA) and cerebral malaria (CM). This...... range of isolates had a higher level of VSA Ab against the recognized isolates (correlation coefficient, 0.727, P<0.001). Unexpectedly, at the time of malaria diagnosis, plasma from patients with CM recognized a significantly larger number of isolates than did the plasma from patients with SMA (P<0...

  14. Malaria and Tropical Travel

    Centers for Disease Control (CDC) Podcasts

    2008-05-15

    Malaria is a serious mosquito-borne disease that can lead to death. This podcast discusses malaria risk when traveling to tropical areas, as well as how to protect yourself and your family from malaria infection.  Created: 5/15/2008 by National Center for Zoonotic, Vector-Borne, and Enteric Diseases (NCZVED).   Date Released: 5/29/2008.

  15. Vaccines against malaria

    OpenAIRE

    Hill, Adrian V. S.

    2011-01-01

    There is no licenced vaccine against any human parasitic disease and Plasmodium falciparum malaria, a major cause of infectious mortality, presents a great challenge to vaccine developers. This has led to the assessment of a wide variety of approaches to malaria vaccine design and development, assisted by the availability of a safe challenge model for small-scale efficacy testing of vaccine candidates. Malaria vaccine development has been at the forefront of assessing many new vaccine technol...

  16. The Oklo phenomenon

    International Nuclear Information System (INIS)

    During 1972, research workers of the French Commissariat a I'Energie Atomique made an astonishing discovery: fission chain reactions had been triggered spontaneously in the very remote past within a uranium deposit in Gabon and parts of the deposit had behaved like a modern nuclear reactor for hundreds of thousands of years. Subsequent investigations showed that the reaction sites had remained in a remarkable state of preservation, so that detailed study was possible. he IAEA felt that the Oklo phenomenon would be an excellent subject for international co-operation in fundamental research and agreed to the suggestion of the Gabon Government and the French Commissariat a I'Energie Atomique that a jointly organized symposium be held. The symposium will take place at Franceville, Gabon, from 23 to 27 June 1975. (author)

  17. The neutron channeling phenomenon.

    Science.gov (United States)

    Khanouchi, A; Sabir, A; Boulkheir, M; Ichaoui, R; Ghassoun, J; Jehouani, A

    1997-01-01

    Shields, used for protection against radiation, are often pierced with vacuum channels for passing cables and other instruments for measurements. The neutron transmission through these shields is an unavoidable phenomenon. In this work we study and discuss the effect of channels on neutron transmission through shields. We consider an infinite homogeneous slab, with a fixed thickness (20 lambda, with lambda the mean free path of the neutron in the slab), which contains a vacuum channel. This slab is irradiated with an infinite source of neutrons on the left side and on the other side (right side) many detectors with windows equal to 2 lambda are placed in order to evaluate the neutron transmission probabilities (Khanouchi, A., Aboubekr, A., Ghassoun, J. and Jehouani, A. (1994) Rencontre Nationale des Jeunes Chercheurs en Physique. Casa Blanca Maroc; Khanouchi, A., Sabir, A., Ghassoun, J. and Jehouani, A. (1995) Premier Congré International des Intéractions Rayonnements Matière. Eljadida Maroc). The neutron history within the slab is simulated by the Monte Carlo method (Booth, T. E. and Hendricks, J. S. (1994) Nuclear Technology 5) and using the exponential biasing technique in order to improve the Monte Carlo calculation (Levitt, L. B. (1968) Nuclear Science and Engineering 31, 500-504; Jehouani, A., Ghassoun, J. and Aboubker, A. (1994) In Proceedings of the 6th International Symposium on Radiation Physics, Rabat, Morocco). Then different geometries of the vacuum channel have been studied. For each geometry we have determined the detector response and calculated the neutron transmission probability for different detector positions. This neutron transmission probability presents a peak for the detectors placed in front of the vacuum channel. This study allowed us to clearly identify the neutron channeling phenomenon. One application of our study is to detect vacuum defects in materials. PMID:9463884

  18. Cerebral palsy.

    Science.gov (United States)

    Graham, H Kerr; Rosenbaum, Peter; Paneth, Nigel; Dan, Bernard; Lin, Jean-Pierre; Damiano, Diane L; Becher, Jules G; Gaebler-Spira, Deborah; Colver, Allan; Reddihough, Dinah S; Crompton, Kylie E; Lieber, Richard L

    2016-01-01

    Cerebral palsy is the most common cause of childhood-onset, lifelong physical disability in most countries, affecting about 1 in 500 neonates with an estimated prevalence of 17 million people worldwide. Cerebral palsy is not a disease entity in the traditional sense but a clinical description of children who share features of a non-progressive brain injury or lesion acquired during the antenatal, perinatal or early postnatal period. The clinical manifestations of cerebral palsy vary greatly in the type of movement disorder, the degree of functional ability and limitation and the affected parts of the body. There is currently no cure, but progress is being made in both the prevention and the amelioration of the brain injury. For example, administration of magnesium sulfate during premature labour and cooling of high-risk infants can reduce the rate and severity of cerebral palsy. Although the disorder affects individuals throughout their lifetime, most cerebral palsy research efforts and management strategies currently focus on the needs of children. Clinical management of children with cerebral palsy is directed towards maximizing function and participation in activities and minimizing the effects of the factors that can make the condition worse, such as epilepsy, feeding challenges, hip dislocation and scoliosis. These management strategies include enhancing neurological function during early development; managing medical co-morbidities, weakness and hypertonia; using rehabilitation technologies to enhance motor function; and preventing secondary musculoskeletal problems. Meeting the needs of people with cerebral palsy in resource-poor settings is particularly challenging. PMID:27188686

  19. The Association between Cognition and Academic Performance in Ugandan Children Surviving Malaria with Neurological Involvement

    OpenAIRE

    Bangirana, Paul; Menk, Jeremiah; John, Chandy C.; Boivin, Michael J.; Hodges, James S.

    2013-01-01

    Background The contribution of different cognitive abilities to academic performance in children surviving cerebral insult can guide the choice of interventions to improve cognitive and academic outcomes. This study's objective was to identify which cognitive abilities are associated with academic performance in children after malaria with neurological involvement. Methods 62 Ugandan children with a history of malaria with neurological involvement were assessed for cognitive ability (working ...

  20. The Offshoring Phenomenon

    Directory of Open Access Journals (Sweden)

    Mery Patricia Tamayo Plata

    2014-06-01

    Full Text Available This paper explains some definitions which are necessary in order to understand the offshoring concept, going through the most relevant works about the development of the offshoring phenomenon and its impact on the demand for labor and on the most skilled workers' income. It is evidenced that the offshoring processes not only deal with the purchase and sale of goods anymore, but that the service sector has an increasingly important role, and that the lower cost is not the only aspect that matters when offshoring, but aspects such as the language and culture are also considered. It is also found that technology and research related services flow not only from the parent companies towards its subsidiaries, but from firms in less developed countries to other companies in advanced countries. It concludes with a review of the works that explores the relationship between offshoring, employment and wages, from both, a macro and microeconomic outlook. In the latter case, special consideration is given to the work carried out by Amity and Wei (2006, Crinó (2010, and Geishecker and Görg (2013.

  1. Effect of prostaglandin E1 on cerebral blood flow in patients with chronic cerebral infarction

    International Nuclear Information System (INIS)

    The effect of prostaglandin E1 (PGE1) on cerebral blood flow (CBF) was studied in 10 patients with chronic cerebral infarction. Regional cerebral blood flow (rCBF) was measured by single photon emission computed tomography before and after they received PGE1 120 μg daily for 2 weeks. The rCBF of the brainstem, cerebellum, and frontal, temporal, and parietal lobes increased significantly after PGE1 administration. PGE1 also significantly increased the rCBF of the non-infarcted area adjacent to infarction. The results indicate that PGE1 increases the CBF of patients with chronic cerebral infarction without causing the intracerebral steal phenomenon. (author)

  2. Periodic paralysis complicating malaria.

    OpenAIRE

    Senanayake, N; Wimalawansa, S J

    1981-01-01

    Episodic muscular weakness, commonly associated with alterations of serum potassium, is the cardinal feature of periodic paralysis. The combination of transient hyperkalaemia and rigors occurring during febrile episodes of malaria is suggested as the underlying cause which precipitated the muscular paralysis. Three patients with malaria who developed a similar paralysis during the paroxysms of fever are described to illustrate this.

  3. Ellagitannins of the fruit rind of pomegranate (Punica granatutm) antagonize in vitro the host inflammatory response mechanisms involved in the onset of malaria

    OpenAIRE

    Bhattacharya Deepak; Romeo Sergio; Basilico Nicoletta; Bulgari Michela; Galli Germana V; Dell'Agli Mario; Taramelli Donatella; Bosisio Enrica

    2010-01-01

    Abstract Background The sun-dried rind of the immature fruit of pomegranate (Punica granatum) is presently used as a herbal formulation (OMARIA, Orissa Malaria Research Indigenous Attempt) in Orissa, India, for the therapy and prophylaxis of malaria. The pathogenesis of cerebral malaria, a complication of the infection by Plasmodium falciparum, is an inflammatory cytokine-driven disease associated to an up-regulation and activity of metalloproteinase-9 and to the increase of TNF production. T...

  4. Cerebral hypoxia

    Science.gov (United States)

    ... the veins ( deep vein thrombosis ) Lung infections (pneumonia) Malnutrition When to Contact a Medical Professional Cerebral hypoxia ... References Bernat JL. Coma, vegetative state, and brain death. In: Goldman L, Schafer AI, eds. Goldman's Cecil ...

  5. Penanggulangan Malaria Melalui Penyuluhan dengan Buku Panduan Malaria

    OpenAIRE

    Siti Sapardiyah Santoso

    2012-01-01

    Penyakit malaria merupakan salah satu penyakit menular yang telah dikenal sejak lama di Indonesia. Pemerintah telah melaksanakan berbagai upaya untuk mengatasinya; meskipun demikian hingga saat ini malaria masih merupakan masalah kesehatan terutama di daerah pedesaan . Untuk mengatasi hal tersebut telah dilakukan penelitian antara lain dengan menggunakan Tenaga Lapangan Malaria/Pelopor Malaria melalui intervensi penyuluhan dengan Buku Panduan Malaria yang berisi beberapa hal berkaitan dengan ...

  6. [Malaria in Iraq].

    Science.gov (United States)

    Shamo, F J

    2001-01-01

    Malaria control campaign started in Iraq in 1957. This made the country largely free of the disease. Since 1991, following the recent war, Iraq has been affected by serious epidemic of P. vivax malaria that started in 3 autonomous governorates and soon involved other parts of the country. There were 49,840 malaria cases in the country in 1995. The national malaria programme personnel did their best to contain and control the epidemic. Active and passive case detection and treatment were introduced. Free of charge drugs are provided at all levels in the endemic area. Vector control includes environmental management, distribution of Gambusia fish, larviciding, indoor residual spraying with pyrithroids. A total of 4134 malaria cases were recorded in the country in 1999. PMID:11548316

  7. Rapid Diagnosis of Malaria

    Directory of Open Access Journals (Sweden)

    Clinton K. Murray

    2009-01-01

    Full Text Available Malaria's global impact is expansive and includes the extremes of the healthcare system ranging from international travelers returning to nonendemic regions with tertiary referral medical care to residents in hyperendemic regions without access to medical care. Implementation of prompt and accurate diagnosis is needed to curb the expanding global impact of malaria associated with ever-increasing antimalarial drug resistance. Traditionally, malaria is diagnosed using clinical criteria and/or light microscopy even though both strategies are clearly inadequate in many healthcare settings. Hand held immunochromatographic rapid diagnostic tests (RDTs have been recognized as an ideal alternative method for diagnosing malaria. Numerous malaria RDTs have been developed and are widely available; however, an assortment of issues related to these products have become apparent. This review provides a summary of RDT including effectiveness and strategies to select the ideal RDT in varying healthcare settings.

  8. Audit of imported and domestic malaria cases at Kuala Lumpur Hospital.

    Science.gov (United States)

    Moore, C S; Cheong, I

    1995-01-01

    The clinical, haematological and biochemical profiles of all domestic and imported malaria cases admitted to the Hospital Kuala Lumpur were analysed. The most common malaria types were Plasmodium falciparum (39.5%) and Plasmodium vivax (42%). The most common patient type was men aged 29-40 years (reflecting the high mobility of this group, many of whom were illegal immigrants). Misdiagnosis on admission was frequently due to the variable clinical presentation of the disease and the difficulties of obtaining an accurate history. Associated haematological abnormalities were common. Chloroquine resistance was diagnosed in four P. falciparum patients and in one P. falciparum/vivax patient. Overall, imported malaria did not seem more severe than domestic. The three patients with cerebral malaria survived. One patient died of acute liver failure. The large influx of illegal immigrants to Malaysia has resulted in a surge in malaria infection; illegal immigrants remain a source of chloroquine resistance. PMID:8554954

  9. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Story" 5 Things to Know About Zika & Pregnancy Cerebral Palsy KidsHealth > For Parents > Cerebral Palsy Print A A ... kids who are living with the condition. About Cerebral Palsy Cerebral palsy is one of the most common ...

  10. Crossed cerebral - cerebellar diaschisis : MRI evaluation.

    Directory of Open Access Journals (Sweden)

    Chakravarty A

    2002-07-01

    Full Text Available MRI, done later in life, in two patients with infantile hemiplegia syndrome showed significant volume loss in the cerebellar hemisphere contralateral to the side of the affected cerebrum. The cerebellar volume loss seemed to correlate with the degree of volume loss in the contralateral cerebral hemisphere. These observations provide morphological evidence of the phenomenon of crossed cerebral-cerebellar diaschisis (CCD. Functional neuroimaging studies in support of the concept of CCD has been critically reviewed.

  11. MALARIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Richard-Fabian Schumacher

    2012-11-01

    Full Text Available This review is focused on childhood specific aspects of malaria, especially in resource-poor settings. We summarise the actual knowledge in the field of epidemiology, clinical presentation, diagnosis, management and prevention. These aspects are important as malaria is responsible for almost a quarter of all child death in sub-Saharan Africa. Malaria control is thus one key intervention to reduce childhood mortality, especially as malaria is also an important risk factor for other severe infections, namely bacteraemia. In children symptoms are more varied and often mimic other common childhood illness, particularly gastroenteritis, meningitis/encephalitis, or pneumonia. Fever is the key symptom, but the characteristic regular tertian and quartan patterns are rarely observed. There are no pathognomonic features for severe malaria in this age group. The well known clinical (fever, impaired consciousness, seizures, vomiting, respiratory distress and laboratory (severe anaemia, thrombocytopenia, hypoglycaemia, metabolic acidosis, and hyperlactataemia features of severe falciparum malaria in children, are equally typical for severe sepsis. Appropriate therapy (considering species, resistance patterns and individual patient factors – possibly a drug combination of an artemisinin derivative with a long-acting antimalarial drug - reduces treatment duration to only three days and should be urgently started. While waiting for the results of ongoing vaccine trials, all effort should be made to better implement other malaria-control measures like the use of treated bed-nets and new chemoprophylaxis regimens.

  12. MALARIA IN CHILDREN

    Directory of Open Access Journals (Sweden)

    Richard-Fabian Schumacher

    2012-01-01

    Full Text Available

    This review is focused on childhood specific aspects of malaria, especially in resource-poor settings. We summarise the actual knowledge in the field of epidemiology, clinical presentation, diagnosis, management and prevention.

    These aspects are important as malaria is responsible for almost a quarter of all child death in sub-Saharan Africa. Malaria control is thus one key intervention to reduce childhood mortality, especially as malaria is also an important risk factor for other severe infections, namely bacteraemia.

    In children symptoms are more varied and often mimic other common childhood illness, particularly gastroenteritis, meningitis/encephalitis, or pneumonia. Fever is the key symptom, but the characteristic regular tertian and quartan patterns are rarely observed. There are no pathognomonic features for severe malaria in this age group. The well known clinical (fever, impaired consciousness, seizures, vomiting, respiratory distress and laboratory (severe anaemia, thrombocytopenia, hypoglycaemia, metabolic acidosis, and hyperlactataemia features of severe falciparum malaria in children, are equally typical for severe sepsis.

    Appropriate therapy (considering species, resistance patterns and individual patient factors – possibly a drug combination of an artemisinin derivative with a long-acting antimalarial drug - reduces treatment duration to only three days and should be urgently started.

    While waiting for the results of ongoing vaccine trials, all effort should be made to better implement other malaria-control measures like the use of treated bed-nets and new chemoprophylaxis regimens.

  13. Malaria's deadly grip

    DEFF Research Database (Denmark)

    Smith, Joseph D; Rowe, J Alexandra; Higgins, Matthew K;

    2013-01-01

    domain composition. This grouping reflects functional specialization of PfEMP1 proteins for different human host and microvascular binding niches and appears to be maintained by gene recombination hierarchies. Inone extreme, a specific PfEMP1 variant is associated with placental binding and malaria...... during pregnancy, while other PfEMP1 subtypes appear to be specialized for infection of malaria naïve hosts. Here, we discuss recent findings on the origins and evolution of the var gene family, the structure-function of PfEMP1 proteins, and a distinct subset of PfEMP1 variants that have been associated...... with severe childhood malaria....

  14. Malaria and Vascular Endothelium

    International Nuclear Information System (INIS)

    Involvement of the cardiovascular system in patients with infectious and parasitic diseases can result from both intrinsic mechanisms of the disease and drug intervention. Malaria is an example, considering that the endothelial injury by Plasmodium-infected erythrocytes can cause circulatory disorders. This is a literature review aimed at discussing the relationship between malaria and endothelial impairment, especially its effects on the cardiovascular system. We discuss the implications of endothelial aggression and the interdisciplinarity that should guide the malaria patient care, whose acute infection can contribute to precipitate or aggravate a preexisting heart disease

  15. Plasmodium vivax malaria vaccines

    OpenAIRE

    2013-01-01

    Malaria is one of the few diseases in which morbidity is still measured in hundreds of millions of cases every year. Plasmodium vivax and Plasmodium falciparum are responsible for nearly all the malaria cases in the world and despite difficulties in obtaining an exact number, estimates indicate an astonishing 349–552 million clinical cases of malaria due to P. falciparum in 2007 and between 132–391 million clinical episodes due to P. vivax in 2009. It is becoming evident that eradication of m...

  16. Malaria and Vascular Endothelium

    Energy Technology Data Exchange (ETDEWEB)

    Alencar, Aristóteles Comte Filho de, E-mail: aristoteles.caf@gmail.com [Universidade Federal do Amazonas, Manaus, AM (Brazil); Lacerda, Marcus Vinícius Guimarães de [Fundação de Medicina Tropical Dr. Heitor Vieira Dourado (FMT-HVD), Manaus, AM (Brazil); Okoshi, Katashi; Okoshi, Marina Politi [Faculdade de Medicina de Botucatu (Unesp), Botucatu, SP (Brazil)

    2014-08-15

    Involvement of the cardiovascular system in patients with infectious and parasitic diseases can result from both intrinsic mechanisms of the disease and drug intervention. Malaria is an example, considering that the endothelial injury by Plasmodium-infected erythrocytes can cause circulatory disorders. This is a literature review aimed at discussing the relationship between malaria and endothelial impairment, especially its effects on the cardiovascular system. We discuss the implications of endothelial aggression and the interdisciplinarity that should guide the malaria patient care, whose acute infection can contribute to precipitate or aggravate a preexisting heart disease.

  17. Tuberculoma cerebral

    OpenAIRE

    BARROSO ELIZABETH CLARA; OLIVEIRA TÂNIA REGINA BRÍGIDO DE; AMARAL ANA MARIA DANTAS DO; PINHEIRO VALÉRIA GÓES FERREIRA; SOUSA ANA LÚCIA DE OLIVEIRA

    2002-01-01

    Relata-se o caso de paciente com crises convulsivas de início recente. A tomografia computadorizada cerebral evidenciou imagem sugestiva de lesão expansiva metastática frontoparietal direita. A investigação de tumor primário ou outra doença foi negativa e o exame histopatológico do tecido cerebral diagnosticou tuberculoma. As convulsões foram controladas com a associação de hidantoína 300mg/dia ao esquema específico, utilizado por 18 meses. A tuberculose do sistema nervoso central representa ...

  18. Pulmonary manifestations of malaria

    International Nuclear Information System (INIS)

    We report on the two different types of pulmonary manifestations in acute plasmodium falciparum malaria. The more severe variant shows long standing interstitial pulmonary infiltrates, whereas in the more benign courses only short-term pulmonary edemas are visible. (orig.)

  19. Muscling out malaria

    DEFF Research Database (Denmark)

    Hughes, David Peter; Boomsma, Jacobus Jan

    2006-01-01

    ) [2] highlighted the back-to-back articles in Science 3 and 4 that demonstrated the potential biocontrol of malaria by targeting mosquitoes with entomopathogenic fungi (Metarhizium and Beauveria spp.). The wide impact of the original articles and the need to find alternatives to pesticidal control are...... where malaria is endemic, humanity cannot afford shortcuts, because any failures owing to poor management or premature implementation will reduce local governmental support rather than enhance it (Andrew Read, pers. commun.). Therefore, if we are to ‘muscle out malaria', well...... key importance, and the new focus on fungal biocontrol of malaria should therefore act as a catalyst for further research on the basic biology of fungal pathogens. Understanding morphological, biochemical or immune system-based resistance to insect pathogenic fungi will be easier if we know their...

  20. Bioinformatics approaches to malaria

    DEFF Research Database (Denmark)

    Hansen, Daniel Aaen

    Malaria is a life threatening disease found in tropical and subtropical regions of the world. Each year it kills 781 000 individuals; most of them are children under the age of five in sub-Saharan Africa. The most severe form of malaria in humans is caused by the parasite Plasmodium falciparum......, which is the subject of the first part of this thesis. The PfEMP1 protein which is encoded by the highly variablevargene family is important in the pathogenesis and immune evasion of malaria parasites. We analyzed and classified these genes based on the upstream sequence in seven......Plasmodium falciparumclones. We show that the amount of nucleotide diversity is just as big within each clone as it is between the clones. DNA methylation is an important epigenetic mark in many eukaryotic species. We are studying DNA methylation in the malaria parasitePlasmodium falciparum. The work is still in progress and...

  1. Pulmonary manifestations of malaria

    Energy Technology Data Exchange (ETDEWEB)

    Rauber, K.; Enkerlin, H.L.; Riemann, H.; Schoeppe, W.

    1987-05-01

    We report on the two different types of pulmonary manifestations in acute plasmodium falciparum malaria. The more severe variant shows long standing interstitial pulmonary infiltrates, whereas in the more benign courses only short-term pulmonary edemas are visible.

  2. Malaria in Pregnancy

    Directory of Open Access Journals (Sweden)

    Jesus R. Alvarez

    2005-01-01

    Full Text Available Recently, there has been a resurgence of malaria in densely populated areas of the United States secondary to human migration from endemic areas where factors such as cessation of vector control, vector resistance to insecticides, disease resistance to drugs, environmental changes, political instability, and indifference, have played a role for malaria becoming an overwhelming infection of these tropical underdeveloped countries. It is important for health care providers of gravida to be alert of the disease and its effects on pregnancy.

  3. Tetracyclines in malaria.

    Science.gov (United States)

    Gaillard, Tiphaine; Madamet, Marylin; Pradines, Bruno

    2015-01-01

    Malaria, a parasite vector-borne disease, is one of the greatest health threats in tropical regions, despite the availability of malaria chemoprophylaxis. The emergence and rapid extension of Plasmodium falciparum resistance to various anti-malarial drugs has gradually limited the number of potential malaria therapeutics available to clinicians. In this context, doxycycline, a synthetically derived tetracycline, constitutes an interesting alternative for malaria treatment and prophylaxis. Doxycycline is a slow-acting blood schizontocidal agent that is highly effective at preventing malaria. In areas with chloroquine and multidrug-resistant P. falciparum parasites, doxycycline has already been successfully used in combination with quinine to treat malaria, and it has been proven to be effective and well-tolerated. Although not recommended for pregnant women and children younger than 8 years of age, severe adverse effects are rarely reported. In addition, resistance to doxycycline is rarely described. Prophylactic and clinical failures of doxycycline have been associated with both inadequate doses and poor patient compliance. The effects of tetracyclines on parasites are not completely understood. A better comprehension of the mechanisms underlying drug resistance would facilitate the identification of molecular markers of resistance to predict and survey the emergence of resistance. PMID:26555664

  4. Malaria induced acute renal failure: A single center experience

    International Nuclear Information System (INIS)

    Malaria has protean clinical manifestations and renal complications, particularly acute renal failure that could be life threatening. To evaluate the incidence, clinical profile, ou come and predictors of mortality in patients with malarial acute renal failure, we retrospectively studied the last two years records of malaria induced acute renal failure in patients with peripheral smear positive for malarial parasites. One hundred (10.4%) (63 males, 37 females) malaria induced acute renal failure amongst 958 cases of acute renal failure were evaluated. Plasmodium (P). falciparum was reported in 85%, P. vivax in 2%, and both in 13% patients. The mean serum creatinine was 9.2 ± 4.2 mg%, and oligo/anuria was present in 82%; 78% of the patients required hemodialysis. Sixty four percent of the patients recovered completely, 10% incompletely, and 5% developed chronic kidney failure; mortality occurred in 21% of the patients. Low hemoglobin, oligo/anuria on admission, hyperbilirubinemia, cerebral malaria, disseminated intravascular coagulation, and high serum creatinine were the main predictors of mortality. We conclude that malaria is associated with acute renal failure, which occurs most commonly in plasmodium falciparum infected patients. Early diagnosis and prompt dialysis with supportive management can reduce morality and enhance recovery of renal function (Author).

  5. Complement receptor 1 and the molecular pathogenesis of malaria

    Directory of Open Access Journals (Sweden)

    Gandhi Monika

    2007-01-01

    Full Text Available Malaria is a pathogenic infection caused by protozoa of the genus plasmodium. It is mainly confined to sub-Saharan Africa, Asia and South America. This disease claims the life of over 1.5 to 2.7 million people per year. Owing to such a high incidence of malarial infections, there is an urgent need for the development of suitable vaccines. For the development of ideal vaccines, it is essential to understand the molecular mechanisms of malarial pathogenesis and the factors that lead to malaria infection. Genetic factors have been proposed to play an important role in malarial pathogenesis. Complement receptor 1 (CR1 is an important host red blood cell protein involved in interaction with malarial parasite. Various polymorphic forms of CR1 have been found to be involved in conferring protection or increasing susceptibility to malaria infections. Low-density allele (L of CR1 gave contradictory results in different set of studies. In addition, Knops polymorphic forms Sl (a + and McC (a have been found to contribute more towards the occurrence of cerebral malaria in malaria endemic regions compared to individuals with Sl (a - / McC (a/b genotype. This article reviews the research currently going on in this area and throws light on as yet unresolved mysteries of the role of CR1 in malarial pathogenesis.

  6. Cerebral Arteriosclerosis

    Science.gov (United States)

    ... the brain can cause a hemorrhagic stroke. Both types of stroke can be fatal. Cerebral arteriosclerosis is also related to a condition known as vascular dementia, in which small, symptom-free strokes cause cumulative damage and death to neurons (nerve cells) in the brain. Personality changes in ...

  7. [Plasma osmolarity and cerebral volume].

    Science.gov (United States)

    Boulard, G

    2001-02-01

    Under normal physiological conditions, the osmolarity of extracellular fluids (ECFs) and natremia are controlled by two regulatory mechanisms modulating the water balance and sodium outflow from information collected by the osmoreceptors and baroreceptors, respectively. As well, under normal physiological conditions, water and electrolytes of brain ECFs are secreted by the endothelial cells of brain capillaries. Furthermore, isotonicity is present on both sides of the blood-brain barrier. In the event of systemic osmolarity disorders, water transport subject to osmosis laws occurs at the level of the blood-brain barrier. In the case of plasmatic hyperosmolarity cerebral dehydration is observed, while cerebral edema occurs in the contrary case. However, plasmatic osmolarity disorders have less effect on the cerebral volume when their introduction is slow. Experimentation in acute conditions shows that measured variations of the cerebral water content are lower than calculated variations, thus suggesting the existence of an adaptive mechanism, that is, the cerebral osmoregulation which limits the variation of the volume of brain cells by modulating their osmoactive molecule content. These osmoactive molecules are, on the one hand, the electrolytes, which are early and rapidly mobilized, and, on the other hand, the organic osmoles (amino acids, etc.), whose secretion is slower and delayed. This phenomenon should be taken into account in the treatment of osmolarity disorders. Thus, the related-risk of treatment for natremia disorders is therapeutic reversal of the osmotic gradient at the level of the blood-brain barrier. This reversal, which corresponds to a second osmotic stress, requires the implementation of a new procedure of cerebral osmoregulation in the opposite direction of the preceding one. As successive osmotic stresses decrease the effectiveness of brain osmoregulation, the risk for cerebral dehydration and pontine myelinolysis increases when the treatment

  8. A subset of group A-like var genes encodes the malaria parasite ligands for binding to human brain endothelial cells

    DEFF Research Database (Denmark)

    Claessens, Antoine; Adams, Yvonne; Ghumra, Ashfaq;

    2012-01-01

    Cerebral malaria is the most deadly manifestation of infection with Plasmodium falciparum. The pathology of cerebral malaria is characterized by the accumulation of infected erythrocytes (IEs) in the microvasculature of the brain caused by parasite adhesins on the surface of IEs binding to human...... receptors on microvascular endothelial cells. The parasite and host molecules involved in this interaction are unknown. We selected three P. falciparum strains (HB3, 3D7, and IT/FCR3) for binding to a human brain endothelial cell line (HBEC-5i). The whole transcriptome of isogenic pairs of selected and.......029) but not by antibodies from controls with uncomplicated malaria (Mann-Whitney test, P = 0.58). This work describes a binding phenotype for virulence-associated group A P. falciparum erythrocyte membrane protein 1 variants and identifies targets for interventions to treat or prevent cerebral malaria....

  9. To report a case of unilateral proliferative retinopathy following noncerebral malaria with Plasmodium falciparum in Southern India

    Directory of Open Access Journals (Sweden)

    Aditya Verma

    2015-01-01

    Full Text Available The retinopathy in association with malaria fever described so far includes retinal hemorrhages, vessel changes, retinal discoloration/whitening and papilledema. Malaria retinopathy has been mostly described in severe cases, associated with Plasmodium falciparum, correlating the patho-physiology of retinal and cerebral manifestations. We report an unusual case of proliferative retinopathy as a manifestation of malaria fever, caused by P. falciparum with no cerebral involvement. The patient had features of unilateral retinal vascular occlusion with proliferative changes and vitreous hemorrhage. To the best of our knowledge, such a case has never been reported so far in the literature. This report highlights the possible occurrence of severe proliferative changes associated with malaria fever, which if diagnosed early can prevent possible blindness.

  10. Aloneness and the Isakower phenomenon.

    Science.gov (United States)

    Peterson, C A

    1992-01-01

    Under the sway of the oedipal imperative, the Isakower phenomenon has long been regarded as a regressive perceptual defense against castration anxiety accompanying incestuous wishes, often stimulated by primal scene exposure-fantasy. Clinical material from the psychoanalytic psychotherapy of a borderline patient with object constancy deficits is offered to support a reconceptualization of the Isakower phenomenon: Following annihilatory rage and the destruction of extant inner objects, resulting in a regression to the "drive organization of memory," the face-breast imagery within the Isakower phenomenon arrives as a hallucinatory alternative to unbearable aloneness. PMID:1607306

  11. Current scenario of Malaria Vaccine

    OpenAIRE

    Malik, SS; Gupta, MC; Braich, JS

    2012-01-01

    Malaria, one of the deadliest infectious diseases, affects millions of people worldwide including India. As an addition to chemoprophylaxis and other antimalarial interventions malaria vaccine is under extensive research since decades. The vaccine development is more difficult to predict than drug development and presents a unique challenge as there has never before been a vaccine effective against a parasite. Effective malaria vaccine could help eliminate and eradicate malaria. There are cur...

  12. Current scenario of malaria vaccine

    OpenAIRE

    Jarnail Singh Braich; Surinder Singh Malik

    2012-01-01

    Malaria is one of the deadliest infectious diseases that affects millions of people worldwide including India. As an addition to chemoprophylaxis and other antimalarial interventions malaria vaccine is under extensive research since decades. The vaccine development is more difficult to predict than drug development and presents a unique challenge as already there has been no vaccine effective against a parasite. Effective malaria vaccine could help eliminate and eradicate malaria; there are c...

  13. Unstable vivax malaria in Korea

    OpenAIRE

    Ree, Han-Il

    2000-01-01

    Korean vivax malaria had been prevalent for longtime throughout the country with low endemicity. As a result of the Korean war (1950-1953), malaria became epidemic. In 1959-1969 when the National Malaria Eradication Service (NMES) was implemented, malaria rates declined, with low endemicity in the south-west and south plain areas and high endemic foci in north Kyongsangbuk-do (province) and north and east Kyonggi-do. NMES activities greatly contributed in accelerating the control and later er...

  14. [Methylphenidate and secondary Raynaud's phenomenon].

    Science.gov (United States)

    Iglesias Otero, M; Portela Romero, M; Bugarín González, R; Ventura Victoria, M A

    2013-09-01

    Raynaud's phenomenon is a clinical disease characterized by episodic attacks of vasoconstriction of the arteries and arterioles of the extremities such as fingers and toes, sometimes the ears and nose, in response to cold or emotional stimuli. A classic attack is the pallor of the distal extremity, followed by cyanosis and redness, accompanied by paresthesia, usually as heat. When it occurs without apparent cause is called primary Raynaud's phenomenon. When associated with other disease, is called secondary Raynaud's phenomenon. The secondary table is associated with increased frequency of rheumatic diseases of collagen. They can also present certain drugs that cause vasoconstriction, such as ergotamine, beta-adrenergic antagonists, contraception and sympathomimetic drugs. Regarding the latter, we present a case of Raynaud's phenomenon secondary to methylphenidate in a 14 years. PMID:24034762

  15. Cerebral sinus venous thrombosis.

    Science.gov (United States)

    Alvis-Miranda, Hernando Raphael; Milena Castellar-Leones, Sandra; Alcala-Cerra, Gabriel; Rafael Moscote-Salazar, Luis

    2013-10-01

    Cerebral sinus venous thrombosis (CSVT) is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT) and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment. PMID:24347950

  16. Cerebral sinus venous thrombosis

    Directory of Open Access Journals (Sweden)

    Hernando Raphael Alvis-Miranda

    2013-01-01

    Full Text Available Cerebral sinus venous thrombosis (CSVT is a rare phenomenon that can be seen with some frequency in young patients. CSVT is a multifactorial condition with gender-related specific causes, with a wide clinical presentation, the leading causes differ between developed and developing countries, converting CSVT in a condition characterized by a highly variable clinical spectra, difficult diagnosis, variable etiologies and prognosis that requires fine medical skills and a high suspicious index. Patients who presents with CSVT should underwent to CT-scan venography (CVT and to the proper inquiry of the generating cause. This disease can affect the cerebral venous drainage and related anatomical structure. The symptoms may appear in relation to increased intracranial pressure imitating a pseudotumorcerebri. Prognosis depends on the early detection. Correcting the cause, generally the complications can be prevented. Mortality trends have diminished, and with the new technologies, surely it will continue. This work aims to review current knowledge about CSVT including its pathogenesis, etiology, clinical manifestations, diagnosis, and treatment.

  17. Employees with Cerebral Palsy

    Science.gov (United States)

    ... Resources Home | Accommodation and Compliance Series: Employees with Cerebral Palsy (CP) By Eddie Whidden, MA Preface Introduction Information ... SOAR) at http://AskJAN.org/soar. Information about Cerebral Palsy (CP) What is CP? Cerebral palsy is a ...

  18. Plasmodium falciparum var genes expressed in children with severe malaria encode CIDRα1 domains

    DEFF Research Database (Denmark)

    Jespersen, Jakob S.; Wang, Christian W.; Mkumbaye, Sixbert I.;

    2016-01-01

    endothelial protein C receptor (EPCR) through the CIDRα1 domain of certain PfEMP1 were recently associated with severe malaria in children. However, it has remained unclear to which extend the EPCR-binding CIDRα1 domains epitomize PfEMP1 expressed in severe malaria. Here, we characterized the near full......-length transcripts dominating the var transcriptome in children with severe malaria and found that the only common feature of the encoded PfEMP1 was CIDRα1 domains. Such genes were highly and dominantly expressed in both children with severe malarial anaemia and cerebral malaria. These observations support the...... hypothesis that the CIDRα1-EPCR interaction is key to the pathogenesis of severe malaria and strengthen the rationale for pursuing a vaccine or adjunctive treatment aiming at inhibiting or reducing the damaging effects of this interaction....

  19. Research toward Malaria Vaccines

    Science.gov (United States)

    Miller, Louis H.; Howard, Russell J.; Carter, Richard; Good, Michael F.; Nussenzweig, Victor; Nussenzweig, Ruth S.

    1986-12-01

    Malaria exacts a toll of disease to people in the Tropics that seems incomprehensible to those only familiar with medicine and human health in the developed world. The methods of molecular biology, immunology, and cell biology are now being used to develop an antimalarial vaccine. The Plasmodium parasites that cause malaria have many stages in their life cycle. Each stage is antigenically distinct and potentially could be interrupted by different vaccines. However, achieving complete protection by vaccination may require a better understanding of the complexities of B- and T-cell priming in natural infections and the development of an appropriate adjuvant for use in humans.

  20. MIGRATION AND MALARIA IN EUROPE

    Directory of Open Access Journals (Sweden)

    Begoña Monge-Maillo

    2012-03-01

    Full Text Available The proportion of imported malaria cases due to immigrants in Europe has increased during the lasts decades, being the higher rates for those settled immigrants who travel to visit friends and relatives (VFRs at their country of origin. Cases are mainly due to P. falciparum and Sub-Saharan Africa is the most common origin. Clinically, malaria in immigrants is characterized by a mild clinical presentation with even asymptomatic o delayed malaria cases and low parasitemic level. These characteristics may be explained by a semi-immunity acquired after long periods of time exposed to stable transmission of malaria. Malaria cases among immigrants, even those asymptomatic patients with sub-microscopic parasitemia, could increase the risk of transmission and reintroduction of malaria in certain areas with the adequate vectors and climate conditions. Moreover imported malaria cases by immigrants can also play an important role in the non-vectorial transmission out of endemic area, by blood transfusions, organ transplantation or congenital or occupational exposures. Probably, out of endemic areas, screening of malaria among recent arrived immigrants coming from malaria endemic countries should be performed. These aim to reduce the risk of clinical malaria in the individual as well as to prevent autochthonous transmission of malaria in areas where it had been eradicated.

  1. Severe imported malaria in an intensive care unit: a review of 59 cases

    Directory of Open Access Journals (Sweden)

    Santos Lurdes C

    2012-03-01

    Full Text Available Abstract Background In view of the close relationship of Portugal with African countries, particularly former Portuguese colonies, the diagnosis of malaria is not a rare thing. When a traveller returns ill from endemic areas, malaria should be the number one suspect. World Health Organization treatment guidelines recommend that adults with severe malaria should be admitted to an intensive care unit (ICU. Methods Severe cases of malaria in patients admitted to an ICU were reviewed retrospectively (1990-2011 and identification of variables associated with in-ICU mortality performed. Malaria prediction score (MPS, malaria score for adults (MSA, simplified acute physiology score (SAPSII and a score based on WHO's malaria severe criteria were applied. Statistical analysis was performed using StataV12. Results Fifty nine patients were included in the study, all but three were adults; 47 (79,6% were male; parasitaemia on admission, quantified in 48/59 (81.3% patients, was equal or greater than 2% in 47 of them (97.9%; the most common complications were thrombocytopaenia in 54 (91.5% patients, associated with disseminated intravascular coagulation (DIC in seven (11.8%, renal failure in 31 (52.5% patients, 18 of which (30.5% oliguric, shock in 29 (49.1% patients, liver dysfunction in 27 (45.7% patients, acidaemia in 23 (38.9% patients, cerebral dysfunction in 22 (37.2% patients, 11 of whom with unrousable coma, pulmonary oedema/ARDS in 22 (37.2% patients, hypoglycaemia in 18 (30.5% patients; 29 (49.1% patients presented five or more dysfunctions. The case fatality rate was 15.2%. Comparing the four scores, the SAPS II and the WHO score were the most sensitive to death prediction. In the univariate analysis, death was associated with the SAPS II score, cerebral malaria, acute renal and respiratory failure, DIC, spontaneous bleeding, acidosis and hypoglycaemia. Age, partial immunity to malaria, delay in malaria diagnosis and the level of parasitaemia were

  2. An integrated malaria control program with community participation on the Pacific Coast of Colombia

    Directory of Open Access Journals (Sweden)

    William Rojas

    2001-01-01

    Full Text Available The study focuses on integrated malaria control in 23 communities on the Pacific Coast of Colombia, with several elements of an ecosystem approach to human health, including malaria-related sociopolitical, ecological, and economic factors. The program fostered community participation. The program presented here had 2 components: implementation and research. The first was conducted in 23 communities, 21 of which lacked adequate health services in terms of education, community participation, prompt diagnosis and complete treatment, and vector control. Research focused on specific vector control measures and the current national health services decentralization process. The project: 1 created a malaria prevention culture in the community; 2 avoided deaths from malaria (no fatal cases in the 3-year period, compared to 5-8 deaths a year previously; 3 avoided cases of cerebral malaria (no cases, as compared to 90-110 per year previously; 4 reduced malaria incidence by 45.36%; 5 decreased length of sick leave from 7.52 to 3.7 days; 6 established a permanent network of microscope technicians and 2-way radio communications; 7 integrated work by local, regional, and outside institutions; 8 demonstrated efficacy of insecticide-impregnated bednets to reduce malaria transmission.

  3. Malaria in Wanokaka and Loli sub-districts, West Sumba District, East Nusa Tenggara Province, Indonesia.

    Science.gov (United States)

    Syafruddin, Din; Asih, Puji B S; Coutrier, Farah N; Trianty, Leily; Noviyanti, Rintis; Luase, Yaveth; Sumarto, Wajiyo; Caley, Marten; van der Ven, Andre J A M; Sauerwein, Robert W

    2006-05-01

    Malaria has long been known as one of the major public health problems in West Sumba District, East Nusa Tenggara Province, Indonesia. To obtain baseline data for establishment of a suitable malaria control program in the area, malariometric surveys were conducted in two sub-districts, Wanokaka and Loli, during the periods of January, May, and August 2005. The survey included three selected villages in each sub-district, and blood smear analyses of 701, 921, and 894 randomly selected subjects in January, May, and August revealed 30.5%, 25.3%, and 28.2% malaria positives, respectively, consisting mainly of Plasmodium falciparum and P. vivax, and in a few cases, P. malariae. Analysis of malaria prevalence at different age groups clearly reflected the common phenomenon that younger individuals are more vulnerable by infection of either P. falciparum or P. vivax. In falciparum malaria, the frequency of cases carrying gametocytes was also relatively high involving all age groups. The findings indicate that the malaria incidence and transmission in the area are relatively high and that further exploration is warranted to establish a precise malaria control program. PMID:16687671

  4. Resurrecting Dead-water Phenomenon

    CERN Document Server

    Mercier, Matthieu; Dauxois, Thierry

    2011-01-01

    We revisit experimental studies performed by Ekman on dead-water using modern techniques in order to present new insights on this peculiar phenomenon. We extend its description to more general situations such as a three-layer fluid or a linearly stratified fluid in presence of a pycnocline, showing the robustness of dead-water phenomenon. We observe large amplitude nonlinear internal waves which are coupled to the boat dynamics, and we emphasize that the modeling of the wave-induced drag requires more analysis, taking into account nonlinear effects.

  5. Cerebral palsy

    International Nuclear Information System (INIS)

    This paper reviews cranial MR findings in patients with cerebral palsy (CP) to clarify and categorize this disorder. The MR images of 40 patients with clinical CP were retrospectively reviewed. All patients suffered either varying spastic plegias, hypotonicity, or choreoathetosis. Concomitantly, the patients suffered from static encephalopathy, developmental delay, and/or microcephaly. Twenty-four patients were born at or near term, 10 were premature, and incomplete birth histories were available in six. The MR images revealed mild to severe degrees of white matter damage in 24 patients (12 term, nine premature, three unknown)

  6. Drug-resistant malaria

    OpenAIRE

    Hyde, John E

    2005-01-01

    In the past 21 years, a modest increase in the range of antimalarial drugs approved for clinical use has been complemented by a more impressive expansion in the analysis and understanding of the molecular mechanisms underlying resistance to these agents. Such resistance is a major factor in the increasing difficulty in controlling malaria, and important developments during this period are recounted here.

  7. Immunodiagnosis of malaria

    International Nuclear Information System (INIS)

    The need for improved diagnostic tests for malaria over conventional methods based on indirect immunofluorescence for the measure of antimalarial antibodies, and for identification of malaria parasites on stained blood films for antigen detection (diagnostic of ongoing infection) has led to the development of several solid phase assays. These assays have been used in limited trials for both antibody and antigen detection. Solid phase assays for antimalarial antibodies are relatively easy to perform but the currently available assays for antigen detection which are based on solid phase antibody binding inhibition are still complicated, poorly standardised and time consuming. They can not be used on a large scale in endemic areas. Several new developments including the availability of monoclonal antimalarial antibodies of known specifications, the cloning of several malarial antigens and the synthesis of malaria specific nucleotides and polypeptides may allow in the near future the development of simple and reliable assays for malarial antigens detection or the identification of genomic malaria DNA by hybridisation on infected blood samples. Moreover the measure of antimalarial antibodies of known specificities would be easily achievable. (author)

  8. Malaria and gold fever.

    OpenAIRE

    Veeken, H

    1993-01-01

    The mineral rich territory of the Yanomami Indians of northern Brazil has been invaded by miners--who have destroyed the environment and introduced disease. Médecins Sans Frontières agreed to help combat the malaria epidemic. Conditions in the rainforest and villages and the health care facilities are described. Mere medical aid cannot prevent the Yanomami from being decimated.

  9. Coadaptation and malaria control

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Tosta

    2007-06-01

    Full Text Available Malaria emerges from a disequilibrium of the system 'human-plasmodium-mosquito' (HPM. If the equilibrium is maintained, malaria does not ensue and the result is asymptomatic plasmodium infection. The relationships among the components of the system involve coadaptive linkages that lead to equilibrium. A vast body of evidence supports this assumption, including the strategies involved in the relationships between plasmodium and human and mosquito immune systems, and the emergence of resistance of plasmodia to antimalarial drugs and of mosquitoes to insecticides. Coadaptive strategies for malaria control are based on the following principles: (1 the system HPM is composed of three highly complex and dynamic components, whose interplay involves coadaptive linkages that tend to maintain the equilibrium of the system; (2 human and mosquito immune systems play a central role in the coadaptive interplay with plasmodium, and hence, in the mainten-ance of the system's equilibrium; the under- or overfunction of human immune system may result in malaria and influence its severity; (3 coadaptation depends on genetic and epigenetic phenomena occurring at the interfaces of the components of the system, and may involve exchange of infectrons (genes or gene fragments between the partners; (4 plasmodia and mosquitoes have been submitted to selective pressures, leading to adaptation, for an extremely long while and are, therefore, endowed with the capacity to circumvent both natural (immunity and artificial (drugs, insecticides, vaccines measures aiming at destroying them; (5 since malaria represents disequilibrium of the system HPM, its control should aim at maintaining or restoring this equilibrium; (6 the disequilibrium of integrated systems involves the disequilibrium of their components, therefore the maintenance or restoration of the system's equilibrium depend on the adoption of integrated and coordinated measures acting on all components, that means

  10. A rare phenomenon: oculonasal synkinesis.

    Science.gov (United States)

    Ciloglu, N Sinem; Duran, Alpay; Buyukdogan, Hasan

    2014-10-01

    Oculonasal synkinesis is the simultaneous contraction of the orbicularis oculi and the compressor narium minor muscles. The etiology of this phenomenon is still unclear; congenital and traumatic reasons are considered to be responsible. Here we report a case of oculonasal synkinesis. PMID:25015551

  11. Is consciousness a nonspatial phenomenon?.

    OpenAIRE

    Gundersen, Ståle

    2011-01-01

    Colin McGinn has argued that consciousness is a nonspatial phenomenon. McGinn’s arguments for the nonspatiality of consciousness are presented and then criticized. It is concluded that consciousness may be as spatial as electric charge and different kinds of abilities.

  12. Translation as a Psycholinguistic Phenomenon

    Science.gov (United States)

    Zasyekin, Serhiy

    2010-01-01

    The article sketches the outlines of a theoretical framework for the analysis of translation of literary texts, viewed as psycho-semiotic phenomenon and based on evaluation of earlier attempts in this direction, and on the results of a psycholinguistic empirical study of translations. Central to this framework is the recent insight that the human…

  13. Use of integrated malaria management reduces malaria in Kenya.

    Directory of Open Access Journals (Sweden)

    Bernard A Okech

    Full Text Available BACKGROUND: During an entomological survey in preparation for malaria control interventions in Mwea division, the number of malaria cases at the Kimbimbi sub-district hospital was in a steady decline. The underlying factors for this reduction were unknown and needed to be identified before any malaria intervention tools were deployed in the area. We therefore set out to investigate the potential factors that could have contributed to the decline of malaria cases in the hospital by analyzing the malaria control knowledge, attitudes and practices (KAP that the residents in Mwea applied in an integrated fashion, also known as integrated malaria management (IMM. METHODS: Integrated Malaria Management was assessed among community members of Mwea division, central Kenya using KAP survey. The KAP study evaluated community members' malaria disease management practices at the home and hospitals, personal protection measures used at the household level and malaria transmission prevention methods relating to vector control. Concurrently, we also passively examined the prevalence of malaria parasite infection via outpatient admission records at the major referral hospital in the area. In addition we studied the mosquito vector population dynamics, the malaria sporozoite infection status and entomological inoculation rates (EIR over an 8 month period in 6 villages to determine the risk of malaria transmission in the entire division. RESULTS: A total of 389 households in Mwea division were interviewed in the KAP study while 90 houses were surveyed in the entomological study. Ninety eight percent of the households knew about malaria disease while approximately 70% of households knew its symptoms and methods to manage it. Ninety seven percent of the interviewed households went to a health center for malaria diagnosis and treatment. Similarly a higher proportion (81% used anti-malarial medicines bought from local pharmacies. Almost 90% of households reported

  14. Family bio-social variables associated with severe malaria disease among under-five children in resource-poor setting of a rural hospital in Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    Gabriel Uche Pascal Iloh

    2013-01-01

    Full Text Available Background: Malaria threatens the lives of under-five in rural Nigerian families. Although factors that influence malaria in under-five are manifold, family bio-social factors may contribute to the variability of the clinical picture. Aim: To determine family bio-social variables associated with severe malaria among under-five children in a resource-poor setting of a rural hospital in Eastern Nigeria. Materials and Methods: A cross-sectional study was carried out on the families of under-five managed for malaria. Data extracted included family bio-social variables and diagnosis. An under-five child was defined to have malaria if the mother gave complaints of fever, vomiting and other symptoms suggestive of malaria, had body temperature exceeding 37.5΀C with the asexual forms of Plasmodium falciparum detected on the peripheral blood film. Severe malaria is the malaria that presents with life-threatening features like severe anemia and cerebral malaria. Results: The prevalence of severe malaria was 31.8%. The family bio-social variables significantly associated with severe malaria were maternal low level of education (P = 0.031, family size >4 (P = 0.044, low social class of the family (P = 0.025, non-living together of parents (P = 0.011, and poor access to health facilities (P = 0.038. The most significant predictor of severe malaria was non-living together of parents (P = 0.000, OR = 3.08, CI = 1.64-5.10. Conclusion: This study has demonstrated that some family bio-social variables are associated with severe malaria. These families should constitute at risk families that could be targeted for malaria interventional programs.

  15. Malaria resurgence in Senegal: measuring malaria mortality in Mlomp

    OpenAIRE

    Géraldine Duthé

    2008-01-01

    Malaria is one of the leading causes of child mortality in sub-Saharan Africa. With the development of drug-resistant parasites, the fight against malaria has become complex, and because demographic and health data are scarce in the most hard-hit countries, the impact of the disease is difficult to evaluate. Demographic surveillance sites provide a means to measure levels and trends in mortality and causes of death. The data they provide are not exhaustive, however, for malaria in particular....

  16. How malaria models relate temperature to malaria transmission

    OpenAIRE

    2013-01-01

    Background: It is well known that temperature has a major influence on the transmission of malaria parasites to their hosts. However, mathematical models do not always agree about the way in which temperature affects malaria transmission.Methods: In this study, we compared six temperature dependent mortality models for the malaria vector Anopheles gambiae sensu stricto. The evaluation is based on a comparison between the models, and observations from semi-field and laboratory sett...

  17. The changing spectrum of severe falciparum malaria: a clinical study from Bikaner (northwest India

    Directory of Open Access Journals (Sweden)

    D.K. Kochar, S.K. Kochar, R.P. Agrawal, M. Sabir, K.C. Nayak, T.D. Agrawal, V.P. Purohit , R.P. Gupta

    2006-09-01

    Full Text Available Background & objectives: Recently there were reports from all over India about changing spectrumof clinical presentation of severe malaria. The present study was planned to study the same in thenorthwest India.Methods: This prospective study was conducted on patients of severe malaria admitted in a classifiedmalaria ward of a tertiary care hospital in Bikaner, Rajasthan (northwest India during 1994 and 2001.It included adult patients of both sexes belonging to all age groups. The diagnosis of Plasmodiumfalciparum was confirmed by demonstrating asexual form of parasites in peripheral blood smear. Allpatients were treated with i.v./oral quinine. The specific complications were treated by standard WHOprotocol. The data for individual complications for both the years were analysed by applying chisquaretest.Results: In a prospective study in 1994 the spectrum of complication was dominated by cerebralmalaria (25.75% followed by jaundice (11.47%, bleeding tendencies (9.59%, severe anaemia(5.83%, shock (5.26%, Acute respiratory distress syndrome—ARDS (3.01%, renal failure (2.07%and hypoglycemia (2.07% whereas in 2001 it was dominated by jaundice (58.85% followed bysevere anaemia (26.04%, bleeding tendencies (25.52%, shock (10.94%, cerebral malaria (10.94%,renal failure (6.25%, ARDS (2.08% and hypoglycemia (1.56%. The sharp difference for presence ofjaundice and severe anaemia in 2001 and cerebral malaria in 1994 was statistically significant. Similarly,the important cause of mortality in 2001 was multiple organ dysfunction syndrome (71.10% withpredominant presentation of jaundice and renal failure, whereas in 1994, it was cerebral malaria (77.96%.Interpretation & conclusion: The observation of changing spectrum of severe malaria in this studyand a significant increase in presentation with jaundice as an important manifestation is highly essentialfor primary, secondary and tertiary level health care providers for proper diagnosis and management.

  18. City as an Interdisciplinary Phenomenon

    Directory of Open Access Journals (Sweden)

    S. A. Riazi

    2013-01-01

    Full Text Available Interdisciplinary as a new approach to the problems of science and knowledge, has a wide range, but there is no consensus on its epistemological range and ontological domain. Among the different and various problems, there is a general agreement on “City” as a field of study as an interdisciplinary phenomenon. At least, three important disciplines, geography, architecture and social sciences, have engaged in analyzing this phenomenon by using each other’s methods, indicators, and objects. The extensive scientific branches of city have attracted the attentions of phenomenologists, engineers, economists, politicians, researchers of cultural studies, environment, and media. In this paper, the interdisciplinary aspect of city is reviewed by focusing on its connection with space, media, politics, economic and culture.

  19. Progress with new malaria vaccines.

    OpenAIRE

    2003-01-01

    Malaria is a parasitic disease of major global health significance that causes an estimated 2.7 million deaths each year. In this review we describe the burden of malaria and discuss the complicated life cycle of Plasmodium falciparum, the parasite responsible for most of the deaths from the disease, before reviewing the evidence that suggests that a malaria vaccine is an attainable goal. Significant advances have recently been made in vaccine science, and we review new vaccine technologies a...

  20. The efficiency of malaria chemoprophylaxis

    OpenAIRE

    Vasiliki Pappa; Maria Saridi

    2008-01-01

    Introduction: Malaria is a highly contagious disease. According to WHO, malaria cases are expected to increase due to climate changes. Despite the eradication efforts, malaria still remains one of the most significant causes of morbidity and mortality in tropical and subtropical regions. Many different antimalarial regimens are used , however resistance is emerging to many of themPurpose: This critical review was conducted, in order to respond to the following questions. A) Which antimalaria...

  1. Surveillance considerations for malaria elimination

    OpenAIRE

    Barclay Victoria C; Smith Rachel A; Findeis Jill L

    2012-01-01

    Abstract Constant malaria monitoring and surveillance systems have been highlighted as critical for malaria elimination. The absence of robust monitoring and surveillance systems able to respond to outbreaks in a timely manner undeniably contributed to the failure of the last global attempt to eradicate malaria. Today, technological advances could allow for rapid detection of focal outbreaks and improved deployment of diagnostic and treatment supplies to areas needing support. However, optimi...

  2. Malaria during pregnancy in Rwanda

    OpenAIRE

    Rulisa, S.

    2014-01-01

    It appears that malaria in Rwanda is not a major contributor to adverse outcomes of pregnancy anymore from a public health perspective but it can still give problems in individual patients, also in areas of low malaria transmission. This thesis shows that for individual cases the current treatment options are safe and sufficient but it remains of utmost important to closely follow pregnant women. Although most of malaria infected women will develop symptoms and seek help, active monitoring du...

  3. Malaria in Kenya's Western Highlands

    OpenAIRE

    Shanks, G. Dennis; Simon I. Hay; Omumbo, Judy A.; Robert W Snow

    2005-01-01

    Records from tea estates in the Kericho district in Kenya show that malaria reemerged in the 1980s. Renewed epidemic activity coincided with the emergence of chloroquine-resistant Plasmodium falciparum malaria and may have been triggered by the failure of antimalarial drugs. Meteorologic changes, population movements, degradation of health services, and changes in Anopheles vector populations are possible contributing factors. The highland malaria epidemics of the 1940s were stopped largely b...

  4. Malaria Diagnostics in Clinical Trials

    OpenAIRE

    Murphy, Sean C.; Shott, Joseph P.; Parikh, Sunil; Etter, Paige; Prescott, William R.; Stewart, V. Ann

    2013-01-01

    Malaria diagnostics are widely used in epidemiologic studies to investigate natural history of disease and in drug and vaccine clinical trials to exclude participants or evaluate efficacy. The Malaria Laboratory Network (MLN), managed by the Office of HIV/AIDS Network Coordination, is an international working group with mutual interests in malaria disease and diagnosis and in human immunodeficiency virus/acquired immunodeficiency syndrome clinical trials. The MLN considered and studied the wi...

  5. Cerebral cysticercosis

    International Nuclear Information System (INIS)

    Two cases of histologically proven cerebral cysticercosis are presented. In both cases subcutaneous tissue nodules, a rare feature, were present. Several disease patterns are apparent - meningeal, parenchymatous and ventricular, spinal cord lesions and mixed patterns. Epilepsy is by far the major presenting symptom of cysticercosis, which in turn plays a significant role in the causation of adult-onset epilepsy in Blacks. Despite its drawbacks, the haemag-glutination inhibition test remains the most satisfactory serological method at present available for the diagnosis of cysticercosis; it is positive in up to 85% of cases of proven cysticercosis. With the advent of computed tomography many cases of unsuspected cysticercosis (symptomatic or asymptomatic) are being discovered

  6. An intriguing oscillating combustion phenomenon

    OpenAIRE

    Corbel, J.M.L.; van Lingen, J.N.J.; Zevenbergen, J.F.; Gijzeman, O.L.J.; Meijerink, A.

    2012-01-01

    Strobes are pyrotechnic compositions that emit bright flashes of white or colored light at regular time intervals. The strobe effect has applications in various fields, most notably in the fireworks industry and in the military area (signaling – missile decoys – crowd control). However, the chemical and physical mechanisms involved in this curious combustion phenomenon remain unknown. This study investigates parameters that influence the strobe effect (frequency, sharpness of flashes). Variat...

  7. TERRORISM AS A COMMUNICATION PHENOMENON

    OpenAIRE

    Atanesian, Arthur

    2009-01-01

    Some of the contemporary theories of the mass media and political communications teach their audiences and mold public ideas about events or phenomena which political forces exploit for their own ends. The media do not merely cover events or describe phenomena-they cover them with "outgrowths" that disfigure them to the extent that the public gradually shifts from discussing the real phenomenon to its virtual likeness, which might well be a product of media skills. This explains why from time...

  8. Entropy-driven cutoff phenomenon

    CERN Document Server

    Lancia, Carlo

    2011-01-01

    In this article we present a theorem relating the cutoff phenomenon for finite Markov chains to suitably chosen random times. We have in mind the generalization to systems with uniform stationary measure of the link between hitting times and cutoff. Such link has been already proved in literature only for systems with stationary measure concentrated in a finite region. We show some examples of application of our result.

  9. PHENOMENON OF CARVED DRIVING WHEELS

    Institute of Scientific and Technical Information of China (English)

    LI Xianghua; ZHANG Jianwu

    2007-01-01

    A newly found phenomenon of carved driving wheels of a rea-wheel-drive tractor used in an airport is discussed. The circum of every driving wheel is damaged at three regions, which distribute regularly and uniformly. Everyday, the tractor tows a trailer which are times heavier than the tractor, and moves on the same road in the airport. The phenomenon is explained by the torsional self-excited vibration system of the powertrain. The simplified torsional vibration system is discribed by a 2-order ordinary differential equation, which has a limit circle. Experiments and numerical simulations show the followings: Because of the heavy trailer, the slip ratio of the tractor's driving wheels is very large. Therefore, there is severe torsional self-excited vibration in the tractor's drivetrain, and the self-excited vibration results in severe and regular fluctuations of the rear wheel's velocity. The severe fluctuations in velocity fastens the damage of the driving wheels. At the same time, the time interval in which an arbitrary point in the circum of the driving wheel contacts with the road twice is two times more than the period of the torsional self-excited vibration, and this times explained the existence of three damaged regions. At last, it points out that the phenomenon can be avoided when the torsional damping is large enough.

  10. Transfected HEK293 Cells Expressing Functional Recombinant Intercellular Adhesion Molecule 1 (ICAM-1) - A Receptor Associated with Severe Plasmodium falciparum Malaria

    DEFF Research Database (Denmark)

    Bengtsson, Anja; Joergensen, Louise; Barbati, Zachary R; Craig, Alister; Hviid, Lars; Jensen, Anja T R

    2013-01-01

    been suggested to be involved in the development of cerebral malaria. However, more studies identifying cross-reactive antibody and ICAM-1-binding epitopes and the establishment of a clinical link between DBLβ expression and e.g. cerebral malaria are needed before the DBLβ domains can be put forward as...... purity, yield, fold, ability to bind DBLβ, and relative cost. We present a HEK293 cell-based, high-yield expression and purification scheme for producing inexpensive, functional ICAM‑1. ICAM-1 expressed in HEK293 is applicable to malaria research and can also be useful in other research fields........ Additionally, ICAM-1 acts as receptor for pathogens like human rhinovirus and Plasmodium falciparum malaria parasites. A group of related P. falciparum erythrocyte membrane protein 1 (PfEMP1) domains, the DBLβ, mediates ICAM-1 binding of P. falciparum-infected erythrocytes. This ICAM‑1-binding phenotype has...

  11. Ungulate malaria parasites

    OpenAIRE

    Thomas J. Templeton; Masahito Asada; Montakan Jiratanh; Ishikawa, Sohta A.; Sonthaya Tiawsirisup; Thillaiampalam Sivakumar; Boniface Namangala; Mika Takeda; Kingdao Mohkaew; Supawan Ngamjituea; Noboru Inoue; Chihiro Sugimoto; Yuji Inagaki; Yasuhiko Suzuki; Naoaki Yokoyama

    2016-01-01

    Haemosporida parasites of even-toed ungulates are diverse and globally distributed, but since their discovery in 1913 their characterization has relied exclusively on microscopy-based descriptions. In order to bring molecular approaches to bear on the identity and evolutionary relationships of ungulate malaria parasites, we conducted Plasmodium cytb-specific nested PCR surveys using blood from water buffalo in Vietnam and Thailand, and goats in Zambia. We found that Plasmodium is readily dete...

  12. Artemether for severe malaria

    OpenAIRE

    Esu, Ekpereonne; Effa, Emmanuel E; Opie, Oko N; Uwaoma, Amirahobu; Meremikwu, Martin M

    2014-01-01

    Background In 2011 the World Health Organization (WHO) recommended parenteral artesunate in preference to quinine as first-line treatment for people with severe malaria. Prior to this recommendation, many countries, particularly in Africa, had begun to use artemether, an alternative artemisinin derivative. This review evaluates intramuscular artemether compared with both quinine and artesunate. Objectives To assess the efficacy and safety of intramuscular artemether versus any other parentera...

  13. Malaria and the heart

    OpenAIRE

    Bhat, Smitha; Alva, Jayaprakash; Muralidhara, Krithika; Fahad, Sayid

    2012-01-01

    A 40-year-old healthy manual labourer from a malaria endemic area with no known risk factors for atherosclerotic coronary vascular disease was admitted to our hospital with a history of fever with chills and rigours. Physical examination revealed tachypnoea and icterus. Peripheral smear showed trophozoites of Plasmodium vivax and thrombocytopaenia. The patient was administered artesunate. Six hours after admission, he complained of severe substernal chest pain. A 12-lead ECG revealed ST eleva...

  14. Oxidative Stress in Malaria

    OpenAIRE

    Dolabela, Maria F; Vilhena, Thyago C; Laurindo, Paula S. O. C.; Gonçalves, Ana Carolina M.; Ferreira, Michelli E. S.; Gomes, Bruno A. Q.; Danilo R. Moreira; Sandro Percário; Green, Michael D.

    2012-01-01

    Malaria is a significant public health problem in more than 100 countries and causes an estimated 200 million new infections every year. Despite the significant effort to eradicate this dangerous disease, lack of complete knowledge of its physiopathology compromises the success in this enterprise. In this paper we review oxidative stress mechanisms involved in the disease and discuss the potential benefits of antioxidant supplementation as an adjuvant antimalarial strategy.

  15. Tumour necrosis factor alpha promoter polymorphism, TNF-238 is associated with severe clinical outcome of falciparum malaria in Ibadan southwest Nigeria.

    Science.gov (United States)

    Olaniyan, Subulade A; Amodu, Olukemi K; Bakare, Adekunle A; Troye-Blomberg, Marita; Omotade, Olayemi O; Rockett, Kirk A

    2016-09-01

    Tumour necrosis factor (TNF) - α has been shown to play an important role in the pathogenesis of falciparum malaria. Two TNF promoter polymorphisms, TNF-308 and TNF-238 have been associated with differential activity and production of TNF. In order to investigate the association between TNF-308 and TNF-238 and the clinical outcome of malaria in a Nigerian population, the two TNF polymorphisms were analysed using Sequenom iPLEX Platform. A total of 782 children; 283 children with uncomplicated malaria, 255 children with severe malaria and 244 children with asymptomatic infection (controls) were studied. The distribution of TNF-308 and TNF-238 genotypes were consistent with the Hardy-Weinberg equilibrium. Distribution of both TNF polymorphisms differed significantly across all clinical groups (TNF-308: p=0.007; TNF-238: p=0.001). Further tests for association with severe malaria using genotype models controlling for age, parasitaemia and HbAS showed a significant association of the TNF-238 polymorphism with susceptibility to severe malaria (95% CI=1.43-6.02, OR=2.94, p=0.003237) The GG genotype of TNF-238 significantly increased the risk of developing cerebral malaria from asymptomatic malaria and uncomplicated malaria (95% CI=1.99-18.17, OR=6.02, pmalaria outcome. These results show thegenetic association of TNF-238 in the clinical outcome of malaria in Ibadan, southwest Nigeria. These findings add support to the role of TNF in the outcome of malaria infection. Further large scale studies across multiple malaria endemic populations will be required to determine the specific roles of TNF-308 and TNF-238 in the outcome of falciparum malaria infection. PMID:27178813

  16. Pitting of malaria parasites and spherocyte formation

    Directory of Open Access Journals (Sweden)

    Gichuki Charity W

    2006-07-01

    Full Text Available Abstract Background A high prevalence of spherocytes was detected in blood smears of children enrolled in a case control study conducted in the malaria holoendemic Lake Victoria basin. It was speculated that the spherocytes reflect intraerythrocytic removal of malarial parasites with a concurrent removal of RBC membrane through a process analogous to pitting of intraerythrocytic inclusion bodies. Pitting and re-circulation of RBCs devoid of malaria parasites could be a host mechanism for parasite clearance while minimizing the anaemia that would occur were the entire parasitized RBC removed. The prior demonstration of RBCs containing ring-infected erythrocyte surface antigen (pf 155 or RESA but no intracellular parasites, support the idea of pitting. Methods An in vitro model was developed to examine the phenomenon of pitting and spherocyte formation in Plasmodium falciparum infected RBCs (iRBC co-incubated with human macrophages. In vivo application of this model was evaluated using blood specimens from patients attending Kisumu Ditrict Hospital. RBCs were probed with anti-RESA monoclonal antibody and a DNA stain (propidium iodide. Flow cytometry and fluorescent microscopy was used to compare RBCs containing both the antigen and the parasites to those that were only RESA positive. Results Co-incubation of iRBC and tumor necrosis factor-alpha activated macrophages led to pitting (14% ± 1.31% macrophages with engulfed trophozoites as opposed to erythrophagocytosis (5.33% ± 0.95% (P Conclusion It is proposed that in malaria holoendemic areas where prevalence of asexual stage parasites approaches 100% in children, RBCs with pitted parasites are re-circulated and pitting may produce spherocytes.

  17. AIDS as a social phenomenon.

    Science.gov (United States)

    Bennett, F J

    1987-01-01

    AIDS as a new lethal and at present incurable sexually transmitted disease is already having remarkable social repercussions not yet fully explicit and hence it can be termed a social phenomenon. Political, behavioural, economic and legal reactions and social responses such as stigmatization, changes in the sick role and the growth of voluntary organizations and international collaboration are described. Communication, education and information aspects of AIDS are considered using material from the press and it is clear that a massive educational approach to modify behaviour must be the basis for a control programme. PMID:3317877

  18. RIFINs are adhesins implicated in severe Plasmodium falciparum malaria

    DEFF Research Database (Denmark)

    Goel, Suchi; Palmkvist, Mia; Moll, Kirsten;

    2015-01-01

    Rosetting is a virulent Plasmodium falciparum phenomenon associated with severe malaria. Here we demonstrate that P. falciparum–encoded repetitive interspersed families of polypeptides (RIFINs) are expressed on the surface of infected red blood cells (iRBCs), where they bind to RBCs—preferentiall......Rosetting is a virulent Plasmodium falciparum phenomenon associated with severe malaria. Here we demonstrate that P. falciparum–encoded repetitive interspersed families of polypeptides (RIFINs) are expressed on the surface of infected red blood cells (iRBCs), where they bind to RBCs......—preferentially of blood group A—to form large rosettes and mediate microvascular binding of iRBCs. We suggest that RIFINs have a fundamental role in the development of severe malaria and thereby contribute to the varying global distribution of ABO blood groups in the human population....

  19. Malaria during pregnancy in Rwanda

    NARCIS (Netherlands)

    S. Rulisa

    2014-01-01

    It appears that malaria in Rwanda is not a major contributor to adverse outcomes of pregnancy anymore from a public health perspective but it can still give problems in individual patients, also in areas of low malaria transmission. This thesis shows that for individual cases the current treatment o

  20. Malaria vaccine: a current perspective

    Directory of Open Access Journals (Sweden)

    Shobhona Sharma

    2008-02-01

    Full Text Available The observation that inactivated Plasmodium sporozoites could protect against malaria is about a hundred years old. However, systematic demonstration of protection using irradiated sporozoites occurred in the nineteen-sixties, providing the impetus for the development of a malaria vaccine. In 1983, the circumsporozoite protein (CSP, a major sporozoite surface antigen, became the first Plasmodium gene to be cloned, and a CSP-based vaccine appeared imminent. Today, 25 years later, we are still without an effective malaria vaccine, despite considerable information regarding the genomics and proteomics of the malaria parasites. Although clinical immunity to malaria has been well-documented in adults living in malaria endemic areas, our understanding of the host-immune responses operating in such malaria immune persons remains poor, and limits the development of immune control of the disease. Currently, several antigen and adjuvant combinations have entered clinical trials, in which efficacy against experimental sporozoite challenge and/or exposure to natural infection is evaluated. This review collates information on the recent status of the field. Unresolved challenges facing the development of a malaria vaccine are also discussed.

  1. Malaria early warning in Kenya

    OpenAIRE

    Simon I. Hay; Rogers, David J.; Shanks, G. Dennis; Monica F. Myers; Robert W Snow

    2001-01-01

    Kenya displays large spatiotemporal diversity in its climate and ecology. It follows that malaria transmission will reflect this environmental heterogeneity in both space and time. In this article, we discuss how such heterogeneity, and its epidemiological consequences, should be considered in the development of early warning systems for malaria epidemics.

  2. A case of Plasmodium vivax related cerebral malaria Case Report

    OpenAIRE

    Bayraktar, Süleyman; Bayrak, Seher Tabanlı; Emir, H. Haldun; Elevli, Murat

    2005-01-01

    Sıtmalı hastada ağrının yerinin belirlenememesi ve ensefalopatinin başka herhangi bir nedenle açıklanamaması durumu serebral malarya olarak tanımlanır Sıklığı kesin olarak bilinmemektedir Plasmodium vivax a bağlı serebral malarya Plasmodium falciparum a göre çok daha nadirdir Nadir rastlanması dolayısıyla Plasmodium vivax a bağlı 7 yaşında bir çocuk serebral malarya olgusu sunulmuştur Anahtar Kelimeler: serebral malarya plasmodium vivax

  3. Advances in the management of cerebral malaria in adults

    DEFF Research Database (Denmark)

    Mishra, Saroj K; Wiese, Lothar

    2009-01-01

    into large clinical trials. SUMMARY: Advances have been made in terms of antiparasitic treatment, but the identification of a well tolerated and effective adjuvant treatment to increase survival and reduce brain damage is still pending. The search for new approaches is a major challenge, not least of which...

  4. Candidate human genetic polymorphisms and severe malaria in a Tanzanian population.

    Directory of Open Access Journals (Sweden)

    Alphaxard Manjurano

    Full Text Available Human genetic background strongly influences susceptibility to malaria infection and progression to severe disease and death. Classical genetic studies identified haemoglobinopathies and erythrocyte-associated polymorphisms, as protective against severe disease. High throughput genotyping by mass spectrometry allows multiple single nucleotide polymorphisms (SNPs to be examined simultaneously. We compared the prevalence of 65 human SNP's, previously associated with altered risk of malaria, between Tanzanian children with and without severe malaria. Five hundred children, aged 1-10 years, with severe malaria were recruited from those admitted to hospital in Muheza, Tanzania and compared with matched controls. Genotyping was performed by Sequenom MassArray, and conventional PCR was used to detect deletions in the alpha-thalassaemia gene. SNPs in two X-linked genes were associated with altered risk of severe malaria in females but not in males: heterozygosity for one or other of two SNPs in the G6PD gene was associated with protection from all forms of severe disease whilst two SNPs in the gene encoding CD40L were associated with respiratory distress. A SNP in the adenyl cyclase 9 (ADCY9 gene was associated with protection from acidosis whilst a polymorphism in the IL-1α gene (IL1A was associated with an increased risk of acidosis. SNPs in the genes encoding IL-13 and reticulon-3 (RTN3 were associated with increased risk of cerebral malaria. This study confirms previously known genetic associations with protection from severe malaria (HbS, G6PD. It identifies two X-linked genes associated with altered risk of severe malaria in females, identifies mutations in ADCY9, IL1A and CD40L as being associated with altered risk of severe respiratory distress and acidosis, both of which are characterised by high serum lactate levels, and also identifies novel genetic associations with severe malaria (TRIM5 and cerebral malaria(IL-13 and RTN3. Further studies

  5. Combined measurement of soluble and cellular ICAM-1 among children with Plasmodium falciparum malaria in Uganda

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    Cserti-Gazdewich Christine M

    2010-08-01

    Full Text Available Abstract Background Intercellular adhesion molecule-1 (ICAM-1 is a cytoadhesion molecule implicated in the pathogenesis of Plasmodium falciparum malaria. Elevated levels of soluble ICAM-1 (sICAM-1 have previously been reported with increased malaria disease severity. However, studies have not yet examined both sICAM-1 concentrations and monocyte ICAM-1 expression in the same cohort of patients. To better understand the relationship of soluble and cellular ICAM-1 measurements in malaria, both monocyte ICAM-1 expression and sICAM-1 concentration were measured in children with P. falciparum infection exhibiting a spectrum of clinical severity. Methods Samples were analysed from 160 children, aged 0.5 to 10.8 years, with documented P. falciparum malaria in Kampala, Uganda. The patients belonged to one of three pre-study defined groups: uncomplicated malaria (UM, severe non-fatal malaria (SM-s, and fatal malaria (SM-f. Subset analysis was done on those with cerebral malaria (CM or severe malaria anaemia (SMA. Monocyte ICAM-1 was measured by flow cytometry. sICAM-1 was measured by enzyme immunoassay. Results Both sICAM-1 and monocyte cell-surface ICAM-1 followed a log-normal distribution. Median sICAM-1 concentrations increased with greater severity-of-illness: 279 ng/mL (UM, 462 ng/mL (SM-s, and 586 ng/mL (SM-f, p Conclusion In this cohort of children with P. falciparum malaria, sICAM-1 levels were associated with severity-of-illness. Patients with UM had higher monocyte ICAM-1 expression consistent with a role for monocyte ICAM-1 in immune clearance during non-severe malaria. Among the subsets of patients with either SMA or CM, monocyte ICAM-1 levels were higher in CM, consistent with the role of ICAM-1 as a marker of cytoadhesion. Categories of disease in pediatric malaria may exhibit specific combinations of soluble and cellular ICAM-1 expression.

  6. United Cerebral Palsy

    Science.gov (United States)

    ... Voices of UCP blog for the latest updates. United Cerebral Palsy UCP educates, advocates and provides support ... Our Partners Merz Logo Sprint Relay Copyright © 2015 United Cerebral Palsy 1825 K Street NW Suite 600 ...

  7. A Research Agenda for Malaria Eradication: Vaccines

    OpenAIRE

    ,

    2011-01-01

    Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of “vaccines that interrupt...

  8. A research agenda for malaria eradication: vaccines.

    OpenAIRE

    Abdulla, S.; Agre, P; P.L. Alonso; Arevalo-Herrera, M.; Bassat, Q.; Binka, F.; Chitnis, C.; Corradin, G; Cowman, A. F.; Culpepper, J.; Portillo, H. del; Dinglasan, R. R.; Duffy, P.; Gargallo, D; Greenwood, B.

    2011-01-01

    Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of "vaccines that interrupt...

  9. Does Reducing Malaria Improve Household Living Standards?

    OpenAIRE

    Laxminarayan, Ramanan

    2003-01-01

    Living in malaria-endemic regions places an economic burden on households even if they do not actually suffer an episode of malaria. Households living with endemic malaria are less likely to have access to economic opportunities and may have to modify agricultural practices and other household behavior to adapt to their disease environment. Data from Vietnam demonstrate that reductions in malaria incidence through government-financed malaria control programs can contribute to higher household...

  10. Cerebral palsy and epilepsy

    OpenAIRE

    Knežević-Pogančev Marija

    2010-01-01

    Introduction. Cerebral palsy is the most common cause of physical disability in early childhood. Epilepsy is known to have a high association with cerebral palsy. All types of epileptic seizures can be seen in patients with cerebral palsy. Complex partial and secondary generalized ones are the most frequent seizure types. In persons with cerebral palsy and mental retardation, the diagnosis of epilepsy presents unique difficulties. Generally they are not able to describe the epileptic ev...

  11. Caso mortal de Malaria Cerebral en la misión de Uganda Death due to cerebral malaria in Uganda

    OpenAIRE

    M.E. Presa García

    2012-01-01

    Las enfermedades y lesiones no de combate han sido y siguen siendo en nuestros días una amenaza muy importante para nuestras tropas. Entre ellas, las enfermedades transmitidas por vectores artrópodos ocupan un lugar importante, como es el caso del paludismo en Uganda. La prevención Sanitaria incluye una fase previa al despliegue, una fase de despliegue y otra fase posterior al despliegue. Durante nuestra misión en Uganda se ha perseguido cada una de estas fases para hacer frente a este riesgo...

  12. Clinical pharmacology and malaria.

    Science.gov (United States)

    Breckenridge, A M; Winstanley, P A

    1997-10-01

    The role of clinical pharmacology in improving the prevention and treatment of malaria is reviewed. A series of general and specific issues is discussed, concentrating on risk-benefit and cost-effectiveness. The techniques of clinical pharmacokinetics play an important role in the optimal use of drugs and this is illustrated by studies on quinine and proguanil. In discussing amodiaquine toxicity, the role of the pharmacologist and the chemist in designing out drug toxicity lends hope for producing a new generation of antimalarial drugs. PMID:9625927

  13. Immunoserology of malaria

    Directory of Open Access Journals (Sweden)

    Eduardo L. F. Franco

    1986-04-01

    Full Text Available This literature review discusses the most frequently used serodiagnostic methods for the determination of the humoral immune response to malarial parasites. The importance of malaria as a global public health problem is stressed in the light of the new discoveries leading to the future development of an anti-malarial vaccine suitable for use in humans. Serological techniques are expected to play an important role in the assessment of the relative efficacy of these candidate vaccines. A discussion of the different antigen preparation techniques is also presented.

  14. Rapid Diagnosis of Vivax Malaria by the SD Bioline Malaria Antigen Test When Thrombocytopenia Is Present▿

    OpenAIRE

    Lee, Sei Won; Jeon, Kyeongman; Jeon, Byung Ryul; Park, Inho

    2007-01-01

    An easy and reliable diagnostic method for malaria is highly desirable. We examined the recently introduced SD Bioline Malaria Antigen test, which detects Plasmodium lactate dehydrogenase, with the additional aid of the presence or absence of thrombocytopenia to diagnose vivax malaria. We enrolled 732 patients with clinically suspected malaria in an area where vivax malaria is endemic. We performed microscopic examination of thin film, applied the SD Bioline Malaria Antigen test, and checked ...

  15. Severe adult malaria is associated with specific PfEMP1 adhesion types and high parasite biomass.

    Science.gov (United States)

    Bernabeu, Maria; Danziger, Samuel A; Avril, Marion; Vaz, Marina; Babar, Prasad H; Brazier, Andrew J; Herricks, Thurston; Maki, Jennifer N; Pereira, Ligia; Mascarenhas, Anjali; Gomes, Edwin; Chery, Laura; Aitchison, John D; Rathod, Pradipsinh K; Smith, Joseph D

    2016-06-01

    The interplay between cellular and molecular determinants that lead to severe malaria in adults is unexplored. Here, we analyzed parasite virulence factors in an infected adult population in India and investigated whether severe malaria isolates impair endothelial protein C receptor (EPCR), a protein involved in coagulation and endothelial barrier permeability. Severe malaria isolates overexpressed specific members of the Plasmodium falciparum var gene/PfEMP1 (P. falciparum erythrocyte membrane protein 1) family that bind EPCR, including DC8 var genes that have previously been linked to severe pediatric malaria. Machine learning analysis revealed that DC6- and DC8-encoding var transcripts in combination with high parasite biomass were the strongest indicators of patient hospitalization and disease severity. We found that DC8 CIDRα1 domains from severe malaria isolates had substantial differences in EPCR binding affinity and blockade activity for its ligand activated protein C. Additionally, even a low level of inhibition exhibited by domains from two cerebral malaria isolates was sufficient to interfere with activated protein C-barrier protective activities in human brain endothelial cells. Our findings demonstrate an interplay between parasite biomass and specific PfEMP1 adhesion types in the development of adult severe malaria, and indicate that low impairment of EPCR function may contribute to parasite virulence. PMID:27185931

  16. The Coupling of Cerebral Metabolic Rate of Glucose and Cerebral Blood Flow In Vivo

    DEFF Research Database (Denmark)

    Hasselbalch, Steen; Paulson, Olaf Bjarne

    2012-01-01

    The energy supplied to the brain by metabolic substrate is largely utilized for maintaining synaptic transmission. In this regulation cerebral blood flow and glucose consumption is tightly coupled as well in the resting condition as during activation. Quantification of cerebral blood flow and...... not used for aerobic metabolism. Although some of the excess glucose uptake can be explained by lactate production, this phenomenon can still not account for the excess glucose uptake. Thus, more complex metabolic patterns in the brain might be reflected in the excess glucose uptake during activation...

  17. Current scenario of malaria vaccine

    Directory of Open Access Journals (Sweden)

    Jarnail Singh Braich

    2012-04-01

    Full Text Available Malaria is one of the deadliest infectious diseases that affects millions of people worldwide including India. As an addition to chemoprophylaxis and other antimalarial interventions malaria vaccine is under extensive research since decades. The vaccine development is more difficult to predict than drug development and presents a unique challenge as already there has been no vaccine effective against a parasite. Effective malaria vaccine could help eliminate and eradicate malaria; there are currently 63 vaccine candidates, 41 in preclinical and clinical stages of development. Vaccines are being designed to target pre-erythrocytic stages, erythrocytic stage or the sexual stages of Plasmodium taken up by a feeding mosquito, or the multiple stages. Two vaccines in preclinical and clinical development target P. falciparum; and the most advanced candidate is the pre-erythrocytic vaccine RTS,S which is in phase-III clinical trials. It is likely that world's first malaria vaccine will be available by 2015 at the country level. More efficacious second generation malaria vaccines are on the way to development. Safety, efficacy, cost and provision of the vaccine to all communities are major concerns in malaria vaccine issue. [Int J Basic Clin Pharmacol 2012; 1(2.000: 60-66

  18. IL-22 dampens the T cell response in experimental malaria

    Science.gov (United States)

    Sellau, Julie; Alvarado, Catherine Fuentes; Hoenow, Stefan; Mackroth, Maria Sophie; Kleinschmidt, Dörte; Huber, Samuel; Jacobs, Thomas

    2016-01-01

    A tight regulation between the pro– and anti–inflammatory immune responses during plasmodial infection is of crucial importance, since a disruption leads to severe malaria pathology. IL-22 is a member of the IL-10 cytokine family, which is known to be highly important in immune regulation. We could detect high plasma levels of IL-22 in Plasmodium falciparum malaria as well as in Plasmodium berghei ANKA (PbA)-infected C57BL/6J mice. The deficiency of IL-22 in mice during PbA infection led to an earlier occurrence of cerebral malaria but is associated with a lower parasitemia compared to wt mice. Furthermore, at an early time point of infection T cells from PbA-infected Il22−/− mice showed an enhanced IFNγ but a diminished IL-17 production. Moreover, dendritic cells from Il22−/− mice expressed a higher amount of the costimulatory ligand CD86 upon infection. This finding can be corroborated in vitro since bone marrow-derived dendritic cells from Il22−/− mice are better inducers of an antigen-specific IFNγ response by CD8+ T cells. Even though there is no IL-22 receptor complex known on hematopoietic cells, our data suggest a link between IL-22 and the adaptive immune system which is currently not identified. PMID:27311945

  19. Ungulate malaria parasites.

    Science.gov (United States)

    Templeton, Thomas J; Asada, Masahito; Jiratanh, Montakan; Ishikawa, Sohta A; Tiawsirisup, Sonthaya; Sivakumar, Thillaiampalam; Namangala, Boniface; Takeda, Mika; Mohkaew, Kingdao; Ngamjituea, Supawan; Inoue, Noboru; Sugimoto, Chihiro; Inagaki, Yuji; Suzuki, Yasuhiko; Yokoyama, Naoaki; Kaewthamasorn, Morakot; Kaneko, Osamu

    2016-01-01

    Haemosporida parasites of even-toed ungulates are diverse and globally distributed, but since their discovery in 1913 their characterization has relied exclusively on microscopy-based descriptions. In order to bring molecular approaches to bear on the identity and evolutionary relationships of ungulate malaria parasites, we conducted Plasmodium cytb-specific nested PCR surveys using blood from water buffalo in Vietnam and Thailand, and goats in Zambia. We found that Plasmodium is readily detectable from water buffalo in these countries, indicating that buffalo Plasmodium is distributed in a wider region than India, which is the only area in which buffalo Plasmodium has been reported. Two types (I and II) of Plasmodium sequences were identified from water buffalo and a third type (III) was isolated from goat. Morphology of the parasite was confirmed in Giemsa-reagent stained blood smears for the Type I sample. Complete mitochondrial DNA sequences were isolated and used to infer a phylogeny in which ungulate malaria parasites form a monophyletic clade within the Haemosporida, and branch prior to the clade containing bird, lizard and other mammalian Plasmodium. Thus it is likely that host switching of Plasmodium from birds to mammals occurred multiple times, with a switch to ungulates independently from other mammalian Plasmodium. PMID:26996979

  20. Drug resistance in malaria

    Directory of Open Access Journals (Sweden)

    S C Parija

    2011-01-01

    Full Text Available Antimalarial chemotherapy is an important component of all malaria control programmes throughout the world. This is especially so in light of the fact that there are no antimalarial vaccines which are available for clinical use at present. Emergence and spread of malaria parasites which are resistant to many of the available antimalarials today is, therefore, a major cause for concern. Till date, resistance to all groups of antimalarials excluding artemisinin has been reported. In recent years, in vitro resistance to even artemisinin has been described. While resistance to antibacterial agents has come to prominence as a clinical problem in recent years, antiparasitic resistance in general and antimalarial resistance in particular has not received much attention, especially in the Indian scenario. The present review deals with commonly used antimalarial drugs and the mechanisms of resistance to them. Various methods of detecting antimalarial resistance and avoiding the same have also been dealt with. Newer parasite targets which can be used in developing newer antimalarial agents and antimalarials obtained from plants have also been mentioned.

  1. Deixis as a symbolic phenomenon

    Directory of Open Access Journals (Sweden)

    West, Donna E.

    2011-01-01

    Full Text Available Children's early development of demonstrative use emanates directly from indexical gestures, namely, eye gaze, pointing, prehensile reaching, and giving exchanges. These indexical gestures become social in that they are joint attentional, and mark the inception of deictic use. Although children's deictic use draws upon index as a directional and social phenomenon, early uses of index alone do not deliver any semantic/lexical/symbolic determinants to the mix. The distinctive premise here is that deictics, especially demonstratives, are not merely social, but symbolic from a Peircian perspective, especially in light of developmental findings (West 1986, 1987, 2010; Tanz 2009 indicating an acquisitional pattern of non-contrastive to contrastive uses of "this" and "that" from 3;0–4;9. While initial non-contrastive uses of demonstratives are directional and/or social, contrastive use after 3;0 requires apprehension of symbolic role taking/role shifting. In addition to delivering the indexical and/or social, deictic indicators must implicitly refer to a class (Nunberg 1993, 1995, e.g., near/far objects from speaker's perspective in the case of demonstratives, and must ultimately have the potential to contrast objects/places with respect to distinctive points of orientation. These components together illustrate how mastery of deictic indicators is both a socio-pragmatic and semantic enterprise. In addition to indexing objects and securing joint attention with gesture, deixis requires semiotic and semantically based orientational competencies to shift perspectives and speech situation roles.

  2. The phenomenon of Soviet science.

    Science.gov (United States)

    Kojevnikov, Alexei

    2008-01-01

    The grand "Soviet experiment" constituted an attempt to greatly accelerate and even shortcut the gradual course of historical development on the assumption of presumed knowledge of the general laws of history. This paper discusses the parts of that experiment that directly concerned scientific research and, in fact, anticipated or helped define important global changes in the functioning of science as a profession and an institution during the twentieth century. The phenomenon of Soviet, or socialist, science is analyzed here from the comparative international perspective, with attention to similarities and reciprocal influences, rather than to the contrasts and dichotomies that have traditionally interested cold war-type historiography. The problem is considered at several levels: philosophical (Soviet thought on the relationship between science and society and the social construction of scientific knowledge); institutional (the state recognition of research as a separate profession, the rise of big science and scientific research institutes); demographic (science becoming a mass profession, with ethnic and gender diversity among scientists); and political (Soviet-inspired influences on the practice of science in Europe and the United States through the social relations of science movement of the 1930s and the Sputnik shock of the 1950s). PMID:18831319

  3. Profiling the host response to malaria vaccination and malaria challenge.

    OpenAIRE

    Dunachie, S; Hill, AV; Fletcher, HA

    2015-01-01

    A vaccine for malaria is urgently required. The RTS,S vaccine represents major progress, but is only partially effective. Development of the next generation of highly effective vaccines requires elucidation of the protective immune response. Immunity to malaria is known to be complex, and pattern-based approaches such as global gene expression profiling are ideal for understanding response to vaccination and protection against disease. The availability of experimental sporozoite challenge in ...

  4. Travel risk, malaria importation and malaria transmission in Zanzibar

    OpenAIRE

    Arnaud Le Menach; Tatem, Andrew J; Cohen, Justin M; Hay, Simon I; Heather Randell; Patil, Anand P.; Smith, David L

    2011-01-01

    The prevalence of Plasmodium falciparum malaria in Zanzibar has reached historic lows. Improving control requires quantifying malaria importation rates, identifying high-risk travelers, and assessing onwards transmission. Estimates of Zanzibar's importation rate were calculated through two independent methodologies. First, mobile phone usage data and ferry traffic between Zanzibar and mainland Tanzania were re-analyzed using a model of heterogeneous travel risk. Second, a dynamic mathematical...

  5. A potential role for plasma uric acid in the endothelial pathology of Plasmodium falciparum malaria.

    Directory of Open Access Journals (Sweden)

    Neida K Mita-Mendoza

    Full Text Available BACKGROUND: Inflammatory cytokinemia and systemic activation of the microvascular endothelium are central to the pathogenesis of Plasmodium falciparum malaria. Recently, 'parasite-derived' uric acid (UA was shown to activate human immune cells in vitro, and plasma UA levels were associated with inflammatory cytokine levels and disease severity in Malian children with malaria. Since UA is associated with endothelial inflammation in non-malaria diseases, we hypothesized that elevated UA levels contribute to the endothelial pathology of P. falciparum malaria. METHODOLOGY/PRINCIPAL FINDINGS: We measured levels of UA and soluble forms of intercellular adhesion molecule-1 (sICAM-1, vascular cell adhesion molecule-1 (sVCAM-1, E-selectin (sE-Selectin, thrombomodulin (sTM, tissue factor (sTF and vascular endothelial growth factor (VEGF in the plasma of Malian children aged 0.5-17 years with uncomplicated malaria (UM, n = 487 and non-cerebral severe malaria (NCSM, n = 68. In 69 of these children, we measured these same factors once when they experienced a malaria episode and twice when they were healthy (i.e., before and after the malaria transmission season. We found that levels of UA, sICAM-1, sVCAM-1, sE-Selectin and sTM increase during a malaria episode and return to basal levels at the end of the transmission season (p<0.0001. Plasma levels of UA and these four endothelial biomarkers correlate with parasite density and disease severity. In children with UM, UA levels correlate with parasite density (r = 0.092, p = 0.043, sICAM-1 (r = 0.255, p<0.0001 and sTM (r = 0.175, p = 0.0001 levels. After adjusting for parasite density, UA levels predict sTM levels. CONCLUSIONS/SIGNIFICANCE: Elevated UA levels may contribute to malaria pathogenesis by damaging endothelium and promoting a procoagulant state. The correlation between UA levels and parasite densities suggests that parasitized erythrocytes are one possible source of excess UA. UA-induced shedding of

  6. Malaria ecology and climate change

    Science.gov (United States)

    McCord, G. C.

    2016-05-01

    Understanding the costs that climate change will exact on society is crucial to devising an appropriate policy response. One of the channels through while climate change will affect human society is through vector-borne diseases whose epidemiology is conditioned by ambient ecology. This paper introduces the literature on malaria, its cost on society, and the consequences of climate change to the physics community in hopes of inspiring synergistic research in the area of climate change and health. It then demonstrates the use of one ecological indicator of malaria suitability to provide an order-of-magnitude assessment of how climate change might affect the malaria burden. The average of Global Circulation Model end-of-century predictions implies a 47% average increase in the basic reproduction number of the disease in today's malarious areas, significantly complicating malaria elimination efforts.

  7. Malaria Prophylaxis: A Comprehensive Review

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    Rosario Russo

    2010-10-01

    Full Text Available The flow of international travellers to and from malaria-endemic areas, especially Africa, has increased in recent years. Apart from the very high morbidity and mortality burden imposed on malaria-endemic areas, imported malaria is the main cause of fever possibly causing severe disease and death in travellers coming from tropical and subtropical areas, particularly Sub-Saharan Africa. The importance of behavioural preventive measures (bed nets, repellents, etc., adequate chemoprophylaxis and, in selected circumstances, stand-by emergency treatment may not be overemphasized. However, no prophylactic regimen may offer complete protection. Expert advice is needed to tailor prophylactic advice according to traveller (age, baseline clinical conditions, etc. and travel (destination, season, etc. characteristics in order to reduce malaria risk.

  8. ENVIRONMENTAL MANAGEMENT FOR MALARIA CONTROL

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    H. A. Rafatjah

    1976-09-01

    Full Text Available Environmental management for malaria control is defined as any planned physical activities that through transformation of land, water and vegetation will result in the prevention, reduction or elimination of malaria. In planning and implementing these activities, full consideration must be given to their long-term effects and benefits and to the preservation of the quality of environment and they need to be fully and closely coordinated with water, land and agricultural development projects. Environmental management activities for malaria control can be classified as source reduction, dealing mainly with physical alteration of the environment; environmental manipulation, introducing temporary environmental changes and the reduction, and prevention of man-vector contact by site selection, mosquito proofing of dwellings and personal protection. For anti-malaria programs to employ these activities they need to re-train the staff, re-orient the services and set up pilot operations for feasibility studies.

  9. Activation-induced resetting of cerebral oxygen and glucose uptake in the rat

    DEFF Research Database (Denmark)

    Madsen, P L; Linde, R; Hasselbalch, S G;

    1998-01-01

    In the clinical setting it has been shown that activation will increase cerebral glucose uptake in excess of cerebral oxygen uptake. To study this phenomenon further, this study presents an experimental setup that enables precise determination of the ratio between cerebral uptake of glucose and...... oxygen in the awake rat. Global CBF was measured by the Kety-Schmidt technique, and the ratio between cerebral uptake rates for oxygen, glucose, and lactate was calculated from cerebral arterial-venous differences. During baseline conditions, rats were kept in a closed box designed to minimize...... interference. During baseline conditions CBF was 1.08 +/- 0.25 mL x g(-1) x minute(-1), and the cerebral oxygen to glucose uptake ratio was 5.5. Activation was induced by opening the sheltering box for 6 minutes. Activation increased CBF to 1.81 mL x g(-1) x minute(-1). During activation cerebral glucose...

  10. The March Toward Malaria Vaccines.

    Science.gov (United States)

    Hoffman, Stephen L; Vekemans, Johan; Richie, Thomas L; Duffy, Patrick E

    2015-12-01

    In 2013 there were an estimated 584,000 deaths and 198 million clinical illnesses due to malaria, the majority in sub-Saharan Africa. Vaccines would be the ideal addition to the existing armamentarium of anti-malaria tools. However, malaria is caused by parasites, and parasites are much more complex in terms of their biology than the viruses and bacteria for which we have vaccines, passing through multiple stages of development in the human host, each stage expressing hundreds of unique antigens. This complexity makes it more difficult to develop a vaccine for parasites than for viruses and bacteria, since an immune response targeting one stage may not offer protection against a later stage, because different antigens are the targets of protective immunity at different stages. Furthermore, depending on the life cycle stage and whether the parasite is extra- or intra-cellular, antibody and/or cellular immune responses provide protection. It is thus not surprising that there is no vaccine on the market for prevention of malaria, or any human parasitic infection. In fact, no vaccine for any disease with this breadth of targets and immune responses exists. In this limited review, we focus on four approaches to malaria vaccines, (1) a recombinant protein with adjuvant vaccine aimed at Plasmodium falciparum (Pf) pre-erythrocytic stages of the parasite cycle (RTS,S/AS01), (2) whole sporozoite vaccines aimed at Pf pre-erythrocytic stages (PfSPZ Vaccine and PfSPZ-CVac), (3) prime boost vaccines that include recombinant DNA, viruses and bacteria, and protein with adjuvant aimed primarily at Pf pre-erythrocytic, but also asexual erythrocytic stages, and (4) recombinant protein with adjuvant vaccines aimed at Pf and Plasmodium vivax sexual erythrocytic and mosquito stages. We recognize that we are not covering all approaches to malaria vaccine development, or most of the critically important work on development of vaccines against P. vivax, the second most important cause of

  11. Suicidal Erythrocyte Death in Malaria

    OpenAIRE

    Koka, Sai Sudha

    2008-01-01

    Malaria is one of the most devastating diseases with lethal outcome in more than 1 million humans per year. The course of the disease is not only a function of the pathogen but is heavily influenced by properties of the host. Mechanisms possibly conferring protection against a severe course of malaria include suicidal death of the infected cell. A particular form of suicidal erythrocyte death is eryptosis, which is characterized by Ca2+-entry with subsequent activation of Ca2+-sensitive K+ ch...

  12. Heritability of Malaria in Africa.

    Directory of Open Access Journals (Sweden)

    2005-11-01

    Full Text Available BACKGROUND: While many individual genes have been identified that confer protection against malaria, the overall impact of host genetics on malarial risk remains unknown. METHODS AND FINDINGS: We have used pedigree-based genetic variance component analysis to determine the relative contributions of genetic and other factors to the variability in incidence of malaria and other infectious diseases in two cohorts of children living on the coast of Kenya. In the first, we monitored the incidence of mild clinical malaria and other febrile diseases through active surveillance of 640 children 10 y old or younger, living in 77 different households for an average of 2.7 y. In the second, we recorded hospital admissions with malaria and other infectious diseases in a birth cohort of 2,914 children for an average of 4.1 y. Mean annual incidence rates for mild and hospital-admitted malaria were 1.6 and 0.054 episodes per person per year, respectively. Twenty-four percent and 25% of the total variation in these outcomes was explained by additively acting host genes, and household explained a further 29% and 14%, respectively. The haemoglobin S gene explained only 2% of the total variation. For nonmalarial infections, additive genetics explained 39% and 13% of the variability in fevers and hospital-admitted infections, while household explained a further 9% and 30%, respectively. CONCLUSION: Genetic and unidentified household factors each accounted for around one quarter of the total variability in malaria incidence in our study population. The genetic effect was well beyond that explained by the anticipated effects of the haemoglobinopathies alone, suggesting the existence of many protective genes, each individually resulting in small population effects. While studying these genes may well provide insights into pathogenesis and resistance in human malaria, identifying and tackling the household effects must be the more efficient route to reducing the burden

  13. DNA Sensors for Malaria Diagnosis

    DEFF Research Database (Denmark)

    Hede, Marianne Smedegaard; Fjelstrup, Søren; Knudsen, Birgitta R.

    2015-01-01

    In the field of malaria diagnosis much effort is put into the development of faster and easier alternatives to the gold standard, blood smear microscopy. Nucleic acid amplification based techniques pose some of the most promising upcoming diagnostic tools due to their potential for high sensitivi......, robustness and user-friendliness. In the current review, we will discuss some of the different DNA-based sensor systems under development for the diagnosis of malaria....

  14. A perspective on malaria vaccines

    OpenAIRE

    Desowitz, R S; Miller, L. H.

    1980-01-01

    The data obtained with adjuvant—antigen vaccines against asexual malaria parasites in different host—parasite systems are reviewed. From these data the problems associated with antimalarial vaccine development and testing are considered. The requirement for an adjuvant to induce immunity and the type of adjuvant required depends primarily on the host. Since the immune response of man to malaria vaccines is unknown, it is impossible to predict which animal infection is most likely to be a fait...

  15. A STUDY OF CLINICAL PROFILE OF PATIENTS WITH PLASMODIUM VIVAX MALARIA

    Directory of Open Access Journals (Sweden)

    Goduguchintha

    2015-06-01

    Full Text Available BACKGROUND AND AIM OF THE STUDY : Malaria remains one of the major health problems in the tropics with increased morbidity & mortality. Although Plasmodium falciparum has been commonly implicated as the cause of complicated malaria but now the trend is changing and vivax is increasingly p resenting with severe complications. Hence this study was undertaken t o study the clinical profile of patients admitted with Plasmodium vivax mono - infection. MATERIALS AND METHODS: 50 patients presenting with fever in whom the peripheral smear and/or quant itative buffy coat was positive for Plasmodium vivax malaria were enrolled for this study. Their clinical features, complications and outcome were studied, analyzed and reported. RESULTS: The most common symptom was found to be fever in all the patients followed by headache, jaundice, and vomiting and pain abdomen. The important signs were splenomegaly, hepatomegaly, pallor and icterus. Complications like hepatic dysfunction, multiorgan fai lure, cerebral malaria, bleeding manifestations, acute kidney injury and acute respiratory distress syndrome were found in significant number of patients. CONCLUSION: Severe complications which were earlier known to occur with falciparum malaria are also o bserved with Plasmodium vivax infection. Early diagnosis, recognition of complications and prompt initiation of treatment is the corner stone in the management of Plasmodium vivax in reducing the morbidity and mortality.

  16. Plasmodium falciparum var genes expressed in children with severe malaria encode CIDRα1 domains.

    Science.gov (United States)

    Jespersen, Jakob S; Wang, Christian W; Mkumbaye, Sixbert I; Minja, Daniel Tr; Petersen, Bent; Turner, Louise; Petersen, Jens Ev; Lusingu, John Pa; Theander, Thor G; Lavstsen, Thomas

    2016-01-01

    Most severe Plasmodium falciparum infections are experienced by young children. Severe symptoms are precipitated by vascular sequestration of parasites expressing a particular subset of the polymorphic P. falciparum erythrocyte membrane protein 1 (PfEMP1) adhesion molecules. Parasites binding human endothelial protein C receptor (EPCR) through the CIDRα1 domain of certain PfEMP1 were recently associated with severe malaria in children. However, it has remained unclear to which extend the EPCR-binding CIDRα1 domains epitomize PfEMP1 expressed in severe malaria. Here, we characterized the near full-length transcripts dominating the var transcriptome in children with severe malaria and found that the only common feature of the encoded PfEMP1 was CIDRα1 domains. Such genes were highly and dominantly expressed in both children with severe malarial anaemia and cerebral malaria. These observations support the hypothesis that the CIDRα1-EPCR interaction is key to the pathogenesis of severe malaria and strengthen the rationale for pursuing a vaccine or adjunctive treatment aiming at inhibiting or reducing the damaging effects of this interaction. PMID:27354391

  17. Steal phenomenon through the anterior communicating artery in Moyamoya disease

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Soo Mee [Ewha Womans University, Department of Radiology, Mok-dong Hospital, College of Medicine, Seoul (Korea); Chae, Eun Jin; Kim, Min Yeong; Kim, Sang Joon; Choi, Choong Gon; Pyun, Hae Wook; Suh, Dae Chul [University of Ulsan College of Medicine, Asan Medical Center, Department of Radiology and Research Institute of Radiology, Seoul (Korea); Kim, Jae Kyun [Seoul Veterans Hospital, Department of Radiology, Seoul (Korea); Ahn, Jae Sung; Ra, Young-Shin [University of Ulsan, Asan Medical Center, Department of Neurosurgery, College of Medicine, Seoul (Korea); Kim, Jong-Uk; Hahm, Kyung Don [University of Ulsan, Asan Medical Center, Department of Anesthesiology, College of Medicine, Seoul (Korea)

    2007-01-15

    Branch occlusion of the anterior cerebral artery (ACA) is regarded as a part of Moyamoya disease. The purpose of this study is to define the ACA steal phenomenon (SP) in Moyamoya disease and to evaluate temporal changes according to the disease progression. From 139 Moyamoya patients we defined ACASP as narrowing of the ipsilateral A1-2 junction while preserving the anterior communicating artery and supplying the contralateral ACA cortical branches with the development of leptomeningeal collaterals by the ipsilateral middle cerebral artery into the hypoperfused ipsilateral ACA territory. Direction of the steal related to the stage in both hemispheres by Suzuki classification was statistically analyzed using the binomial test based on binomial distribution. Follow-ups of ACASP were evaluated in five patients. We identified ACASP in 13 (9%) patients (male:female=7:6, mean age 18 years, range: 2-58 years) of the 139 study patients. The presenting pattern was ischemic in 12 and hemorrhagic in one. The direction of SP occurred from the hemisphere in the lower to the higher stage of Suzuki classification (two-tail P value=0.0002). After revascularization surgery, ACASP disappeared or diminished. ACASP may occur in bilaterally different stages of Moyamoya disease as a transient self-adaptive process. It regresses after revascularization surgery. (orig.)

  18. Risk as a social phenomenon.

    Science.gov (United States)

    Jamison, Wesley V

    2003-01-01

    What do nuclear power, smoking, and eating beef have in common? The answer is multifaceted. They all share aspects of mass production and consumption, and therefore consumer confidence comes into play in evaluating each of the products' merits. They all produce some level of anxiety--be it in response to adverse media coverage, or the successes of adversarial interest groups in publicizing those products' weaknesses--among consumers who wonder what if any level of the product should be consumed. Finally, nuclear power, smoking, and eating beef all share risk; that is, the perceived and real detriments of producing and consuming those products. Whether or not the associated risks--from increased cancer to increased heart disease--are real is beside the point. When talking about risk, scientific education must deal with the perception of risk as much as its reality. Risk is a socially defined phenomenon, and as such, the successful scientists/communicator must understand the social evaluations of it. While many scientists take a rational view of risk evaluation and consumers often make rational decisions about technological and scientific risk based upon the costs and benefits of that technology, this approach is problematic for three reasons. First, the nature of modern risks has changed in that risk is complex, incomprehensible and uncontrollable to the average person. Second, the rational approach assumes that all costs and benefits of a technology, both real and potential, both current and future, can be known and therefore rationally evaluated. This is not the case. Third, evidence from Europe indicates that trust in information sources about risk has fallen, and thus classic scientific education campaigns that rely upon increasing public knowledge and acceptance of technological and scientific risk are problematic. Because of these factors we argue that effective scientific response must begin to understand the social components of risk if campaigns to shape

  19. The phenomenon of retarded potentials

    International Nuclear Information System (INIS)

    The logic simulation of process of time delay of potential on a moved body - recipient resulted in the deduction about cyclic irregularity of time delay, that means, that the moved body makes longitudinal vibrations. A conclusion is drawn that length of longitudinal vibrations depending from three variable: the law of interaction, spacing interval between bodies of interaction and phase velocity looks like: λ=Hvph/R·F(R) (1), where λ- length of oscillations; H- factor of proportionality; vph - phase velocity of a body; R - distance between test and central bodies R(t); F(R) - law of interaction. So far as λ=vph/v, and R·F(R)=∫∞RF(R)dR=Emove, then formula (1) will be transformed into: Emove=Hvpv/λ=Hv. Thus, the energy of radiating having the similar law is only reflex of motion of a matter. The energy of oscillating motion can be expressed through linear maximal velocity. It is established, that different expressions of the same energy, result in the law of a view of a proportion for lengths of de Broglie's waves: It shows that de Broglie's waves - the actual oscillating motions of bodies, as demonstrate interference and diffraction pictures at a dissipation of the accelerated particles on crystalline gratings. This deduction has far-reaching consequences for finding - out of the cause bases of the laws of a nature. So, the quantum mechanics becomes partition of mechanics of solids and is comprises all interactions. The nuclear energy is not 'defect of mass', but is 'defect' of energy of oscillating motion: ΔE=Hv1-Hv2. Definition of real cause of nuclear energy is very important for construction of model of nuclei and for development of physics as the whole. The interconnection of the phenomenon of longitudinal vibrations of moved bodies, as result of irregularity of time delay of potential, with many other natural phenomena is looked through. By such, as: motion of planets and electrons on elliptical orbits, oscillating of dipping drips of a rain, gusts

  20. Cerebral angiography in leptomeningitis and cerebritis

    International Nuclear Information System (INIS)

    This is a report of the cerebral angiographic findings in cases of meningitis and cerebritis. Fifty-nine patients, 38 of whom were under 1 year of age, underwent cerebral angiography by means of femoral catheterization. All the patients had signs of increased intracranial pressure, seizures, focal cerebral signs, positive transillumination of the head, and or abnormal brain scan findings. A few patients who did not respond to systemic antibiotics as was expected were also evaluated by means of cerebral angiography. The following characteristic angiographic findings were observed in 18 cases of active meningitis: (1) A hasy appearance around the arteries (halo formation) between the late arterial and capillary phases. (2) Narrowing of the arteries in the basal cistern. This sometimes extended to the peripheral arteries. (3) Irregular caliber following the narrowing of arteries (in few cases). (4) Circulation time so slow that veins could be seen in the late arterial phase. (5) Halo formation around the anterior chroidal artery and the clear appearance of the choroid plexus in the venous phase (when the infectious process reached the choroid plexus). Cerebritis could be identified on the angiograms by two signs: (1) local swelling of the brain (mainly the temporal lobe) and (2) staining around the veins without any abnormal signs in the arterial phase (laminar staining). In conclusion, angiography is a meaningful test by which to determine the phase of meningitis and cerebritis. These two conditions should be treated based on valid information obtained by means of CSF examinations and neuroradiological tests, especially CT scan and cerebral angiography. (author)

  1. Exonuclease-mediated degradation of nascent RNA silences genes linked to severe malaria.

    Science.gov (United States)

    Zhang, Qingfeng; Siegel, T Nicolai; Martins, Rafael M; Wang, Fei; Cao, Jun; Gao, Qi; Cheng, Xiu; Jiang, Lubin; Hon, Chung-Chau; Scheidig-Benatar, Christine; Sakamoto, Hiroshi; Turner, Louise; Jensen, Anja T R; Claes, Aurelie; Guizetti, Julien; Malmquist, Nicholas A; Scherf, Artur

    2014-09-18

    Antigenic variation of the Plasmodium falciparum multicopy var gene family enables parasite evasion of immune destruction by host antibodies. Expression of a particular var subgroup, termed upsA, is linked to the obstruction of blood vessels in the brain and to the pathogenesis of human cerebral malaria. The mechanism determining upsA activation remains unknown. Here we show that an entirely new type of gene silencing mechanism involving an exonuclease-mediated degradation of nascent RNA controls the silencing of genes linked to severe malaria. We identify a novel chromatin-associated exoribonuclease, termed PfRNase II, that controls the silencing of upsA var genes by marking their transcription start site and intron-promoter regions leading to short-lived cryptic RNA. Parasites carrying a deficient PfRNase II gene produce full-length upsA var transcripts and intron-derived antisense long non-coding RNA. The presence of stable upsA var transcripts overcomes monoallelic expression, resulting in the simultaneous expression of both upsA and upsC type PfEMP1 proteins on the surface of individual infected red blood cells. In addition, we observe an inverse relationship between transcript levels of PfRNase II and upsA-type var genes in parasites from severe malaria patients, implying a crucial role of PfRNase II in severe malaria. Our results uncover a previously unknown type of post-transcriptional gene silencing mechanism in malaria parasites with repercussions for other organisms. Additionally, the identification of RNase II as a parasite protein controlling the expression of virulence genes involved in pathogenesis in patients with severe malaria may provide new strategies for reducing malaria mortality. PMID:25043062

  2. [Current malaria situation in Turkey].

    Science.gov (United States)

    Gockchinar, T; Kalipsi, S

    2001-01-01

    Geographically, Turkey is situated in an area where malaria is very risky. The climatic conditions in the region are suitable for the malaria vector to proliferate. Due to agricultural infrastructural changes, GAP and other similar projects, insufficient environmental conditions, urbanization, national and international population moves, are a key to manage malaria control activities. It is estimated that malaria will be a potential danger for Turkey in the forthcoming years. The disease is located largely in south-eastern Anatolia. The Diyarbakir, Batman, Sanliurfa, Siirt, and Mardin districts are the most affected areas. In western districts, like Aydin and Manisa, an increase in the number of indigenous cases can be observed from time to time. This is due to workers moving from malaria districts to western parts to final work. Since these workers cannot be controlled, the population living in these regions get infected from indigenous cases. There were 84,345 malaria cases in 1994 and 82,096 in 1995, they decreased to 60,884 in 1996 and numbered 35,456 in 1997. They accounted for 36,842 and 20,963 in 1998 and 1999, respectively. In Turkey there are almost all cases of P. vivax malaria. There are also P. vivax and P. falciparum malaria cases coming from other countries: There were 321 P. vivax cases, including 2 P. falciparum ones, arriving to Turkey from Iraq in 1995. The P. vivax malaria cases accounted for 229 in 1996, and 67, cases P. vivax including 12 P. falciparum cases, in 1997, and 4 P. vivax cases in 1998 that came from that country. One P. vivax case entered Turkey from Georgia in 1998. The cause of higher incidence of P. vivax cases in 1995, it decreasing in 1999, is the lack of border controls over workers coming to Turkey. The other internationally imported cases are from Syria, Sudan, Pakistan, Afghanistan, Nigeria, India, Azerbaijan, Malaysia, Ghana, Indonesia, Yemen. Our examinations have shown that none of these internationally imported cases

  3. Collapse phenomenon during Chartis collateral ventilation assessment.

    Science.gov (United States)

    Gesierich, Wolfgang; Samitas, Konstantinos; Reichenberger, Frank; Behr, Juergen

    2016-06-01

    Chartis is increasingly used for bronchoscopic assessment of collateral ventilation before endobronchial valve (EBV) treatment for severe emphysema. Its prognostic value is, however, limited by the airway collapse phenomenon. The frequency and clinical significance of the collapse phenomenon remain largely unknown.We performed a retrospective analysis of 92 patients undergoing Chartis evaluation under spontaneous breathing (n=55) or jet ventilation (n=37) from May 2010 to November 2013. Collateral ventilation status (positive/negative/collapse phenomenon/unclear) was reassessed and correlated with high-resolution computed tomography (HRCT) fissure analysis and clinical response.In the absence of the collapse phenomenon, the predictive value of Chartis measurements and HRCT fissural analysis was comparable. The collapse phenomenon was observed in 31.5% of all assessments, and was more frequent in lower lobes (44.9% versus 16.9% in upper lobes) and under jet ventilation (41.4% versus 22.1% under spontaneous breathing). 69.8% of lobes with the collapse phenomenon had complete fissures. Most patients with the collapse phenomenon in the target lobe and complete fissures treated with EBVs were responders (n=11/15). All valve-treated collapse phenomenon patients with fissure defects were nonresponders (n=3).In the absence of the collapse phenomenon Chartis measurement is reliable to predict response to valve treatment. In patients with the collapse phenomenon, treatment decisions should be based on HRCT detection of fissure integrity. Chartis assessment should be performed under spontaneous breathing. PMID:27076587

  4. The antibody response to well-defined malaria antigens after acute malaria in individuals living under continuous malaria transmission

    DEFF Research Database (Denmark)

    Petersen, E; Høgh, B; Dziegiel, M;

    1992-01-01

    a synthetic peptide (EENV)6 representing the C-terminal repeats from Pf155/RESA, were investigated longitudinally in 13 children and 7 adults living under conditions of continuous, intense malaria transmission. Some subjects did not recognize the antigens after malaria infection, and in subjects...... not uniformly elicited by natural malaria infection in previously primed donors....

  5. Hemozoin Inhibition and Control of Clinical Malaria

    Directory of Open Access Journals (Sweden)

    Chibueze Peter Ihekwereme

    2014-01-01

    Full Text Available Malaria has a negative impact on health and social and economic life of residents of endemic countries. The ultimate goals of designing new treatment for malaria are to prevent clinical infection, reduce morbidity, and decrease mortality. There are great advances in the understanding of the parasite-host interaction through studies by various scientists. In some of these studies, attempts were made to evaluate the roles of malaria pigment or toxins in the pathogenesis of malaria. Hemozoin is a key metabolite associated with severe malaria anemia (SMA, immunosuppression, and cytokine dysfunction. Targeting of this pigment may be necessary in the design of new therapeutic products against malaria. In this review, the roles of hemozoin in the morbidity and mortality of malaria are highlighted as an essential target in the quest for effective control of clinical malaria.

  6. EU grid computing effort takes on malaria

    CERN Multimedia

    Lawrence, Stacy

    2006-01-01

    Malaria is the world's most common parasitic infection, affecting more thatn 500 million people annually and killing more than 1 million. In order to help combat malaria, CERN has launched a grid computing effort (1 page)

  7. Malaria Vaccine Shows Promise in Small Study

    Science.gov (United States)

    ... nlm.nih.gov/medlineplus/news/fullstory_158765.html Malaria Vaccine Shows Promise in Small Study It protected ... TUESDAY, May 10, 2016 (HealthDay News) -- An experimental malaria vaccine protects a majority of adults against the ...

  8. Understanding Malaria: Fighting an Ancient Scourge

    Science.gov (United States)

    Understanding Malaria Fighting an Ancient Scourge U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health National Institute of Allergy and Infectious Diseases Understanding Malaria Fighting an Ancient Scourge U.S. DEPARTMENT OF HEALTH ...

  9. Mapping residual transmission for malaria elimination.

    Science.gov (United States)

    Reiner, Robert C; Le Menach, Arnaud; Kunene, Simon; Ntshalintshali, Nyasatu; Hsiang, Michelle S; Perkins, T Alex; Greenhouse, Bryan; Tatem, Andrew J; Cohen, Justin M; Smith, David L

    2015-01-01

    Eliminating malaria from a defined region involves draining the endemic parasite reservoir and minimizing local malaria transmission around imported malaria infections . In the last phases of malaria elimination, as universal interventions reap diminishing marginal returns, national resources must become increasingly devoted to identifying where residual transmission is occurring. The needs for accurate measures of progress and practical advice about how to allocate scarce resources require new analytical methods to quantify fine-grained heterogeneity in malaria risk. Using routine national surveillance data from Swaziland (a sub-Saharan country on the verge of elimination), we estimated individual reproductive numbers. Fine-grained maps of reproductive numbers and local malaria importation rates were combined to show 'malariogenic potential', a first for malaria elimination. As countries approach elimination, these individual-based measures of transmission risk provide meaningful metrics for planning programmatic responses and prioritizing areas where interventions will contribute most to malaria elimination. PMID:26714110

  10. Managing Malaria ; an evolutionary modelling approach

    NARCIS (Netherlands)

    Janssen MA; Martens WJM; MNV

    1996-01-01

    Door toenemende resistentie-ontwikkeling van de malariaparasiet voor antimalaria medicijnen, en van de malariamuskiet voor insecticiden, wordt een effectief beleid voor malaria in veel tropische landen bemoeilijkt. Tezamen met een mogelijke klimaatverandering zou dit de incidentie van malaria in

  11. Complement activation in experimental human malaria infection.

    NARCIS (Netherlands)

    Roestenberg, M.; McCall, M.B.B.; Mollnes, T.E.; Deuren, M. van; Sprong, T.; Klasen, I.S.; Hermsen, C.C.; Sauerwein, R.W.; Ven, A.J.A.M. van der

    2007-01-01

    The objective of this study was to investigate complement activation in uncomplicated, early phases of human malaria. Fifteen healthy volunteers were experimentally infected with Plasmodium falciparum malaria. Parasitemia and complement activation products were assessed. During blood stage parasitem

  12. Early home-based recognition of anaemia via general danger signs, in young children, in a malaria endemic community in north-east Tanzania

    DEFF Research Database (Denmark)

    Ringsted, Frank M; Bygbjerg, Ib C; Samuelsen, Helle

    2006-01-01

    BACKGROUND: Ethnographic studies from East Africa suggest that cerebral malaria and anaemia are not classified in local knowledge as malaria complications, but as illnesses in their own right. Cerebral malaria 'degedege' has been most researched, in spite of anaemia being a much more frequent...... complication in infants, and not much is known on how this is interpreted by caretakers. Anaemia is difficult to recognize clinically, even by health workers. METHODS: Ethnographic longitudinal cohort field study for 14 months, with monthly home-visits in families of 63 newborn babies, identified by community...... census, followed throughout April - November 2003 and during follow-up in April-May 2004. Interviews with care-takers (mostly mothers) and observational studies of infants and social environment were combined with three haemoglobin (Hb) screenings, supplemented with reports from mothers after health...

  13. Particularities of the Romanian Money Laundering Phenomenon

    OpenAIRE

    Condrea Elena

    2012-01-01

    By analyzing the components of the underground economy matrix, we can say that its financial support is "money laundering" a comprehensive, dynamic phenomenon which lies in the desire of criminals to hide practiced illegal activities behind their sources of income, in order to allow a normal development in society. In this study we tried to highlight some of the features of the phenomenon of money laundering, as well as some preoccupations concerning combating this phenomenon in Romania, memb...

  14. Potential impact of host immunity on malaria treatment outcome in Tanzanian children infected with Plasmodium falciparum

    DEFF Research Database (Denmark)

    Enevold, Anders; Nkya, Watoky M M M; Theisen, Michael;

    2007-01-01

    BACKGROUND: In malaria endemic areas children may recover from malaria after chemotherapy in spite of harbouring genotypically drug-resistant Plasmodium falciparum. This phenomenon suggests that there is a synergy between drug treatment and acquired immunity. This hypothesis was examined in an area...... parasite resistant haplotypes, while the IgG responses to none of the other 11 malaria antigens were not significantly associated with ACPR. CONCLUSION: These findings suggest that GLURP-specific IgG antibodies in this setting contribute to clearance of drug-resistant infections and support the hypothesis...... of moderately intense transmission of P. falciparum in Tanzania during a drug trail with sulphadoxine-pyrimethamine (SP) or amodiaquine (AQ). METHODS: One hundred children with uncomplicated malaria were treated with either SP or AQ and followed for 28 days. Mutations in parasite genes related to SP...

  15. Malaria in India: The Center for the Study of Complex Malaria in India

    OpenAIRE

    Das, Aparup; Anvikar, Anupkumar R.; Cator, Lauren J.; Dhiman, Ramesh C.; Eapen, Alex; Mishra, Neelima; Nagpal, Bhupinder N.; Nanda, Nutan; Raghavendra, Kamaraju; Read, Andrew F; Sharma, Surya K.; Singh, Om P.; Singh, Vineeta; Sinnis, Photini; Srivastava, Harish C.

    2011-01-01

    Malaria is a major public health problem in India and one which contributes significantly to the overall malaria burden in Southeast Asia. The National Vector Borne Disease Control Program of India reported ~1.6 million cases and ~1100 malaria deaths in 2009. Some experts argue that this is a serious underestimation and that the actual number of malaria cases per year is likely between 9 and 50 times greater, with an approximate 13-fold underestimation of malaria-related mortality. The diffic...

  16. Opsoclonus-myoclonus in Falciparum malaria infection.

    OpenAIRE

    SUNIL HS; SANJUKTA SR; Sudhir, U.

    2013-01-01

    Involvement of the central nervous system in malaria is exclusively a feature of infection with Plasmodium falciparum. Neurological manifestations such as altered mentation, seizure, coma, extra pyramidal symptoms, peripheral neuropathy and neuropsychiatric illnesses have been reported in Falciparum malaria (F. malaria). We report a case of transient opsoclonus-myoclonus in a 40-year-old lady with F. malaria, a clinical entity described only once previously (opsoclonus) in the medical literat...

  17. Plasmodium vivax malaria: An unusual presentation

    OpenAIRE

    Kasliwal, Prasad; Rao, Manimala S.; Kujur, Rash

    2009-01-01

    Acute renal failure, disseminated intravascular coagulation (DIC), acute respiratory distress syndrome (ARDS), hypoglycemia, coma, or epileptic seizures are manifestations of severe Plasmodium falciparum malaria. On the other hand, Plasmodium vivax malaria seldom results in pulmonary damage, and pulmonary complications are exceedingly rare. We report the case of a 42-year-old male living in a malaria-endemic area who presented with ARDS and was diagnosed as having Plasmodium vivax malaria. A ...

  18. An open source business model for malaria

    OpenAIRE

    2015-01-01

    Greater investment is required in developing new drugs and vaccines against malaria in order to eradicate malaria. These precious funds must be carefully managed to achieve the greatest impact. We evaluate existing efforts to discover and develop new drugs and vaccines for malaria to determine how best malaria R&D can benefit from an enhanced open source approach and how such a business model may operate. We assess research articles, patents, clinical trials and conducted a smaller survey amo...

  19. An Open Source Business Model for Malaria

    OpenAIRE

    Årdal, Christine; Røttingen, John-Arne

    2015-01-01

    Greater investment is required in developing new drugs and vaccines against malaria in order to eradicate malaria. These precious funds must be carefully managed to achieve the greatest impact. We evaluate existing efforts to discover and develop new drugs and vaccines for malaria to determine how best malaria R&D can benefit from an enhanced open source approach and how such a business model may operate. We assess research articles, patents, clinical trials and conducted a smaller survey amo...

  20. Exchange Transfusion in Severe Falciparum Malaria

    OpenAIRE

    Dongare, Harshad Chandrakant; Khatib, Khalid Ismail

    2016-01-01

    Malaria is endemic in India with the incidence of P. falciparum Malaria increasing gradually over the last decade. Severe malaria is an acute disease, caused by P. falciparum, but increasingly also by P. vivax with major signs of organ dysfunction and/or high levels of parasitaemia (>10%) in blood smear. Use of exchange transfusion with antimalarial drug therapy as an additional modality of treatment in severe Falciparum malaria is controversial and is unclear. We report a case of severe mala...

  1. Malaria in Highlands of Ecuador since 1900

    OpenAIRE

    Lauren L. Pinault; Hunter, Fiona F.

    2012-01-01

    A recent epidemic of malaria in the highlands of Bolivia and establishment of multiple Anopheles species mosquitoes in the highlands of Ecuador highlights the reemergence of malaria in the Andes Mountains in South America. Because malaria was endemic to many highland valleys at the beginning of the 20th century, this review outlines the 20th century history of malaria in the highlands of Ecuador, and focuses on its incidence (e.g., geographic distribution) and elimination from the northern hi...

  2. Ethical aspects of malaria control and research

    OpenAIRE

    Jamrozik, Euzebiusz; de la Fuente-Núñez, Vânia; Reis, Andreas; Ringwald, Pascal; Selgelid, Michael J

    2015-01-01

    Malaria currently causes more harm to human beings than any other parasitic disease, and disproportionally affects low-income populations. The ethical issues raised by efforts to control or eliminate malaria have received little explicit analysis, in comparison with other major diseases of poverty. While some ethical issues associated with malaria are similar to those that have been the subject of debate in the context of other infectious diseases, malaria also raises distinct ethical issues ...

  3. UK malaria treatment guidelines 2016.

    Science.gov (United States)

    Lalloo, David G; Shingadia, Delane; Bell, David J; Beeching, Nicholas J; Whitty, Christopher J M; Chiodini, Peter L

    2016-06-01

    1.Malaria is the tropical disease most commonly imported into the UK, with 1300-1800 cases reported each year, and 2-11 deaths. 2. Approximately three quarters of reported malaria cases in the UK are caused by Plasmodium falciparum, which is capable of invading a high proportion of red blood cells and rapidly leading to severe or life-threatening multi-organ disease. 3. Most non-falciparum malaria cases are caused by Plasmodium vivax; a few cases are caused by the other species of plasmodium: Plasmodium ovale, Plasmodium malariae or Plasmodium knowlesi. 4. Mixed infections with more than one species of parasite can occur; they commonly involve P. falciparum with the attendant risks of severe malaria. 5. There are no typical clinical features of malaria; even fever is not invariably present. Malaria in children (and sometimes in adults) may present with misleading symptoms such as gastrointestinal features, sore throat or lower respiratory complaints. 6. A diagnosis of malaria must always be sought in a feverish or sick child or adult who has visited malaria-endemic areas. Specific country information on malaria can be found at http://travelhealthpro.org.uk/. P. falciparum infection rarely presents more than six months after exposure but presentation of other species can occur more than a year after exposure. 7. Management of malaria depends on awareness of the diagnosis and on performing the correct diagnostic tests: the diagnosis cannot be excluded until more than one blood specimen has been examined. Other travel related infections, especially viral haemorrhagic fevers, should also be considered. 8. The optimum diagnostic procedure is examination of thick and thin blood films by an expert to detect and speciate the malarial parasites. P. falciparum and P. vivax (depending upon the product) malaria can be diagnosed almost as accurately using rapid diagnostic tests (RDTs) which detect plasmodial antigens. RDTs for other Plasmodium species are not as reliable. 9

  4. Malaria - sick air on the march

    International Nuclear Information System (INIS)

    The article surveys the expansion of the malaria risk zones with increasing temperatures, change in climate and habitat alterations. Factors such as the living conditions for various malaria parasites, climatic changes, immunity and drug resistance are studied. It is evident that the greenhouse effects contribute to the expanding malaria risk zones

  5. Malaria transmission rates estimated from serological data.

    OpenAIRE

    M.N. Burattini; Massad, E.; Coutinho, F. A.

    1993-01-01

    A mathematical model was used to estimate malaria transmission rates based on serological data. The model is minimally stochastic and assumes an age-dependent force of infection for malaria. The transmission rates estimated were applied to a simple compartmental model in order to mimic the malaria transmission. The model has shown a good retrieving capacity for serological and parasite prevalence data.

  6. Malaria and Irrigated Crops, Accra, Ghana

    OpenAIRE

    Klinkenberg, Eveline; McCall, P. J.; Hastings, Ian M.; Wilson, Michael D.; Amerasinghe, Felix P.; Donnelly, Martin J

    2005-01-01

    We investigated the prevalence of malaria and associated risk factors in children living in urban Ghana. Malaria prevalence was associated with low hemoglobin concentration, low socioeconomic status, and higher age. Our findings indicate that African urban poor are seriously affected by malaria and that irrigated agriculture may increase this risk.

  7. Malaria in India: Challenges and opportunities

    Indian Academy of Sciences (India)

    A P Dash; Neena Valecha; A R Anvikar; A Kumar

    2008-11-01

    India contributes about 70% of malaria in the South East Asian Region of WHO. Although annually India reports about two million cases and 1000 deaths attributable to malaria, there is an increasing trend in the proportion of Plasmodium falciparum as the agent. There exists heterogeneity and variability in the risk of malaria transmission between and within the states of the country as many ecotypes/paradigms of malaria have been recognized. The pattern of clinical presentation of severe malaria has also changed and while multi-organ failure is more frequently observed in falciparum malaria, there are reports of vivax malaria presenting with severe manifestations. The high burden populations are ethnic tribes living in the forested pockets of the states like Orissa, Jharkhand, Madhya Pradesh, Chhattisgarh and the North Eastern states which contribute bulk of morbidity and mortality due to malaria in the country. Drug resistance, insecticide resistance, lack of knowledge of actual disease burden along with new paradigms of malaria pose a challenge for malaria control in the country. Considering the existing gaps in reported and estimated morbidity and mortality, need for estimation of true burden of malaria has been stressed. Administrative, financial, technical and operational challenges faced by the national programme have been elucidated. Approaches and priorities that may be helpful in tackling serious issues confronting malaria programme have been outlined.

  8. Changing malaria transmission and implications in China towards National Malaria Elimination Programme between 2010 and 2012.

    Directory of Open Access Journals (Sweden)

    Jian-hai Yin

    Full Text Available BACKGROUND: Towards the implementation of national malaria elimination programme in China since 2010, the epidemiology of malaria has changed dramatically, and the lowest malaria burden was achieved yearly. It is time to analyze the changes of malaria situation based on surveillance data from 2010 to 2012 to reconsider the strategies for malaria elimination. METHODS AND PRINCIPAL FINDINGS: Malaria epidemiological data was extracted from the provincial annual reports in China between 2010 and 2012. The trends of the general, autochthonous and imported malaria were analyzed, and epidemic areas were reclassified according to Action Plan of China Malaria Elimination (2010-2020. As a result, there reported 2743 malaria cases with a continued decline in 2012, and around 7% autochthonous malaria cases accounted. Three hundred and fifty-three individual counties from 19 provincial regions had autochthonous malaria between 2010 and 2012, and only one county was reclassified into Type I (local infections detected in 3 consecutive years and the annual incidences ≥ 1/10,000 again. However, the imported malaria cases reported of each year were widespread, and 598 counties in 29 provinces were suffered in 2012. CONCLUSIONS/SIGNIFICANCE: Malaria was reduced significantly from 2010 to 2012 in China, and malaria importation became an increasing challenge. It is necessary to adjust or update the interventions for subsequent malaria elimination planning and resource allocation.

  9. Averting a malaria disaster: will insecticide resistance derail malaria control?

    Science.gov (United States)

    Hemingway, Janet; Ranson, Hilary; Magill, Alan; Kolaczinski, Jan; Fornadel, Christen; Gimnig, John; Coetzee, Maureen; Simard, Frederic; Roch, Dabiré K; Hinzoumbe, Clément Kerah; Pickett, John; Schellenberg, David; Gething, Peter; Hoppé, Mark; Hamon, Nicholas

    2016-04-23

    World Malaria Day 2015 highlighted the progress made in the development of new methods of prevention (vaccines and insecticides) and treatment (single dose drugs) of the disease. However, increasing drug and insecticide resistance threatens the successes made with existing methods. Insecticide resistance has decreased the efficacy of the most commonly used insecticide class of pyrethroids. This decreased efficacy has increased mosquito survival, which is a prelude to rising incidence of malaria and fatalities. Despite intensive research efforts, new insecticides will not reach the market for at least 5 years. Elimination of malaria is not possible without effective mosquito control. Therefore, to combat the threat of resistance, key stakeholders need to rapidly embrace a multifaceted approach including a reduction in the cost of bringing new resistance management methods to market and the streamlining of associated development, policy, and implementation pathways to counter this looming public health catastrophe. PMID:26880124

  10. [Malaria in Poland in 2009].

    Science.gov (United States)

    Stepiń, Małgorzata

    2011-01-01

    In Poland in 2009 were reported 22 malaria cases confirmed according to the EU case definition for the purposes of routine surveillance system. All of them were imported, including 1 case of recrudescence, 86% from Africa. In 18 cases P falciparum etiology was confirmed and in 2--P vivax, in 1--P ovale and 1 P malariae. Most cases occurred in the age group 21-40 years, there were 21 cases in males and 1 in female. Common reasons for travel to endemic countries were work-related visits (14 cases) and tourism (6 cases), one person who visited the family and in one case unknown reason for travel. Three persons used chemoprophylaxis during their travel but only one of them appropriately, relevant information was missing in 5 cases. Clinical course was severe in 7 cases of P falciparum malaria and medium-severe in one case. In 2009, there were no malaria deaths in Poland. Education on the prevention of malaria and pretravel health advising is still greatly needed. PMID:21913479

  11. Surveillance considerations for malaria elimination

    Directory of Open Access Journals (Sweden)

    Barclay Victoria C

    2012-08-01

    Full Text Available Abstract Constant malaria monitoring and surveillance systems have been highlighted as critical for malaria elimination. The absence of robust monitoring and surveillance systems able to respond to outbreaks in a timely manner undeniably contributed to the failure of the last global attempt to eradicate malaria. Today, technological advances could allow for rapid detection of focal outbreaks and improved deployment of diagnostic and treatment supplies to areas needing support. However, optimizing diffusion activities (e.g., distributing vector controls and medicines, as well as deploying behaviour change campaigns requires networks of diverse scholars to monitor, learn, and evaluate data and multiple organizations to coordinate their intervention activities. Surveillance systems that can gather, store and process information, from communities to national levels, in a centralized, widely accessible system will allow tailoring of surveillance and intervention efforts. Different systems and, thus reactions, will be effective in different endemic, geographical or socio-cultural contexts. Investing in carefully designed monitoring technologies, built for a multiple-acter, dynamic system, will help to improve malaria elimination efforts by improving the coordination, timing, coverage, and deployment of malaria technologies.

  12. Simplified Model for the Population Dynamics Involved in a Malaria Crisis

    International Nuclear Information System (INIS)

    We adapt a simple model of predator-prey to the population involved in a crisis of malaria. The study is made only in the stream blood inside the human body except for the liver. Particularly we look at the dynamics of the malaria parasites 'merozoites' and their interaction with the blood components, more specifically the red blood cells (RBC) and the immune response grouped under the white blood cells (WBC). The stability analysis of the system reveals an important practical direction to investigate as regards the ratio WBC over RBC since it is a fundamental parameter that characterizes stable regions. The model numerically presents a wide range of possible features of the disease. Even with its simplified form, the model not only recovers well-known results but in addition predicts possible hidden phenomenon and an interesting clinical feature a malaria crisis. (author)

  13. The cerebral venous system and hypoxia.

    Science.gov (United States)

    Wilson, Mark H; Imray, Christopher H E

    2016-01-15

    Most hypobaric hypoxia studies have focused on oxygen delivery and therefore cerebral blood inflow. Few have studied venous outflow. However, the volume of blood entering and leaving the skull (∼700 ml/min) is considerably greater than cerebrospinal fluid production (0.35 ml/min) or edema formation rates and slight imbalances of in- and outflow have considerable effects on intracranial pressure. This dynamic phenomenon is not necessarily appreciated in the currently taught static "Monro-Kellie" doctrine, which forms the basis of the "Tight-Fit" hypothesis thought to underlie high altitude headache, acute mountain sickness, and high altitude cerebral edema. Investigating both sides of the cerebral circulation was an integral part of the 2007 Xtreme Everest Expedition. The results of the relevant studies performed as part of and subsequent to this expedition are reviewed here. The evidence from recent studies suggests a relative venous outflow insufficiency is an early step in the pathogenesis of high altitude headache. Translation of knowledge gained from high altitude studies is important. Many patients in a critical care environment develop hypoxemia akin to that of high altitude exposure. An inability to drain the hypoxemic induced increase in cerebral blood flow could be an underappreciated regulatory mechanism of intracranial pressure. PMID:26294747

  14. Cerebral Palsy (CP) Quiz

    Science.gov (United States)

    ... Submit Button Past Emails CDC Features Pop Quiz: Cerebral Palsy Language: English Español (Spanish) Recommend on Facebook Tweet ... Sandy is the parent of a child with cerebral palsy and the Board President of Gio’s Garden , a ...

  15. Reversible cerebral vasoconstriction syndrome

    Directory of Open Access Journals (Sweden)

    Saini Monica

    2009-01-01

    Full Text Available Reversible cerebral vasoconstriction syndromes (RCVS are a group of disorders that have in common an acute presentation with headache, reversible vasoconstriction of cerebral arteries, with or without neurological signs and symptoms. In contrast to primary central nervous system vasculitis, they have a relatively benign course. We describe here a patient who was diagnosed with RCVS.

  16. Plasmodium falciparum variant surface antigen expression varies between isolates causing severe and nonsevere malaria and is modified by acquired immunity

    DEFF Research Database (Denmark)

    Nielsen, Morten A; Staalsoe, Trine; Kurtzhals, Jørgen; Goka, Bamenla Q; Dodoo, Daniel; Alifrangis, Michael; Theander, Thor G; Akanmori, Bartholomew D; Hviid, Lars

    2002-01-01

    In areas of endemic parasite transmission, protective immunity to Plasmodium falciparum malaria is acquired over several years with numerous disease episodes. Acquisition of Abs to parasite-encoded variant surface Ags (VSA) on the infected erythrocyte membrane is important in the development of...... immunity, as disease-causing parasites appear to be those not controlled by preexisting VSA-specific Abs. In this work we report that VSA expressed by parasites from young Ghanaian children with P. falciparum malaria were commonly and strongly recognized by plasma Abs from healthy children in the same area......, whereas recognition of VSA expressed by parasites from older children was weaker and less frequent. Independent of this, parasites isolated from children with severe malaria (cerebral malaria and severe anemia) were better recognized by VSA-specific plasma Abs than parasites obtained from children with...

  17. Protein C system defects inflicted by the malaria parasite protein PfEMP1 can be overcome by a soluble EPCR variant

    DEFF Research Database (Denmark)

    Petersen, Jens E V; Bouwens, Eveline A M; Tamayo, Ibai;

    2015-01-01

    The Endothelial Protein C receptor (EPCR) is essential for the anticoagulant and cytoprotective functions of the Protein C (PC) system. Selected variants of the malaria parasite protein, Plasmodium falciparum Erythrocyte Membrane Protein 1 (PfEMP1) associated with severe malaria, including cerebral...... malaria, specifically target EPCR on vascular endothelial cells. Here, we examine the cellular response to PfEMP1 engagement to elucidate its role in malaria pathogenesis. Binding of the CIDRα1.1 domain of PfEMP1 to EPCR obstructed activated PC (APC) binding to EPCR and induced a loss of cellular EPCR...... interfere with (A)PC binding to cellular EPCR. E86A-sEPCR used as a decoy to capture PfEMP1, permitted normal PC activation on endothelial cells, normal barrier protective effects of APC, and greatly reduced cytoadhesion of infected erythrocytes to brain endothelial cells. These data imply important...

  18. Immunoinformatics of Placental Malaria Vaccine Development

    DEFF Research Database (Denmark)

    Jessen, Leon Eyrich

    Malaria is an infectious disease caused by a protozoan parasite of the genus Plasmodium, which is transferred by female Anopheles mosquitos. WHO estimates that in 2012 there were 207 million cases of malaria, of which 627,000 were fatal. People living in malaria-endemic areas, gradually acquire...... immunity with multiple infections. Placental malaria (PM) is caused by P. falciparum sequestering in the placenta of pregnant women due to the presence of novel receptors in the placenta. An estimated 200,000 infants die a year as a result of PM. In 2004 the specific protein responsible for the...... and development in the field of placental malaria vaccine development....

  19. Cutaneous findings in five cases of malaria

    Directory of Open Access Journals (Sweden)

    Jignesh B Vaishnani

    2011-01-01

    Full Text Available Malaria is an infectious disease caused by protozoa of the genus Plasmodium. Cutaneous lesions in malaria are rarely reported and include urticaria, angioedema, petechiae, purpura, and disseminated intravascular coagulation (DIC. Here, five malaria cases associated with cutaneous lesions have been described. Out of the five cases of malaria, two were associated with urticaria and angioedema, one case was associated with urticaria, and other two were associated with reticulated blotchy erythema with petechiae. Most of the cutaneous lesions in malaria were nonspecific and reflected the different immunopathological mechanism in malarial infection.

  20. Maternal manifestations of malaria in pregnancy: a review.

    Science.gov (United States)

    Maitra, N; Joshi, M; Hazra, M

    1993-01-01

    Malaria is a major cause of maternal and fetal morbidity and mortality, and this risk is highest in the areas of unstable malaria transmission. In 1990 and 1991 the Department of Obstetrics and Gynecology of Sir Sayajirao General Hospital in central Gujarat, India, has cared for a total of 445 urban as well as rural patients with malaria in pregnancy: 232 were labor ward admissions and 213 were antenatal ward admissions. Plasmodium falciparum infection affected 97.27% of patients, both primigravidae and multigravidae. Heavy parasitemia was observed in 27.14% of primigravidae and 48.57% in secundigravidae, however, this was not statistically significant. Out of the 260 (58.42.) cases who had various degrees of anaemia, 59 (22.69) had severe anaemia with haemoglobin of less than 6.0 gm O/dl. Within this group, 71.16% women were primigravidae or secundigravidae, the rest were multigravidae. Out of the 6 patients in first trimester, the miscarriage rate was 100%. In the second trimester, out of 52 patients 74.99 pregnancies were discontinued, whereas in the third trimester, the miscarriage rate was 18.17%. This observation was statistically significant (p 0.05). 178 patients who were admitted antenatally were discharged, their pregnancy outcome was not known, and accordingly they were excluded. There were 11 patients in the first trimester, 139 in the second trimester, and 295 in the third trimester. The known pregnancy losses were 54.54% in the first trimester. 28.05% in the second trimester, and 12.88% in the third trimester. 75.59% of those with minor parasitemia and 47.36% with heavy parasitemia had a normal pregnancy outcome. The overall fetal loss was 31.08%, which was almost twice that of the miscarriage rates among the general population. Maternal deaths attributed to malaria in pregnancy were 15, with cerebral malaria accounting for 5 deaths. 46.66% of the deaths occurred in primigravidae and secundigravidae. The other causes of mortality were postpartum

  1. Severe malaria - a case of fatal Plasmodium knowlesi infection with post-mortem findings: a case report

    Directory of Open Access Journals (Sweden)

    Adem Patricia

    2010-01-01

    Full Text Available Abstract Background Zoonotic malaria caused by Plasmodium knowlesi is an important, but newly recognized, human pathogen. For the first time, post-mortem findings from a fatal case of knowlesi malaria are reported here. Case presentation A formerly healthy 40 year-old male became symptomatic 10 days after spending time in the jungle of North Borneo. Four days later, he presented to hospital in a state of collapse and died within two hours. He was hyponatraemic and had elevated blood urea, potassium, lactate dehydrogenase and amino transferase values; he was also thrombocytopenic and eosinophilic. Dengue haemorrhagic shock was suspected and a post-mortem examination performed. Investigations for dengue virus were negative. Blood for malaria parasites indicated hyperparasitaemia and single species P. knowlesi infection was confirmed by nested-PCR. Macroscopic pathology of the brain and endocardium showed multiple petechial haemorrhages, the liver and spleen were enlarged and lungs had features consistent with ARDS. Microscopic pathology showed sequestration of pigmented parasitized red blood cells in the vessels of the cerebrum, cerebellum, heart and kidney without evidence of chronic inflammatory reaction in the brain or any other organ examined. Brain sections were negative for intracellular adhesion molecule-1. The spleen and liver had abundant pigment containing macrophages and parasitized red blood cells. The kidney had evidence of acute tubular necrosis and endothelial cells in heart sections were prominent. Conclusions The overall picture in this case was one of systemic malaria infection that fit the WHO classification for severe malaria. Post-mortem findings in this case were unexpectedly similar to those that define fatal falciparum malaria, including cerebral pathology. There were important differences including the absence of coma despite petechial haemorrhages and parasite sequestration in the brain. These results suggest that further

  2. Induction of HO-1 in tissue macrophages and monocytes in fatal falciparum malaria and sepsis

    Directory of Open Access Journals (Sweden)

    Liomba N

    2003-11-01

    Full Text Available Abstract Background As well as being inducible by haem, haemoxygenase -1 (HO-1 is also induced by interleukin-10 and an anti-inflammatory prostaglandin, 15d PGJ2, the carbon monoxide thus produced mediating the anti-inflammatory effects of these molecules. The cellular distribution of HO-1, by immunohistochemistry, in brain, lung and liver in fatal falciparum malaria, and in sepsis, is reported. Methods Wax sections were stained, at a 1:1000 dilution of primary antibody, for HO-1 in tissues collected during paediatric autopsies in Blantyre, Malawi. These comprised 37 acutely ill comatose patients, 32 of whom were diagnosed clinically as cerebral malaria and the other 5 as bacterial diseases with coma. Another 3 died unexpectedly from an alert state. Other control tissues were from Australian adults. Results Apart from its presence in splenic red pulp macrophages and microhaemorrhages, staining for HO-1 was confined to intravascular monocytes and certain tissue macrophages. Of the 32 clinically diagnosed cerebral malaria cases, 11 (category A cases had negligible histological change in the brain and absence of or scanty intravascular sequestration of parasitized erythrocytes. Of these 11 cases, eight proved at autopsy to have other pathological changes as well, and none of these eight showed HO-1 staining within the brain apart from isolated moderate staining in one case. Two of the three without another pathological diagnosis showed moderate staining of scattered monocytes in brain vessels. Six of these 11 (category A cases exhibited strong lung staining, and the Kupffer cells of nine of them were intensely stained. Of the seven (category B cases with no histological changes in the brain, but appreciable sequestered parasitised erythrocytes present, one was without staining, and the other six showed strongly staining, rare or scattered monocytes in cerebral vessels. All six lung sections not obscured by neutrophils showed strong staining of

  3. CLINICAL ASPECTS OF UNCOMPLICATED AND SEVERE MALARIA

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    Alessandro Bartoloni

    2012-05-01

    Full Text Available The first symptoms of malaria, common to all the different malaria species, are nonspecific and mimic a flu-like syndrome. Although fever represents the cardinal feature, clinical findings in malaria are extremely diverse and may range in severity from mild headache to serious complications leading to death, particularly in falciparum malaria. As the progression to these complications can be rapid, any malaria patient must be assessed and treated rapidly, and frequent observations are needed to look for early signs of systemic complications. In fact, severe malaria is a life threatening but treatable disease.  The protean and nonspecific clinical findings occurring in malaria (fever, malaise, headache, myalgias, jaundice and sometimes gastrointestinal symptoms of nausea, vomiting and diarrhoea may lead physicians who see malaria infrequently to a wrong diagnosis, such as influenza (particularly during the seasonal epidemic flu, dengue, gastroenteritis, typhoid fever, viral hepatitis, encephalitis. Physicians should be aware that malaria is not a clinical diagnosis but must be diagnosed, or excluded, by performing microscopic examination of blood films. Prompt diagnosis and appropriate treatment are then crucial to prevent morbidity and fatal outcomes. Although Plasmodium falciparum malaria is the major cause of severe malaria and death, increasing evidence has recently emerged that Plasmodium vivax and Plasmodium knowlesi can also be severe and even fatal.

  4. Plasmodium vivax malaria: An unusual presentation

    Directory of Open Access Journals (Sweden)

    Kasliwal Prasad

    2009-01-01

    Full Text Available Acute renal failure, disseminated intravascular coagulation (DIC, acute respiratory distress syndrome (ARDS, hypoglycemia, coma, or epileptic seizures are manifestations of severe Plasmodium falciparum malaria. On the other hand, Plasmodium vivax malaria seldom results in pulmonary damage, and pulmonary complications are exceedingly rare. We report the case of a 42-year-old male living in a malaria-endemic area who presented with ARDS and was diagnosed as having Plasmodium vivax malaria. A diagnosis of Plasmodium vivax malaria was established by a positive Plasmodium LDH immunochromatographic assay while a negative PfHRP2 based assay ruled out P. falciparum malaria. After specific anti-plasmodial therapy and intensive supportive care, the patient recovered and was discharged from hospital. The use of NIPPV in vivax-malaria related ARDS was associated with a good outcome.

  5. Lack of association of interferon regulatory factor 1 with severe malaria in affected child-parental trio studies across three African populations.

    Directory of Open Access Journals (Sweden)

    Valentina D Mangano

    Full Text Available Interferon Regulatory Factor 1 (IRF-1 is a member of the IRF family of transcription factors, which have key and diverse roles in the gene-regulatory networks of the immune system. IRF-1 has been described as a critical mediator of IFN-gamma signalling and as the major player in driving TH1 type responses. It is therefore likely to be crucial in both innate and adaptive responses against intracellular pathogens such as Plasmodium falciparum. Polymorphisms at the human IRF1 locus have been previously found to be associated with the ability to control P. falciparum infection in populations naturally exposed to malaria. In order to test whether genetic variation at the IRF1 locus also affects the risk of developing severe malaria, we performed a family-based test of association for 18 Single Nucleotide Polymorphisms (SNPs across the gene in three African populations, using genotype data from 961 trios consisting of one affected child and his/her two parents (555 from The Gambia, 204 from Kenya and 202 from Malawi. No significant association with severe malaria or severe malaria subphenotypes (cerebral malaria and severe malaria anaemia was observed for any of the SNPs/haplotypes tested in any of the study populations. Our results offer no evidence that the molecular pathways regulated by the transcription factor IRF-1 are involved in the immune-based pathogenesis of severe malaria.

  6. Prevalence of human malaria infection in Pakistani areas bordering with Iran

    International Nuclear Information System (INIS)

    Objective: To study the prevalence of malarial infections in human population of district Panjgur in south-western Pakistan. Methods: The cross-sectional study identified malarial parasites in the blood slides of 6119 suspected malaria patients from July 2006 to June 2008 through passive and active case detection methods. SPSS 11 was used for statistical analysis. Results: Out of 6119 suspected cases of malaria, 2346 (38.3%) were found to be positive for malarial parasite on blood smear slides. Of these, 1868 (79.6%) cases were due to Plasmodium vivax infection, and 478 (20.3%) had P. falciparum. However, seasonal variation was also noted: P. vivax infection was the highest (n=131/144, 90.9%) in November and the lowest (n=83/176, 47.1%) in October. The prevalence was higher (n=1831, 78%) in males. Age-wise, the prevalence of the disease was 81.2% (n=334) and 80% (n=860) for age groups 1-10 years and 11-20 years. No case of P. malaria and P. ovale was detected in the study period. No association was found between types of infection and age groups. Conclusion: Human malaria infection was quite frequent in the study region, which is one of the hottest areas of Balochistan, Pakistan. In clinically-suspected cases of malaria, there was a high slide positivity rate. The high prevalence rate of P. vivax poses a significant health hazard but P. falciparum also may lead to serious complications, including cerebral malaria. (author)

  7. Flip-flop phenomenon: observations and theory

    CERN Document Server

    Elstner, D

    2005-01-01

    In many active stars the spots concentrate on two permanent active longitudes which are 180 degrees apart. In some of these stars the dominant part of the spot activity changes the longitude every few years. This so-called flip-flop phenomenon has up to now been reported in 11 stars, both single and binary alike, and including also the Sun. To explain this phenomenon, a non-axisymmetric dynamo mode, giving rise to two permanent active longitudes at opposite stellar hemispheres, is needed together with an oscillating axisymmetric magnetic field. Here we discuss the observed characteristics of the flip-flop phenomenon and present a dynamo solution to explain them.

  8. Cerebral haematocrit measurement

    International Nuclear Information System (INIS)

    Regional cerebral haematocrit was measured in a group of sixteen subjects by the single-photon emission computerized tomography method. This group included three normal subjects as controls and thirteen patients affected with ischaemic cerebral disease presenting clinically with transient ischaemic attacks-six patients - or recent cerebral stroke - seven patients. Two intravenous radioactive tracers - technetium-99m labelled autologous red blood cells and Tc-99m human serum albumin were used. Cerebral tomographic imaging was performed using a rotating scintillation camera. The values of cerebral haematocrit obtained, taken as a ratio to venous haematocrit, range between 0.65-0.88 in the subjects studied. As a general finding in normal subjects and in patients with transient ischaemic attacks, no significant difference between right and left hemispheric haematocrit value was noted. However, in the group of patients affected with stroke, a significant difference in the right versus left hemispheric Hct was observed in 3 patients, the higher Hct value corresponding to the affected side. The clinical implication is on the emphasis of cerebral Hct measurement when the measurement of cerebral blood flow or volume is sought. Also the variation in regional Hct value observed in patients with stroke, above mentioned, points to a regulation mechanism of the blood composition for optimal oxygen delivery to the brain that is impaired in these patients. 14 refs. (Author)

  9. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  10. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    Energy Technology Data Exchange (ETDEWEB)

    Hayakawa, Katsumi [Department of Radiology, Kyoto City Hospital, 1-2 Higashi-Takada-cho, Mibu, Nakagyo-ku, 604-8845 Kyoto (Japan); Kanda, Toyoko; Yamori, Yuriko [Department of Pediatric Neurology, St. Joseph Hospital for Handicapped Children, 603-8323 Kyoto (Japan)

    2002-10-01

    We evaluated six children in whom MR imaging showed unilateral cerebral polymicrogyria associated with ipsilateral cerebral atrophy and ipsilateral brain stem atrophy. The aim of this study was to clarify whether this disorder based on neuroimaging constitutes a new homogeneous clinical entity. The subjects were six children whose ages at the time of MR imaging ranged from 8 months to 11 years. Their clinical and MR features were analyzed. All of the children were born between 38 and 42 weeks gestation, without any significant perinatal events. Spastic hemiplegia and epilepsy were observed in all of the patients, and mental retardation was observed in four. The MR findings included unilateral cerebral polymicrogyria associated with ipsilateral cerebral hemiatrophy and ipsilateral brain stem atrophy in all patients. The ipsilateral sylvian fissure was hypoplastic in four patients. These patients showed relatively homogeneous clinical and neuroimaging features. Although the additional clinical features varied according to the site and the extent affected by the polymicrogyria, this disorder could constitute a new relatively homogeneous clinical entity. (orig.)

  11. Emerging new trends of malaria in children: A study from a tertiary care centre in northern India

    Directory of Open Access Journals (Sweden)

    Medha Mittal

    2014-04-01

    Full Text Available Background & objectives: Vivax malaria has long been considered a benign entity. However, an increasing number of reports are highlighting that it may no longer be so. An investigation was carried out to study the profile of malarial admissions in a tertiary care pediatric hospital and to analyse the burden of vivax-related complications. Methods: It is a retrospective observational study. The medical case records of all the patients admitted in the year 2011 with the clinical diagnosis of malaria and laboratory evidence in the form of positive peripheral smear and/or rapid malarial antigen test were retrieved and retrospectively analysed. Results: Overall, 198 cases were included, 128 (64.6% were due to Plasmodium vivax, 66 (33.3% due to P. falciparum and 4 (2% had evidence of mixed infection of Pv + Pf. The clinical features on admission were similar in all the groups. In total, 64/128 (50% patients with vivax infection had one or more complications with severe anemia in 33 (26% and cerebral malaria in 16 (12.5%. Six deaths were reported in P. vivax cases. In the falciparum group, 52 (78.8% had one or more complications with severe anemia in 37 (56.1% and cerebral malaria in 24 (36.4%. Four deaths were reported in P. falciparum cases. Interpretation & conclusion: Overall because of their larger numbers, vivax patients outnumbered other groups, with regards to severe complications and deaths. It was concluded that vivax malaria is emerging as an important cause of malaria-related complications in children.

  12. Is Global Warming likely to cause an increased incidence of Malaria?

    OpenAIRE

    Nabi SA; SS Qader

    2009-01-01

    Abstract: The rise in the average temperature of earth has been described as global warming which is mainly attributed to the increasing phenomenon of the greenhouse effect. It is believed that global warming can have several harmful effects on human health, both directly and indirectly. Since malaria is greatly influenced by climatic conditions because of its direct relationship with the mosquito population, it is widely assumed that its incidence is likely to increase in a future warmer wor...

  13. The Origin of Malignant Malaria

    Science.gov (United States)

    Plasmodium falciparum is the causative agent of malignant malaria, which is among the most severe human infectious diseases. Despite its overwhelming significance to human health, the parasite’s origins remain unclear. The favored origin hypothesis holds that P. falciparum and its closest known rel...

  14. [Malaria in Poland in 2007].

    Science.gov (United States)

    Rosińska, Magdalena

    2009-01-01

    In Poland in 2007 there were 11 malaria cases confirmed according to the European Union cases definition reported through the routine surveillance system. All of them were imported, 82% from Africa, including 2 cases of relapse. Invasion with Plasmodium falciparum was diagnosed in 7 cases, mixed invasion in 2 cases and P. vivax- in one case. The majority of cases were in the age group 35-45 (8 cases) and were males (10 cases). Common reasons for travel to endemic countries were work-related (5 cases) and tourism or family visits (4 cases). Approximately half of the cases for whom the information was available used malaria chemoprophylaxis during their travel. Clinical course was severe in one case of P. falciparum malaria and the person died of the disease. The decreasing trend in malaria incidence in Poland is likely related to incomplete reporting as tourist and professional travel to endemic areas has not decreased and there is no indication of wider use ofchemoprophylaxis. PMID:19799261

  15. Chemical biology: Knockout for malaria

    Science.gov (United States)

    Krysiak, Joanna; Sieber, Stephan A.

    2014-02-01

    Discovering and validating new targets is urgently required to tackle the rise in resistance to antimalarial drugs. Now, inhibition of the enzyme N-myristoyltransferase has been shown to prevent the formation of a critical subcellular organelle in the parasite that causes malaria, leading to death of the parasite.

  16. Malaria-induced immune thrombocytopenia

    DEFF Research Database (Denmark)

    Sørensen, P G; Mickley, H; Schmidt, K G

    1984-01-01

    On return from Liberia, a previously healthy 36-year-old man showed signs of malaria accompanied by severe haemolysis and slight thrombocytopenia. We found evidence of a platelet-associated IgG being responsible for the thrombocytopenia, inasmuch as the direct platelet suspension immunofluorescen...

  17. Acoustojet: acoustic analogue of photonic jet phenomenon

    CERN Document Server

    Minin, Igor V

    2016-01-01

    It has been demonstrated for the first time that an existence of acoustic analogue of photonic jet phenomenon, called acoustojet, providing for subwavelength localization of acoustic field in the shadow area of arbitrary 3D penetrable mesoscale particle, is possible.

  18. Professor Nambu, String Theory and Moonshine Phenomenon

    CERN Document Server

    Eguchi, Tohru

    2016-01-01

    I first recall the last occasion of meeting the late Professor Yoichiro Nambu in a hospital in Osaka. I then present a brief introduction to the moonshine phenomenon in string theory which is under recent investigations.

  19. Tamm-Horsfall phenomenon in neonates

    International Nuclear Information System (INIS)

    Tamm-Horsfall phenomenon is a transient hyperechogenicity of the renal pyramids during the first few days of life. The purpose of this study was to determine whether there is a correlation between the Tamm-Horsfall phenomenon and the pathology of pregnancy, the kind of delivery, or selected biochemical parameters of urine. The study involved 153 neonates, divided into two groups based on pregnancy age. Group I consisted of 118 full term neonates born in the 37th - 42nd week of pregnancy, while Group II included 35 premature neonates born before the 37th week of pregnancy. Ultrasonograms of the kidneys were performed on the 1st and 3rd day of life, as well as examinations of urine protein, creatinine, uric acid and urea concentration. The Examinations were repeated in the 2nd month of life after making a diagnosis of Tamm-Hosfall phenomenon. Tamm-Horsfall phenomenon was diagnosed in 32 eutrophic children (22.7% of the group). Among the term neonates, diagnoses of Tamm-Horsfall phenomenon were made in 24.6% of the children (29/118), as opposed to 8.6% (3/35) in the preterm group in. Pregnancy was terminated by caesarean section in 22 cases (68.7 % of all 32). 10 children (31.3 % of all 32) were born spontaneously (p=0.01). Significantly higher urine protein and creatinine concentrations were noted in this group only on the 3rd day of life. Children with Tamm-Horsfall phenomenon had greater body mass at birth (p=0.01) than the others. Repeated examinations of 23 children diagnosed with Tamm-Horsfall phenomenon performed in the 2nd month of life showed that this phenomenon had disappeared. Tamm-Horsfall phenomenon is observed more often in children delivered by caesarean section. Children diagnosed with Tamm-Horsfall phenomenon have higher urine levels of protein and creatinine on the 3rd day of life. Tamm-Horsfall phenomenon is observed more often in term, eutrophic children. (author)

  20. Spatially discontinuous ionization phenomenon in inhomogeneous soil

    Institute of Scientific and Technical Information of China (English)

    2010-01-01

    By using X-ray film imaging technology,a phenomenon of discontinuous ionization was observed in the inhomogeneous soil around the grounding electrode on which a surge voltage was applied.A simplified two-phase solid-gas model was built to study the electric field distribution in the soil to explain the discontinuous ionization phenomenon.Analysis showed the differences of the dielectric properties,the shapes and sizes of soil particles can cause discontinuous ionization in the soil.

  1. PROSTITUTION PHENOMENON - LEGAL AND SOCIAL ASPECTS

    OpenAIRE

    Ilinca Alexandra TÃLNAR; Camelia Augusta HIMCINSCHI

    2012-01-01

    The prostitution phenomenon is a global, complex, controversial, and problematic phenomenon which remains one of the current subjects debated at national and international level. From a judicial point of view, despite of the numerous legal measures and sporadic actions realized by the police, prostitution continues to be present in Romania, partially due to the low efficiency of legal controls and laws’ implementation. In this respect, we have focused on the distinction between offence and co...

  2. Open source innovation phenomenon, participant behaviour, impact

    CERN Document Server

    Herstatt, Cornelius

    2015-01-01

    Open Source Innovation (OSI) has gained considerable momentum within the last years. Academic and management practice interest grows as more and more end-users consider and even participate in Open Source product development like Linux, Android, or Wikipedia. Open Source Innovation: Phenomenon, Participant Behaviour, Impact brings together rigorous academic research and business importance in scrutinizing OCI from three perspectives: The Phenomenon, Participants' Behavior, and Business Implications. The first section introduces OCI artefacts, including who is participating and why, and provide

  3. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2009-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  4. Koebner phenomenon of the ear canal skin.

    LENUS (Irish Health Repository)

    Young, O

    2012-02-01

    The Koebner phenomenon originally described the appearance of psoriatic lesions in the uninvolved skin of patients with psoriasis as a consequence of trauma. We describe a case of concurrent lichen planus and sarcoidosis in the auditory canal, which represents an unusual manifestation of the Koebner phenomenon. This is the first case of concurrent lichen planus and sarcoidosis in the head and neck region and highlights the need for biopsy to allow accurate histopathological diagnosis and treatment.

  5. Validation of the Impostor Phenomenon Among Managers

    OpenAIRE

    Sonja eRohrmann; Myriam eBechtoldt; Mona eLeonhardt

    2016-01-01

    Following up on earlier investigations, the present research aims to validate the construct impostor phenomenon by taking personality correlates into account and to examine whether the impostor phenomenon is a construct in its own right. In addition, gender effects as well as effects on working style and stress or strain are examined. In an online study we surveyed a sample of N = 242 individuals occupying leadership positions in different sectors. Confirmatory factor analyses provide empiric...

  6. Validation of the Impostor Phenomenon among Managers

    OpenAIRE

    Rohrmann, Sonja; Bechtoldt, Myriam N.; Leonhardt, Mona

    2016-01-01

    Following up on earlier investigations, the present research aims at validating the construct impostor phenomenon by taking other personality correlates into account and to examine whether the impostor phenomenon is a construct in its own right. In addition, gender effects as well as associations with dispositional working styles and strain are examined. In an online study we surveyed a sample of N = 242 individuals occupying leadership positions in different sectors. Confirmatory factor anal...

  7. Prussian phenomenon and its historical distortion

    OpenAIRE

    Oleg Y. Plenkov; Vladimir N. Baryshnikov; Viktor N. Borisenko; Vladimir L. Piankewich; Nina E. Adamova

    2016-01-01

    The article deals with the phenomenon of Prussia. Once, Prussia had been the largest continental Protestant state in Europe. The main issue of this phenomenon is that upon the tragic events of the World War II Prussian history and heritage had been considerably distorted, in order to compensate somehow for the dreadful casualties suffered by the victorious powers. The common European misconception implied that Prussia had been the bulwark of militarism, and therefore had to bear all the respo...

  8. The impact of genetic susceptibility to systemic lupus erythematosus on placental malaria in mice.

    Directory of Open Access Journals (Sweden)

    Michael Waisberg

    Full Text Available Severe malaria, including cerebral malaria (CM and placental malaria (PM, have been recognized to have many of the features of uncontrolled inflammation. We recently showed that in mice genetic susceptibility to the lethal inflammatory autoimmune disease, systemic lupus erythematosus (SLE, conferred resistance to CM. Protection appeared to be mediated by immune mechanisms that allowed SLE-prone mice, prior to the onset of overt SLE symptoms, to better control their inflammatory response to Plasmodium infection. Here we extend these findings to ask does SLE susceptibility have 1 a cost to reproductive fitness and/or 2 an effect on PM in mice? The rates of conception for WT and SLE susceptible (SLE(s mice were similar as were the number and viability of fetuses in pregnant WT and SLE(s mice indicating that SLE susceptibility does not have a reproductive cost. We found that Plasmodium chabaudi AS (Pc infection disrupted early stages of pregnancy before the placenta was completely formed resulting in massive decidual necrosis 8 days after conception. Pc-infected pregnant SLE(s mice had significantly more fetuses (∼1.8 fold but SLE did not significantly affect fetal viability in infected animals. This was despite the fact that Pc-infected pregnant SLE(s mice had more severe symptoms of malaria as compared to Pc-infected pregnant WT mice. Thus, although SLE susceptibility was not protective in PM in mice it also did not have a negative impact on reproductive fitness.

  9. Validation of the Impostor Phenomenon among Managers.

    Science.gov (United States)

    Rohrmann, Sonja; Bechtoldt, Myriam N; Leonhardt, Mona

    2016-01-01

    Following up on earlier investigations, the present research aims at validating the construct impostor phenomenon by taking other personality correlates into account and to examine whether the impostor phenomenon is a construct in its own right. In addition, gender effects as well as associations with dispositional working styles and strain are examined. In an online study we surveyed a sample of N = 242 individuals occupying leadership positions in different sectors. Confirmatory factor analyses provide empirical evidence for the discriminant validity of the impostor phenomenon. In accord with earlier studies we show that the impostor phenomenon is accompanied by higher levels of anxiety, dysphoric moods, emotional instability, a generally negative self-evaluation, and perfectionism. The study does not reveal any gender differences concerning the impostor phenomenon. With respect to working styles, persons with an impostor self-concept tend to show perfectionist as well as procrastinating behaviors. Moreover, they report being more stressed and strained by their work. In sum, the findings show that the impostor phenomenon constitutes a dysfunctional personality style. Practical implications are discussed. PMID:27313554

  10. Validation of the Impostor Phenomenon among Managers

    Science.gov (United States)

    Rohrmann, Sonja; Bechtoldt, Myriam N.; Leonhardt, Mona

    2016-01-01

    Following up on earlier investigations, the present research aims at validating the construct impostor phenomenon by taking other personality correlates into account and to examine whether the impostor phenomenon is a construct in its own right. In addition, gender effects as well as associations with dispositional working styles and strain are examined. In an online study we surveyed a sample of N = 242 individuals occupying leadership positions in different sectors. Confirmatory factor analyses provide empirical evidence for the discriminant validity of the impostor phenomenon. In accord with earlier studies we show that the impostor phenomenon is accompanied by higher levels of anxiety, dysphoric moods, emotional instability, a generally negative self-evaluation, and perfectionism. The study does not reveal any gender differences concerning the impostor phenomenon. With respect to working styles, persons with an impostor self-concept tend to show perfectionist as well as procrastinating behaviors. Moreover, they report being more stressed and strained by their work. In sum, the findings show that the impostor phenomenon constitutes a dysfunctional personality style. Practical implications are discussed. PMID:27313554

  11. X-linked G6PD deficiency protects hemizygous males but not heterozygous females against severe malaria.

    Directory of Open Access Journals (Sweden)

    Aldiouma Guindo

    2007-03-01

    Full Text Available BACKGROUND: Glucose-6-phosphate dehydrogenase (G6PD is important in the control of oxidant stress in erythrocytes, the host cells for Plasmodium falciparum. Mutations in this enzyme produce X-linked deficiency states associated with protection against malaria, notably in Africa where the A- form of G6PD deficiency is widespread. Some reports have proposed that heterozygous females with mosaic populations of normal and deficient erythrocytes (due to random X chromosome inactivation have malaria resistance similar to or greater than hemizygous males with populations of uniformly deficient erythrocytes. These proposals are paradoxical, and they are not consistent with currently hypothesized mechanisms of protection. METHODS AND FINDINGS: We conducted large case-control studies of the A- form of G6PD deficiency in cases of severe or uncomplicated malaria among two ethnic populations of rural Mali, West Africa, where malaria is hyperendemic. Our results indicate that the uniform state of G6PD deficiency in hemizygous male children conferred significant protection against severe, life-threatening malaria, and that it may have likewise protected homozygous female children. No such protection was evident from the mosaic state of G6PD deficiency in heterozygous females. We also found no significant differences in the parasite densities of males and females with differences in G6PD status. Pooled odds ratios from meta-analysis of our data and data from a previous study confirmed highly significant protection against severe malaria in hemizygous males but not in heterozygous females. Among the different forms of severe malaria, protection was principally evident against cerebral malaria, the most frequent form of life-threatening malaria in these studies. CONCLUSIONS: The A- form of G6PD deficiency in Africa is under strong natural selection from the preferential protection it provides to hemizygous males against life-threatening malaria. Little or no such

  12. Using Malaria Medication for Leg Cramps Is Risky

    Science.gov (United States)

    ... Products Vaccines, Blood & Biologics Articulos en Espanol Using Malaria Medication for Leg Cramps is Risky Printer-friendly ... approved only to treat a certain type of malaria (uncomplicated malaria) caused by the parasite Plasmodium falciparum. ...

  13. Shape of Key Malaria Protein Could Help Improve Vaccine Efficacy

    Science.gov (United States)

    ... children. The development of a safe and effective malaria vaccine is critical to control malaria globally, especially given ... in July 2015 and is the first licensed malaria vaccine. In clinical trials, it was shown to protect ...

  14. Neonatal Cerebral Sinovenous Thrombosis

    OpenAIRE

    J Gordon Millichap

    2006-01-01

    The presentation, treatment, and outcome of neonatal cerebral sinovenous thrombosis (SVT) were studied in 42 children, using neurology clinic records (1986-2005) at Indiana University School of Medicine.

  15. Cerebral Aneurysms Fact Sheet

    Science.gov (United States)

    ... cerebral aneurysm from forming. People with a diagnosed brain aneurysm should carefully control high blood pressure, stop smoking, and avoid cocaine use or other stimulant drugs. They should also ...

  16. Cerebral amyloid angiopathy

    Science.gov (United States)

    ... Fenichel GM, Jankovic J, Mazziotta JC, eds. Bradley's Neurology in Clinical Practice . 6th ed. Philadelphia, PA: Elsevier ... al. Course of cerebral amyloid angiopathy-related inflammation. Neurology. 2007;68:1411-1416. PMID: 17452586 www.ncbi. ...

  17. From "forest malaria" to "bromeliad malaria": a case-study of scientific controversy and malaria control.

    Science.gov (United States)

    Gadelha, P

    1994-08-01

    The article analyses the evolution of knowledge and rationale of control of a special case of malaria transmission based on Bromelia-Kerteszia complex. Since bromeliaceae function as a 'host of the carrier' and were previously associated with natural forests, the elucidation of bromeliad malaria historically elicited controversies concerning the imputation of Kertesziae as transmitters as well as over control strategies directed to bromelia eradication (manual removal, herbicides and deforestation), use of insecticides and chemoprophylaxis. Established authority, disciplinary traditions, conceptual premises and contemporary criteria for validating knowledge in the field partly explain the long time gap since Adolpho Lutz announced at the beginning of the century the existence of a new mosquito and breeding site as responsible for a 'forest malaria' epidemic occurring at a high altitude. The article brings attention to how economic, political and institutional determinants played an important role in redefining studies that led both in Trinidad and Brazil to the recognition of the importance of kerteszia transmission, including urban areas, and establishing new approaches to its study, most relevant of all the concurrence of broad ecological research. The article then describes the Brazilian campaign strategies which showed significant short-term results but had to wait four decades to achieve the goal of eradication due to the peculiar characteristics of this pathogenic complex. Finally, it brings attention to the importance of encompassing social values and discourses, in this case, environmental preservation, to understanding historical trends of malaria control programs. PMID:7898955

  18. Acute ischemic cerebral attack

    OpenAIRE

    Franco-Garcia Samir; Barreiro-Pinto Belis

    2010-01-01

    The decrease of the cerebral blood flow below the threshold of autoregulation led to changes of cerebral ischemia and necrosis that traduce in signs and symtoms of focal neurologic dysfunction called acute cerebrovascular symdrome (ACS) or stroke. Two big groups according to its etiology are included in this category the hemorragic that constitue a 20% and the ischemic a 80% of cases. Great interest has wom the ischemic ACS because of its high social burden, being the third cause of no violen...

  19. Cerebral aneurysms and inflammation

    Directory of Open Access Journals (Sweden)

    Toshihiro Yokoi

    2015-06-01

    Full Text Available Multiple inflammatory factors, playing a crucial role in cerebral aneurysm formation, have been identified. tumor necrosis factor-alpha (TNF-α has been revealed to have a close connection with several risk factors that affect aneurysm formation. Remarkable expression in aneurysm walls of mRNA for TNF-α has been observed in humans. Possible therapeutic interventions to reduce the formation of cerebral aneurysms may include the inhibition of mediators of inflammation.

  20. Rehabilitation in cerebral palsy.

    OpenAIRE

    Molnar, G. E.

    1991-01-01

    Cerebral palsy is the most frequent physical disability of childhood onset. Over the past four decades, prevalence has remained remarkably constant at 2 to 3 per 1,000 live births in industrialized countries. In this article I concentrate on the rehabilitation and outcome of patients with cerebral palsy. The epidemiologic, pathogenetic, and diagnostic aspects are highlighted briefly as they pertain to the planning and implementation of the rehabilitation process.

  1. Cerebral Palsy Litigation

    OpenAIRE

    Sartwelle, Thomas P.; Johnston, James C.

    2015-01-01

    The cardinal driver of cerebral palsy litigation is electronic fetal monitoring, which has continued unabated for 40 years. Electronic fetal monitoring, however, is based on 19th-century childbirth myths, a virtually nonexistent scientific foundation, and has a false positive rate exceeding 99%. It has not affected the incidence of cerebral palsy. Electronic fetal monitoring has, however, increased the cesarian section rate, with the expected increase in mortality and morbidity risks to mothe...

  2. Ecology, economics and political will: the vicissitudes of malaria strategies in Asia.

    Science.gov (United States)

    Kidson, C; Indaratna, K

    1998-06-01

    The documented history of malaria in parts of Asia goes back more than 2,000 years, during which the disease has been a major player on the socioeconomic stage in many nation states as they waxed and waned in power and prosperity. On a much shorter time scale, the last half century has seen in microcosm a history of large fluctuations in endemicity and impact of malaria across the spectrum of rice fields and rain forests, mountains and plains that reflect the vast ecological diversity inhabited by this majority aggregation of mankind. That period has seen some of the most dramatic changes in social and economic structure, in population size, density and mobility, and in political structure in history: all have played a part in the changing face of malaria in this extensive region of the world. While the majority of global malaria cases currently reside in Africa, greater numbers inhabited Asia earlier this century before malaria programs savored significant success, and now Asia harbors a global threat in the form of the epicenter of multidrug resistant Plasmodium falciparum which is gradually encompassing the tropical world. The latter reflects directly the vicissitudes of economic change over recent decades, particularly the mobility of populations in search of commerce, trade and personal fortunes, or caught in the misfortunes of physical conflicts. The period from the 1950s to the 1990s has witnessed near "eradication" followed by resurgence of malaria in Sri Lanka, control and resurgence in India, the influence of war and postwar instability on drug resistance in Cambodia, increase in severe and cerebral malaria in Myanmar during prolonged political turmoil, the essential disappearance of the disease from all but forested border areas of Thailand where it remains for the moment intractable, the basic elimination of vivax malaria from many provinces of central China. Both positive and negative experiences have lessons to teach in the debate between eradication

  3. Rapid urban malaria appraisal (RUMA) I: Epidemiology of urban malaria in Ouagadougou

    OpenAIRE

    Convelbo Natalie; Pritroipa Xavier; Diadie Diallo A; Vounatsou Penelope; Smith Thomas A; Lengeler Christian; Wang Shr-Jie; Kientga Mathieu; Tanner Marcel

    2005-01-01

    Abstract Background Rapid urbanization in sub-Saharan Africa has a major impact on malaria epidemiology. While much is known about malaria in rural areas in Burkina Faso, the urban situation is less well understood. Methods An assessment of urban malaria was carried out in Ouagadougou in November -December, 2002 during which a rapid urban malaria appraisal (RUMA) was applied. Results The school parasitaemia prevalence was relatively high (48.3%) at the cold and dry season 2002. Routine malari...

  4. Malaria vaccines and their potential role in the elimination of malaria

    OpenAIRE

    Greenwood Brian M; Targett Geoffrey A

    2008-01-01

    Abstract Research on malaria vaccines is currently directed primarily towards the development of vaccines that prevent clinical malaria. Malaria elimination, now being considered seriously in some epidemiological situations, requires a different vaccine strategy, since success will depend on killing all parasites in the community in order to stop transmission completely. The feature of the life-cycles of human malarias that presents the greatest challenge to an elimination programme is the pe...

  5. Plasmodium vivax Hospitalizations in a Monoendemic Malaria Region: Severe Vivax Malaria?

    OpenAIRE

    Quispe, Antonio M.; Pozo, Edwar; Guerrero, Edith; Durand, Salomón; Baldeviano, G. Christian; Edgel, Kimberly A.; Graf, Paul C. F.; Lescano, Andres G.

    2014-01-01

    Severe malaria caused by Plasmodium vivax is no longer considered rare. To describe its clinical features, we performed a retrospective case control study in the subregion of Luciano Castillo Colonna, Piura, Peru, an area with nearly exclusive vivax malaria transmission. Severe cases and the subset of critically ill cases were compared with a random set of uncomplicated malaria cases (1:4). Between 2008 and 2009, 6,502 malaria cases were reported, including 106 hospitalized cases, 81 of which...

  6. Hitting Hotspots: Spatial Targeting of Malaria for Control and Elimination

    OpenAIRE

    Bousema, Jan Teun; Griffin, J.T.; Sauerwein, R.W.; Smith, D. L.; Churcher, T.S.; Takken, W.; Ghani, A.; Drakeley, C.; Gosling, R.

    2012-01-01

    Current malaria elimination guidelines are based on the concept that malaria transmission becomes heterogeneous in the later phases of malaria elimination [1]. In the pre-elimination and elimination phases, interventions have to be targeted to entire villages or towns with higher malaria incidence until only individual episodes of malaria remain and become the centre of attention [1]. With increasing evidence of clustering of malaria episodes within villages, we argue that there is an interme...

  7. Review of the malaria epidemiology and trends in Zambia

    OpenAIRE

    Masaninga, Freddie; Chanda, Emmanuel; Chanda-Kapata, Pascalina; Hamainza, Busiku; Masendu, Hieronymo T; Kamuliwo, Mulakwa; Kapelwa, Wambinji; Chimumbwa, John; Govere, John; Otten, Mac; Fall, Ibrahima Soce; Babaniyi, Olusegun

    2013-01-01

    A comprehensive desk review of malaria trends was conducted between 2000-2010 in Zambia to study malaria epidemiology and trends to guide strategies and approaches for effective malaria control. This review considered data from the National Health Information Management System, Malaria Surveys and Programme Review reports and analyzed malaria in-patient cases and deaths in relation to intervention coverage for all ages. Data showed three distinct epidemiological strata after a notable malaria...

  8. Cardiovascular involvement in severe vivax and falciparum malaria

    OpenAIRE

    Kailash Chandra Nayak; Shyam Lal Meena; Bal Kishan Gupta; Surendra Kumar; Vikas Pareek

    2013-01-01

    Background & objectives: Recently, vivax malaria is also presenting as severe malaria causing multiorgan dysfunction similar to falciparum malaria. The present study was undertaken to evaluate the involvement of cardiovascular system in severe malaria. Methods: This is a clinical prospective study conducted on the cases of severe malaria in S.P. Medical College and PBM Hospital, Bikaner, India. In total, 100 cases (45 males, 55 females; age range 13-75 yr) of severe malaria (P. vivax 60; P...

  9. Measuring malaria endemicity from intense to interrupted transmission

    OpenAIRE

    Hay, Simon I; Smith, David L; Snow, Robert W.

    2008-01-01

    Summary The quantification of malaria transmission for the classification of malaria risk has long been a concern for epidemiologists. During the era of the Global Malaria Eradication Programme, measurements of malaria endemicity were institutionalised by their incorporation into rules outlining defined action points for malaria control programmes. We review the historical development of these indices and their contemporary relevance. This is at a time when many malaria-endemic countries are ...

  10. [The epidemiology of malaria in Kocaeli].

    Science.gov (United States)

    Sönmez Tamer, Gülden

    2008-01-01

    Malaria is a very important disease both for the world and Turkey. In this retrospective study, malaria cases detected by the Malaria Control Unit Division of the Bursa Health Directorship from 1997-2007 have been evaluated. During this ten-year period, a total of 46,959 blood specimens were examined and 64 (0.14%) malaria cases were detected. Out of the 64 cases of malaria, 63 (98.44%) were caused by Plasmodium vivax and 1 (1.56%) by Plasmodium falciparum. Of the 64 cases, 45 (70.3%) were male and (29.7%), female. Positivity rates were found to be highest in 1997 and 1998. In this study, we have reviewed the malaria cases according to age, gender, locality and source of infection. PMID:19156602

  11. The role of vitamin D in malaria.

    Science.gov (United States)

    Lương, Khanh Vinh Quốc; Nguyễn, Lan Thi Hoàng

    2015-01-01

    An abnormal calcium-parathyroid hormone (PTH)-vitamin D axis has been reported in patients with malaria infection. A role for vitamin D in malaria has been suggested by many studies. Genetic studies have identified numerous factors that link vitamin D to malaria, including human leukocyte antigen genes, toll-like receptors, heme oxygenase-1, angiopoietin-2, cytotoxic T lymphocyte antigen-4, nucleotide-binding oligomerization domain-like receptors, and Bcl-2. Vitamin D has also been implicated in malaria via its effects on the Bacillus Calmette-Guerin (BCG) vaccine, matrix metalloproteinases, mitogen-activated protein kinase pathways, prostaglandins, reactive oxidative species, and nitric oxide synthase. Vitamin D may be important in malaria; therefore, additional research on its role in malaria is needed. PMID:25596566

  12. Evaluation of Students' Conceptual Understanding of Malaria

    Science.gov (United States)

    Poh-Ai Cheong, Irene; Treagust, David; Kyeleve, Iorhemen J.; Oh, Peck-Yoke

    2010-12-01

    In this study, a two-tier diagnostic test for understanding malaria was developed and administered to 314 Bruneian students in Year 12 and in a nursing diploma course. The validity, reliability, difficulty level, discriminant indices, and reading ability of the test were examined and found to be acceptable in terms of measuring students' understanding and identifying alternative conceptions with respect to malaria. Results showed that students' understanding of malaria was high for content, low for reasons, and limited and superficial for both content and reasons. The instrument revealed several common alternative conceptual understandings students' hold about malaria. The MalariaTT2 instrument developed could be used in classroom lessons for challenging alternative conceptions and enhancing conceptions of malaria.

  13. Maintenance of phenotypic diversity within a set of virulence encoding genes of the malaria parasite Plasmodium falciparum.

    Science.gov (United States)

    Holding, Thomas; Recker, Mario

    2015-12-01

    Infection by the human malaria parasite Plasmodium falciparum results in a broad spectrum of clinical outcomes, ranging from severe and potentially life-threatening malaria to asymptomatic carriage. In a process of naturally acquired immunity, individuals living in malaria-endemic regions build up a level of clinical protection, which attenuates infection severity in an exposure-dependent manner. Underlying this shift in the immunoepidemiology as well as the observed range in malaria pathogenesis is the var multigene family and the phenotypic diversity embedded within. The var gene-encoded surface proteins Plasmodium falciparum erythrocyte membrane protein 1 mediate variant-specific binding of infected red blood cells to a diverse set of host receptors that has been linked to specific disease manifestations, including cerebral and pregnancy-associated malaria. Here, we show that cross-reactive immune responses, which minimize the within-host benefit of each additionally expressed gene during infection, can cause selection for maximum phenotypic diversity at the genome level. We further show that differential functional constraints on protein diversification stably maintain uneven ratios between phenotypic groups, in line with empirical observation. Our results thus suggest that the maintenance of phenotypic diversity within P. falciparum is driven by an evolutionary trade-off that optimizes between within-host parasite fitness and between-host selection pressure. PMID:26674193

  14. HIPOGLIKEMIA PADA SEORANG PENDERITA MALARIA

    Directory of Open Access Journals (Sweden)

    P. N. Harianto

    2012-09-01

    Full Text Available Hypoglycemia is a serious and often fatal complication of severe malaria. This condition has been reported in many parts of the world including from Thailand (1983 and from Indonesia by Hoffman (1988 and Harianto (1990. Two main causes that can lead to development of this condition are quinine administration and the severity of the malaria condition itself. A case study is presented about development of prolonged hypoglycemia after quinine administration. A 41 years old male was hospitalized with 4 days history of fever, headache vomiting and icterus. On examination he was found to be in good mental status, had a normal blood pressure, and a body temperature of 40°C. He also had icterus and hepatomegaly. Laboratory examination on admission showed malaria slide positive forRfalciparum ring 30-40, with parasite count of 3% (+ on day I. CBC showed: WBC of 21,700/mm3 and platelet count of 40,000/mm3. Blood chemistry showed glucose level of 77 mm %, serum bilirubin of 29.34 mg % (direct 21.87 mg % SGOT 31 u/l, SGPT 20 u/l, serum ureum 167 mg %, creatinine of 3.36 mg %, serum Na 123 m Eq/L and K 3.99 Eq/L. Urinalysis was normal except for specific gravity of 1.07. After diagnosis of bilious malaria was confirmed, the patient was given i.v. quinine 500 mg diluted in 500 ml 5% dextrose, infused over 4 hours and repeated every 8 hours. On day IVi.v. quinine was switched to oral preparation of 600 mg given bid and the next day quinine was changed to oral chloroquine. The day after admission (30 hours after quinine administration, blood glucose dropped to 21 mg %, 16-46 mg % on day III, and to less than 10 mg % on day IV. It gradulty returned to normal afterwards. Administration of 10% dextrose and boluses of 40% glucose were able to keep the patient in good clinical condition and prevent death. Malaria slide improved on day III, became negative by day IV and serum bilirubin also decreased on follow up. Hypoglycemia should be expected in severe malaria

  15. Malaria vaccine efficacy: the difficulty of detecting and diagnosing malaria

    OpenAIRE

    McKenzie F Ellis; Hall B Fenton; O'Meara Wendy

    2007-01-01

    Abstract New sources of funding have revitalized efforts to control malaria. An effective vaccine would be a tremendous asset in the fight against this devastating disease and increasing financial and scientific resources are being invested to develop one. A few candidates have been tested in Phase I and II clinical trials, and several others are poised to begin trials soon. Some studies have been promising, and others disappointing. It is difficult to compare the results of these clinical tr...

  16. Low autochtonous urban malaria in Antananarivo (Madagascar

    Directory of Open Access Journals (Sweden)

    Le Bras Jacques

    2006-03-01

    Full Text Available Abstract Background The study of urban malaria is an area undergoing rapid expansion, after many years of neglect. The problem of over-diagnosis of malaria, especially in low transmission settings including urban areas, is also receiving deserved attention. The primary objective of the present study was to assess the frequency of malaria among febrile outpatients seen in private and public primary care facilities of Antananarivo. The second aim was to determine, among the diagnosed malaria cases, the contribution of autochthonous urban malaria. Methods Two cross-sectional surveys in 43 health centres in Antananarivo in February 2003 (rainy season and in July 2003 (dry season were conducted. Consenting clinically suspected malaria patients with fever or history of fever in the past 48 hours were included. Malaria rapid diagnostic tests and microscopy were used to diagnose malaria. Basic information was collected from patients to try to identify the origin of the infection: autochthonous or introduced. Results In February, among 771 patients, 15 (1.9% positive cases were detected. Three malaria parasites were implicated: Plasmodium. falciparum (n = 12, Plasmodium vivax (n = 2 and Plasmodium. ovale (n = 1. Only two cases, both P. falciparum, were likely to have been autochthonous (0.26%. In July, among 739 blood smears examined, 11 (1.5% were positive: P. falciparum (n = 9 and P. vivax (n = 2. Three cases of P. falciparum malaria were considered to be of local origin (0.4%. Conclusion This study demonstrates that malaria cases among febrile episodes are low in Antananarivo and autochthonous malaria cases exist but are rare.

  17. Novel image processing approach to detect malaria

    Science.gov (United States)

    Mas, David; Ferrer, Belen; Cojoc, Dan; Finaurini, Sara; Mico, Vicente; Garcia, Javier; Zalevsky, Zeev

    2015-09-01

    In this paper we present a novel image processing algorithm providing good preliminary capabilities for in vitro detection of malaria. The proposed concept is based upon analysis of the temporal variation of each pixel. Changes in dark pixels mean that inter cellular activity happened, indicating the presence of the malaria parasite inside the cell. Preliminary experimental results involving analysis of red blood cells being either healthy or infected with malaria parasites, validated the potential benefit of the proposed numerical approach.

  18. DIAGNOSIS OF MALARIA BY MAGNETIC DEPOSITION MICROSCOPY

    OpenAIRE

    Zimmerman, Peter A.; Thomson, Jodi M.; Fujioka, Hisashi; Collins, William E.; Zborowski, Maciej

    2006-01-01

    Although malaria contributes to a significant public health burden, malaria diagnosis relies heavily on either non-specific clinical symptoms or blood smear microscopy methods developed in the 1930s. These approaches severely misrepresent the number of infected individuals and the reservoir of parasites in malaria-endemic communities and undermine efforts to control disease. Limitations of conventional microscopy-based diagnosis center on time required to examine slides, time required to atta...

  19. [Current management of imported severe malaria].

    Science.gov (United States)

    Venanzi, E; López-Vélez, R

    2016-09-01

    Severe malaria is a diagnostic and therapeutic emergency with great impact worldwide for incidence and mortality. The clinical presentation of severe malaria can be very polymorphic and rapidly progressing. Therefore a correct diagnosis and an early and adequate antiparasitic and support therapy are essential. This paper attempts to outline the diagnosis frame and the treatment of severe malaria for adults, paediatric patients and for pregnant. PMID:27608318

  20. A Research Agenda for Malaria Eradication: Modeling

    OpenAIRE

    ,

    2011-01-01

    Malaria modeling can inform policy and guide research for malaria elimination and eradication from local implementation to global policy. A research and development agenda for malaria modeling is proposed, to support operations and to enhance the broader eradication research agenda. Models are envisioned as an integral part of research, planning, and evaluation, and modelers should ideally be integrated into multidisciplinary teams to update the models iteratively, communicate their appropria...

  1. Vaccines for Malaria: How Close Are We?

    OpenAIRE

    Thera, Mahamadou A.; Plowe, Christopher V.

    2011-01-01

    Vaccines are the most powerful public health tools mankind has created, but malaria parasites are bigger, more complicated, and wilier than the viruses and bacteria that have been conquered or controlled with vaccines. Despite decades of research toward a vaccine for malaria, this goal has remained elusive. Nevertheless, recent advances justify optimism that a licensed malaria vaccine is within reach. A subunit recombinant protein vaccine that affords in the neighborhood of 50% protective eff...

  2. Advances and challenges in malaria vaccine development

    OpenAIRE

    Wang, Ruobing; Smith, Joseph D.; Kappe, Stefan H.I.

    2010-01-01

    Malaria remains one of the most devastating infectious diseases that threaten humankind. Human malaria is caused by five different species of Plasmodium parasites, each transmitted by the bite of female Anopheles mosquitoes. Plasmodia are eukaryotic protozoans with more than 5000 genes and a complex life cycle that takes place in the mosquito vector and the human host. The life cycle can be divided into pre-erythrocytic stages, erythrocytic stages and mosquito stages. Malaria vaccine research...

  3. Global malaria connectivity through air travel

    OpenAIRE

    Huang, Zhuojie; Tatem, Andrew J

    2013-01-01

    Background Air travel has expanded at an unprecedented rate and continues to do so. Its effects have been seen on malaria in rates of imported cases, local outbreaks in non-endemic areas and the global spread of drug resistance. With elimination and global eradication back on the agenda, changing levels and compositions of imported malaria in malaria-free countries, and the threat of artemisinin resistance spreading from Southeast Asia, there is a need to better understand how the modern flow...

  4. Chemotherapy of Drug-Resistant Malaria

    OpenAIRE

    1996-01-01

    OBJECTIVE: To review the impact of drug-resistant malaria on current management of plasmodial infections.DATA SOURCES: A MEDLINE search of the English-language medical literature from 1985 to 1995; bibliographies of selected papers; international malaria advisory experts.DATA SYNTHESIS: Combinations of artemisinin derivatives and mefloquine or atovaquone plus proguanil appear to be the most active drug regimens against multidrug-resistant falciparum malaria from Southeast Asia. The optimal th...

  5. Malaria reemergence in the Peruvian Amazon region.

    OpenAIRE

    Aramburú Guarda, J.; Ramal Asayag, C.; Witzig, R.

    1999-01-01

    Epidemic malaria has rapidly emerged in Loreto Department, in the Peruvian Amazon region. Peru reports the second highest number of malaria cases in South America (after Brazil), most from Loreto. From 1992 to 1997, malaria increased 50-fold in Loreto but only fourfold in Peru. Plasmodium falciparum infection, which has increased at a faster rate than P. vivax infection in the last 3 years, became the dominant Plasmodium infection in the highest transmission areas in the 1997 rainy season. Th...

  6. New emerging drug-resistant malaria

    OpenAIRE

    Viroj Wiwanitkit

    2010-01-01

    Viroj WiwanitkitWiwanitkit House, Bangkhae, Bangkok ThailandDate of preparation: 20th August 2008Conflict of interest: None declaredClinical question: What is the best treatment for artemisinin-resistant malaria?Results: There is still no better treatment than the presently used artemisinin-based combination therapies. A new antimalarial drug for this problem needs to be found.Implementation: Pitfalls to avoid when treating drug-resistant malaria:Keywords: malaria, drug resistance

  7. The evolution of drug-resistant malaria

    OpenAIRE

    Plowe, Christopher V.

    2008-01-01

    Molecular epidemiological investigations have uncovered the patterns of emergence and global spread of Plasmodium falciparum resistance to chloroquine and sulfadoxine-pyrimethamine. Malaria parasites highly resistant to chloroquine and pyrimethamine spread from Asian origins to Africa, at great cost to human health and life. If artemisinin-resistant falciparum malaria follows the same pattern, renewed efforts to eliminate and eradicate malaria will be gravely threatened. This paper, adapted f...

  8. Malaria in Africa Can Be Eliminated

    OpenAIRE

    Campbell, Carlos C.; Richard W Steketee

    2011-01-01

    A concerted effort to control malaria in Africa has produced dramatic reductions in childhood death in the past decade. This early success has prompted the global community to commit to eradication of malaria deaths and eventually all transmission. Evidence suggests that this is a feasible goal using currently available interventions, augmented with newer tools such as vaccines, which are in development. Malaria deaths are entirely preventable now, and our sustained political and financial co...

  9. Konfirmasi Pemeriksaan Mikroskopik terhadap Diagnosis Klinis Malaria

    OpenAIRE

    Arsin, Arsunan; paeruran, Heri; Syatriani, Sri

    2012-01-01

    ABSTRACT Malaria is one of health problems in the world. In Indonesia morbidity of malaria is still high, mainly in Java and Bali island outside. In special at Bunta Public Health Center Banggai Regency in 2008, The AMI still high was 109,9???. The objective of research was to compare clinical malaria diagnosis result to microscophic examination and to find out the correlations between clinical sign and symptoms to microscophic examination. The methods used in research were observa...

  10. Hidden burden of malaria in Indian women

    Directory of Open Access Journals (Sweden)

    Sharma Vinod P

    2009-12-01

    Full Text Available Abstract Malaria is endemic in India with an estimated 70-100 million cases each year (1.6-1.8 million reported by NVBDCP; of this 50-55% are Plasmodium vivax and 45-50% Plasmodium falciparum. A recent study on malaria in pregnancy reported from undivided Madhya Pradesh state (includes Chhattisgarh state, that an estimated over 220,000 pregnant women contract malaria infection each year. Malaria in pregnancy caused- abortions 34.5%; stillbirths 9%; and maternal deaths 0.45%. Bulk of this tragic outcome can be averted by following the Roll Back Malaria/WHO recommendations of the use of malaria prevention i.e. indoor residual spraying (IRS/insecticide-treated bed nets (ITN preferably long-lasting treated bed nets (LLIN; intermittent preventive therapy (IPT; early diagnosis, prompt and complete treatment using microscopic/malaria rapid diagnostics test (RDT and case management. High incidence in pregnancy has arisen because of malaria surveillance lacking coverage, lack of age and sex wise data, staff shortages, and intermittent preventive treatment (IPT applicable in high transmission states/pockets is not included in the national drug policy- an essential component of fighting malaria in pregnancy in African settings. Inadequate surveillance and gross under-reporting has been highlighted time and again for over three decades. As a result the huge problem of malaria in pregnancy reported occasionally by researchers has remained hidden. Malaria in pregnancy may quicken severity in patients with drug resistant parasites, anaemia, endemic poverty, and malnutrition. There is, therefore, urgent need to streamline malaria control strategies to make a difference in tackling this grim scenario in human health.

  11. A simple method for defining malaria seasonality

    Directory of Open Access Journals (Sweden)

    Smith Lucy

    2009-12-01

    Full Text Available Abstract Background There is currently no standard way of defining malaria seasonality, resulting in a wide range of definitions reported in the literature. Malaria cases show seasonal peaks in most endemic settings, and the choice and timing for optimal malaria control may vary by seasonality. A simple approach is presented to describe the seasonality of malaria, to aid localized policymaking and targeting of interventions. Methods A series of systematic literature reviews were undertaken to identify studies reporting on monthly data for full calendar years on clinical malaria, hospital admission with malaria and entomological inoculation rates (EIR. Sites were defined as having 'marked seasonality' if 75% or more of all episodes occurred in six or less months of the year. A 'concentrated period of malaria' was defined as the six consecutive months with the highest cumulative proportion of cases. A sensitivity analysis was performed based on a variety of cut-offs. Results Monthly data for full calendar years on clinical malaria, all hospital admissions with malaria, and entomological inoculation rates were available for 13, 18, and 11 sites respectively. Most sites showed year-round transmission with seasonal peaks for both clinical malaria and hospital admissions with malaria, with a few sites fitting the definition of 'marked seasonality'. For these sites, consistent results were observed when more than one outcome or more than one calendar year was available from the same site. The use of monthly EIR data was found to be of limited value when looking at seasonal variations of malaria transmission, particularly at low and medium intensity levels. Conclusion The proposed definition discriminated well between studies with 'marked seasonality' and those with less seasonality. However, a poor fit was observed in sites with two seasonal peaks. Further work is needed to explore the applicability of this definition on a wide-scale, using routine

  12. Cerebral Ischemic Preconditioning: the Road So Far….

    Science.gov (United States)

    Thushara Vijayakumar, N; Sangwan, Amit; Sharma, Bhargy; Majid, Arshad; Rajanikant, G K

    2016-05-01

    Cerebral preconditioning constitutes the brain's adaptation to lethal ischemia when first exposed to mild doses of a subtoxic stressor. The phenomenon of preconditioning has been largely studied in the heart, and data from in vivo and in vitro models from past 2-3 decades have provided sufficient evidence that similar machinery exists in the brain as well. Since preconditioning results in a transient protective phenotype labeled as ischemic tolerance, it can open many doors in the medical warfare against stroke, a debilitating cerebrovascular disorder that kills or cripples thousands of people worldwide every year. Preconditioning can be induced by a variety of stimuli from hypoxia to pharmacological anesthetics, and each, in turn, induces tolerance by activating a multitude of proteins, enzymes, receptors, transcription factors, and other biomolecules eventually leading to genomic reprogramming. The intracellular signaling pathways and molecular cascades behind preconditioning are extensively being investigated, and several first-rate papers have come out in the last few years centered on the topic of cerebral ischemic tolerance. However, translating the experimental knowledge into the clinical scaffold still evades practicality and faces several challenges. Of the various preconditioning strategies, remote ischemic preconditioning and pharmacological preconditioning appears to be more clinically relevant for the management of ischemic stroke. In this review, we discuss current developments in the field of cerebral preconditioning and then examine the potential of various preconditioning agents to confer neuroprotection in the brain. PMID:26081149

  13. T-cell responses in malaria

    DEFF Research Database (Denmark)

    Hviid, L; Jakobsen, P H; Abu-Zeid, Y A;

    1992-01-01

    Malaria is caused by infection with protozoan parasites of the genus Plasmodium. It remains one of the most severe health problems in tropical regions of the world, and the rapid spread of resistance to drugs and insecticides has stimulated intensive research aimed at the development of a malaria...... vaccine. Despite this, no efficient operative vaccine is currently available. A large amount of information on T-cell responses to malaria antigens has been accumulated, concerning antigens derived from all stages of the parasite life cycle. The present review summarizes some of that information, and...... discusses factors affecting the responses of T cells to malaria antigens....

  14. Malaria treatment services in Nigeria: A review

    Directory of Open Access Journals (Sweden)

    Benjamin SC Uzochukwu

    2010-01-01

    Full Text Available Malaria remains a major Public Health problem in Nigeria and causes death and illness in children and adults, especially pregnant women. Malaria case management remains a vital component of the malaria control strategies. This entails early diagnosis and prompt treatment with effective antimalarial medicines. The objectives of this review is to enable health professionals to understand the magnitude of malaria treatment services in Nigeria, to improve knowledge for rational malaria management within different health system contexts with a view to improving access to malaria treatment. The review therefore looks at the following areas: clinical disease and epidemiology; the burden of malaria in Nigeria; objectives of treatment; antimalarial treatment policy; malaria diagnosis, treatment strategies/ National responses; treatment sources. The review concludes that for improved malaria treatment services in Nigeria, there is an urgent need to develop adequate strategies that will ensure better access to medicines by getting evidence-based and effective medicines to the people who need them, whether by reducing their costs, promoting equity in access, improving their distribution, increasing their efficacy and acceptability, or slowing down the development of antimicrobial resistance.

  15. Hidden burden of malaria in Indian women

    OpenAIRE

    Sharma Vinod P

    2009-01-01

    Abstract Malaria is endemic in India with an estimated 70-100 million cases each year (1.6-1.8 million reported by NVBDCP); of this 50-55% are Plasmodium vivax and 45-50% Plasmodium falciparum. A recent study on malaria in pregnancy reported from undivided Madhya Pradesh state (includes Chhattisgarh state), that an estimated over 220,000 pregnant women contract malaria infection each year. Malaria in pregnancy caused- abortions 34.5%; stillbirths 9%; and maternal deaths 0.45%. Bulk of this tr...

  16. Historical Aspects in Tolerance Phenomenon Research

    Directory of Open Access Journals (Sweden)

    Janat A. Karmanova

    2013-01-01

    Full Text Available The article examines the historical aspect of the tolerance phenomenon research, particularly the study of tolerance in the age of Antiquity, Middle Ages, New Times, Enlightenment. It is remarkable that the problem of tolerance, emerged in Western civilization on religious grounds, laid the foundation for all other freedoms, attained in many countries. Besides, the article attaches special attention to the researchers of the East, such as Abu Nasr al-Farabi, Khoja Ahmed Yasawi, studies the historical aspect of works by Kazakhstan thinkers A. Kunanbayev, C. Valikhanova, K.B. Zharikbayev, S.K. Kaliyev, A.N. Nysanbayev, A.I. Artemev and others. The analysis of historical research of the tolerance phenomenon brings the author to the conclusion that religious freedom was the starting point for the emergence of new areas of tolerance display. The content of this phenomenon changed according to the historical peculiarities of the societies’ development

  17. Nanomedicine in cerebral palsy

    Directory of Open Access Journals (Sweden)

    Balakrishnan B

    2013-11-01

    Full Text Available Bindu Balakrishnan,1 Elizabeth Nance,1 Michael V Johnston,2 Rangaramanujam Kannan,3 Sujatha Kannan1 1Department of Anesthesiology and Critical Care Medicine, Johns Hopkins University; Baltimore, MD, USA; 2Department of Neurology and Pediatrics, Kennedy Krieger Institute, Baltimore, MD, USA; 3Department of Ophthalmology, Center for Nanomedicine, Johns Hopkins University, Baltimore, MD, USA Abstract: Cerebral palsy is a chronic childhood disorder that can have diverse etiologies. Injury to the developing brain that occurs either in utero or soon after birth can result in the motor, sensory, and cognitive deficits seen in cerebral palsy. Although the etiologies for cerebral palsy are variable, neuroinflammation plays a key role in the pathophysiology of the brain injury irrespective of the etiology. Currently, there is no effective cure for cerebral palsy. Nanomedicine offers a new frontier in the development of therapies for prevention and treatment of brain injury resulting in cerebral palsy. Nanomaterials such as dendrimers provide opportunities for the targeted delivery of multiple drugs that can mitigate several pathways involved in injury and can be delivered specifically to the cells that are responsible for neuroinflammation and injury. These materials also offer the opportunity to deliver agents that would promote repair and regeneration in the brain, resulting not only in attenuation of injury, but also enabling normal growth. In this review, the current advances in nanotechnology for treatment of brain injury are discussed with specific relevance to cerebral palsy. Future directions that would facilitate clinical translation in neonates and children are also addressed. Keywords: dendrimer, cerebral palsy, neuroinflammation, nanoparticle, neonatal brain injury, G4OH-PAMAM

  18. [Malaria in Poland in 2006].

    Science.gov (United States)

    Rosińska, Magdalena

    2008-01-01

    There were 19 cases of malaria meeting European Union case definition for confirmed case registered in Poland in 2006. All of them were imported, including 1 case of relapse: 17 from Africa, 1 from Asia and 1 from Oceania. Species of Plasmodium was determined for 12 cases (68%): P. falciparum in 12 cases and P. vivax in one. There were 15 cases in males and 4 in females. Age at onset ranged from 17 to 59 years and a considerable number of cases occurred in persons 50 years old or older (5.26%). Common reasons for travel to endemic countries included tourism or family visits (10 cases) and professional or missionary travel (5 cases). Only four cases used chemoprophylaxis and the relevant information was missing in 4 cases. In two cases of malaria caused by Pl. falciparum the clinical course was severe and one of them died. PMID:18807482

  19. [Malaria in Poland in 2008].

    Science.gov (United States)

    Stepień, Małgorzata

    2010-01-01

    There were 22 malaria cases confirmed according to the European Union cases definition registered in Poland in 2008. All of them were imported, 13 cases (59%) from Africa, 3 from Asia, 5 from Oceania and 1 from South America. Invasion with Plasmodium falciparum was confirmed in 14 cases, P. vivax in 4 cases, mixed invasion in 2 cases and in 2 cases species of Plasmodium was undetermined. There were 13 cases in males and 9 in females. Age at onset ranged from 23 to 58 years and majority of cases were in the age group 25-40. Common reason for travel to endemic countries were tourism (11 cases) and work-related visits (7 cases). Clinical course was severe in 6 cases of P. falciparum malaria and 1 person died because of the disease. Nine cases used chemoprophylaxis during their travel but only one of them appropriately, relevant information was missing in 6 cases. PMID:20731236

  20. PENENTUAN VEKTOR MALARIA DI FLORES

    Directory of Open Access Journals (Sweden)

    Harijani A. Marwoto

    2012-09-01

    Full Text Available A field study on entomology has been conducted in 6 villages which were located in coastal and in-land areas of Sikka Regency of Central Flores since April 1990 - October 1991. The results of this study showed that the suspected malaria vectors in those areas were An. sundaicus, An. subpictus, An. barbirostris, An. aconitus and An. maculatus. Only 3 species were confirmed as vector using ELISA test, i.e. An. sundaicus, An. barbirostris and An. subpictus with sporosoite rates of 4.2%, 2.1% and 0.1% respectively. An. aconitus, a potential malaria vector in Java and in some onther places was not confirmed as vector in Flores yet. The 3 confirmed vectors were also found positive with sporozoites in West Flores and also found predominant in East Flores.

  1. Non-genetic phenomenons of radiosensitivity

    International Nuclear Information System (INIS)

    Transcription factors are activated by radiation induced DNA damage. This is followed by cell cycle regulation (cell cycle blocks and DNA repair), which influence radiosensitivity. This phenomenon is seen as a genetic effect. Proteins as transcription factors (e.g. NF-κB) are directly activated by ionizing radiation, genes coding for cytokines and growth factors are expressed and influence the radiosensitivity. Damage of the cell membrane also induces signal transduction cascades and activates genes via transcription factors, which influence radiosensitivity. The latter two phenomenons are described as non genetics and will get more and more importance in He radiobiology. (orig.)

  2. Flip-flop phenomenon: observations and theory

    OpenAIRE

    Elstner, D.; Korhonen, H.

    2005-01-01

    In many active stars the spots concentrate on two permanent active longitudes which are 180 degrees apart. In some of these stars the dominant part of the spot activity changes the longitude every few years. This so-called flip-flop phenomenon has up to now been reported in 11 stars, both single and binary alike, and including also the Sun. To explain this phenomenon, a non-axisymmetric dynamo mode, giving rise to two permanent active longitudes at opposite stellar hemispheres, is needed toge...

  3. Clinical Neuroimaging of cerebral ischemia

    International Nuclear Information System (INIS)

    Notice points in clinical imaging of cerebral ischemia are reviewed. When cerebral blood flow is determined in acute stage of cerebral embolism (cerebral blood flow SPECT), it is important to find area of ischemic core and ischemic penumbra. When large cortex area is assigned to ischemic penumbra, thrombolytic therapy is positively adapted, but cautious correspondence is necessary when ischemic core is recognized. DWI is superior in the detection of area equivalent to ischemic core of early stage, but, in imaging of area equivalent to ischemic penumbra, perfusion image or distribution image of cerebral blood volume (CBV) by MRI need to be combined. Luxury perfusion detected by cerebral blood flow SPECT in the cases of acute cerebral embolism suggests vascular recanalization, but a comparison with CT/MRI and continuous assessment of cerebral circulation dynamics were necessary in order to predict brain tissue disease (metabolic abnormality). In hemodynamic cerebral ischemia, it is important to find stage 2 equivalent to misery perfusion by quantification of cerebral blood flow SPECT. Degree of diaschisis can indicate seriousness of brain dysfunction for lacuna infarct. Because cerebral circulation reserve ability (perfusion pressure) is normal in all areas of the low cerebral blood flow by diaschisis mechanism, their areas are easily distinguished from those of hemodynamic cerebral ischemia. (K.H.)

  4. The Malaria Problem: short communication

    Directory of Open Access Journals (Sweden)

    Charles Ebikeme

    2010-09-01

    Full Text Available Malaria is the world's most prevalent infectious disease, a major cause of mortality, and a barrier to social and economic development and growth in many countries throughout the world. Antimalarials represent an important part of strategy to curbing this debilitating disease. The spread of drug resistance is becoming increasingly important. To date, parasite resistance to all but one case of antimalarials exists in most endemic countries. Meaning, new drug to combat the disease are a priority.

  5. PENGOBATAN MALARIA DENGAN KOMBINASI ARTEMISININ

    Directory of Open Access Journals (Sweden)

    Emilianan Tjitra

    2012-09-01

    Full Text Available Previous approaches in malaria treatment fail to reduce the morbidity and mortality of malaria. Widespread overuse of antimalarial treatment of clinical malaria may have contributed to increase drug resistance. Moreover, poor compliance or inadequate dosage also selects for parasite resistance. The paradigm of radical treatment using drug combinations may improve the cure rate and compliance, thereby preventing or delaying the emergence of parasites resistant to antimalarial drugs. The ideal combined antimalarial regimen in Indonesia should be safe and tolerated by all age groups, effective and rapidly acting for both P.falciparum and P.vivax malaria, short course, good compliance and acceptable, without resistance and/or cross-resistance or , not widely spread use, cost-effective and affordable. Artemisinin derivatives are the best partner drug for combination, with advantages that include: well absorbed, safe and well tolerated, rapidly converted to active metabolite, having very short half-life, broad specificity of action, and extremely potent. Current artemisinin-based combinations which are suitable for Indonesia include: amodiaquine plus artesunate given as single daily dose for 3 days (AQ3+ATS3, mefloquine plus artesunate given as single daily dose for 3 days (MQ3+ATS3, lumefantrine/benflumetol plus artemether given as twice daily dose for 3 days (COARTEMETHER, piperaquine plus dihydroartemisinin given as single daily dose for 2-3 days (PPQ2-3+DHA2-3, and piperaquine plus artemisinin given as single daily dose for 2 days (PPQ2+ATM2. Given the imbalance between rapid development of parasite resistance and slow availability of new effective antimalarial drugs, research and development of antimalarial drugs must be encouraged.

  6. Traditionell gegen Malaria eingesetzte Arzneipflanzen

    OpenAIRE

    Kraft, Carola

    2010-01-01

    This work describes the evaluation of crude extracts from several plant species, traditionally used against malaria, regarding their in vitro activity against Plasmodium falciparum. Of the 18 species investigated, four were selected for further phytochemical and pharmacological studies. The stems and leaves of Andira inermis (W.Wright) H.B.K., Fabaceae (Panama), the aerial parts of Artemisia afra Jacq., the leaves of Vernonia colorata (Wild.) Drake, Asteraceae (Zimbabwe) and the root b...

  7. Epidemiology of malaria in Malaysia.

    Science.gov (United States)

    Rahman, K M

    1982-01-01

    Malaria is a major public health problem in Malaysia, particularly in peninsular Malaysia and the state of Sabah. An eradication program started in the states of Sabah and Sarawak in 1961 initially was remarkably successful. A similar but staged program was started in peninsular Malaysia in 1967 and was also quite successful. However, a marked upsurge in incidence in Sabah in 1975-1978 showed that malaria is still a major hazard. The disease leads to great economic losses in terms of the productivity of the labor force and the learning capacity of schoolchildren. The topography, the climate, and the migrations of the people due to increased economic activity are similar in peninsular Malaysia, Sabah, and Sarawak. However, the epidemiologic picture differs strikingly from area to area in terms of species of vectors, distribution of parasitic species, and resistance of Plasmodium falciparum to chloroquine. Likewise, the problems faced by the eradication or control programs in the three regions are dissimilar. Because solutions to only some of these problems are possible, the eradication of malaria in Malaysia is not likely in the near future. However, the situation offers an excellent opportunity for further studies of antimalaria measures. PMID:6755616

  8. The efficiency of malaria chemoprophylaxis

    Directory of Open Access Journals (Sweden)

    Vasiliki Pappa

    2008-07-01

    Full Text Available Introduction: Malaria is a highly contagious disease. According to WHO, malaria cases are expected to increase due to climate changes. Despite the eradication efforts, malaria still remains one of the most significant causes of morbidity and mortality in tropical and subtropical regions. Many different antimalarial regimens are used , however resistance is emerging to many of themPurpose: This critical review was conducted, in order to respond to the following questions. A Which antimalarial regimen is most effective? B Which regimen is the safest for travelers in endemic regions? C Which regimen is best tolerated?Methodology: The literature research was conducted through the Internet. The Medline and Cinahl databases were used, as well as the search engines google, altavista and lycos. The research included articles that described clinical trials. The material was selected based on the aforementioned research questions and the chronological time limits.Results: Atovaquone/proguanil, tafenoquine, primaquine were the most effective regimens. Tafenoquine, as well as, primaquine have been related to hemolytic events in individuals with G6PD deficiency, gastrointestinal disorders, backache and flue-like syndrome. Doxycycline and mefloquine were related to gastrointestinal and neurological disorders. Those were the less tolerated regimens.Conclusions: Atovaquone/proguanil, tafenoquine, primaquine were the most effective regimens. As far as safety is concerned, tafenoquine and primaquine should not be prescribed to individuals with G6PD deficiency. All the regimens were considered well tolerated, however, in doxycycline and mefloquine trials were the most withdrawals due to adverse effects.

  9. Automated detection of malaria pigment: feasibility for malaria diagnosing in an area with seasonal malaria in northern Namibia

    NARCIS (Netherlands)

    A.J. de Langen; J. van Dillen; P. Witte; S. Mucheto; N. Nagelkerke; P. Kager

    2006-01-01

    OBJECTIVE To evaluate the feasibility of automated malaria detection with the Cell-Dyn (R) 3700 (Abbott Diagnostics, Santa Clara, CA, USA) haematology analyser for diagnosing malaria in northern Namibia. METHODS From April to June 2003, all patients with a positive blood smear result and a subset of

  10. Climate, environment and transmission of malaria.

    Science.gov (United States)

    Rossati, Antonella; Bargiacchi, Olivia; Kroumova, Vesselina; Zaramella, Marco; Caputo, Annamaria; Garavelli, Pietro Luigi

    2016-06-01

    Malaria, the most common parasitic disease in the world, is transmitted to the human host by mosquitoes of the genus Anopheles. The transmission of malaria requires the interaction between the host, the vector and the parasite.The four species of parasites responsible for human malaria are Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae and Plasmodium vivax. Occasionally humans can be infected by several simian species, like Plasmodium knowlesi, recognised as a major cause of human malaria in South-East Asia since 2004. While P. falciparum is responsible for most malaria cases, about 8% of estimated cases globally are caused by P. vivax. The different Plasmodia are not uniformly distributed although there are areas of species overlap. The life cycle of all species of human malaria parasites is characterised by an exogenous sexual phase in which multiplication occurs in several species of Anopheles mosquitoes, and an endogenous asexual phase in the vertebrate host. The time span required for mature oocyst development in the salivary glands is quite variable (7-30 days), characteristic of each species and influenced by ambient temperature. The vector Anopheles includes 465 formally recognised species. Approximately 70 of these species have the capacity to transmit Plasmodium spp. to humans and 41 are considered as dominant vector capable of transmitting malaria. The intensity of transmission is dependent on the vectorial capacity and competence of local mosquitoes. An efficient system for malaria transmission needs strong interaction between humans, the ecosystem and infected vectors. Global warming induced by human activities has increased the risk of vector-borne diseases such as malaria. Recent decades have witnessed changes in the ecosystem and climate without precedent in human history although the emphasis in the role of temperature on the epidemiology of malaria has given way to predisposing conditions such as ecosystem changes, political

  11. Associations between maternal helminth and malaria infections in pregnancy, and clinical malaria in the offspring

    DEFF Research Database (Denmark)

    Ndibazza, Juliet; Webb, Emily L; Lule, Swaib;

    2013-01-01

    Background. Helminth and malaria coinfections are common in the tropics. We investigated the hypothesis that prenatal exposure to these parasites might influence susceptibility to infections such as malaria in childhood.Methods. In a birth cohort of 2,345 mother-child pairs in Uganda, maternal...... helminth and malaria infection status was determined during pregnancy, and childhood malaria episodes recorded from birth to age five years. We examined associations between maternal infections and malaria in the offspring.Results. Common maternal infections were hookworm (45%), Mansonella perstans (21......%), Schistosoma mansoni (18%), and Plasmodium falciparum (11%). At age 5 years, 69% of the children were still under follow-up. The incidence of malaria was 34 episodes per 100 child-years, and the mean prevalence of asymptomatic malaria at annual visits was 5.4%. Maternal hookworm and M. perstans infections were...

  12. EDUCATION AS A SOCIO-CULTURAL PHENOMENON

    Directory of Open Access Journals (Sweden)

    Victor A. SHTURBA

    2016-01-01

    Full Text Available In the article author analyze the socio-cultural phenomenon of education through the prism of its values and target components. Understanding of the role and place of education in society is not possible out of the human essence context. In living nature man appears as a phenomenon - this thesis is recognized the absolute majoriy of scientific and philosophical theories, concepts and doctrines, including non-humanistic oriented. It is known that man is a social being - society is environment for its full life. As Aristotle said, only the gods and the animals can live outside society. However, human nature does not imply a simple social existence in the form of an intensive exchange of information with similar entities and, based on this, building complex collective actions. The man has a mind that is capable of abstract thought, speech, language, complex psyche, important component of which is imagination. These features formed the basis of theoretical and methodological basis of the analysis of education as a phenomenon. The author indicated value and target measurement of socio-cultural phenomenon of education, which led to the conclusion about the need to rely on a properly organized philosophical and pedagogical knowledge, the importance of implementation in the educational process of program-target approach and the relevance of the audit of modern educational models for nonborrowed trainings, upbringing and socialization. doi: 10.17748/2075-9908-2016-8-2/1-124-126. [en

  13. Left renal vein compression syndrome ("nutcracker phenomenon").

    Science.gov (United States)

    Stassen, C M; Weil, E H; Janevski, B K

    1989-06-01

    Four cases are presented with clinical diagnosis of scrotal varicocele on the left side, and one case with ureter varices and left-sided haematuria as a result of compression of the left renal vein between the aorta and superior mesenteric artery (SMA), also known as "nutcracker phenomenon". The clinical signs and the radiological diagnostic methods of the condition are discussed. PMID:2544950

  14. Left renal vein compression syndrome ('nutcracker phenomenon')

    International Nuclear Information System (INIS)

    Four cases are presented with clinical diagnosis of scrotal varicocele on the left side, and one case with ureter varices and left-sided haematuria as a result of compression of the left renal vein between the aorta and superior mesenteric artery (SMA), also known as 'nutcracker phenomenon'. The clinical signs and the radiological diagnostic methods of the condition are discussed. (orig.)

  15. Bullying: Description and Analysis of the Phenomenon

    Science.gov (United States)

    Benitez, Juan Luis; Justicia, Fernando

    2006-01-01

    This article purports to present this Special Issue about Bullying and, at the same time, to introduce the phenomenon of bullying in order to facilitate readers an updated vision about the problem that will be worked from different perspectives by researchers from national and international scope. With this purpose, we present some controversial…

  16. Mesoscale Phenomenon Revealed by an Acoustic Sounder

    DEFF Research Database (Denmark)

    Lundtang Petersen, Erik; Jensen, Niels Otto

    1976-01-01

    A particular phenomenon observed on an acoustic sounder record is analyzed, and is interpreted as being associated with the passing of a land breeze front. A simple physical explanation of the frontal movements is suggested. The actual existence of the land breeze is demonstrated by examination of...

  17. Methods to Minimize Zero-Missing Phenomenon

    DEFF Research Database (Denmark)

    da Silva, Filipe Miguel Faria; Bak, Claus Leth; Gudmundsdottir, Unnur Stella; Wiechowski, W.; Knardrupgård, M. R.

    2010-01-01

    With the increasing use of high-voltage AC cables at transmission levels, phenomena such as current zero-missing start to appear more often in transmission systems. Zero-missing phenomenon can occur when energizing cable lines with shunt reactors. This may considerably delay the opening of the ci...

  18. Fujita phenomenon in inhomogeneous fast diffusion system

    Science.gov (United States)

    Yang, Jinge; Zheng, Sining; Qu, Chengyuan

    2013-04-01

    This paper deals with the Fujita phenomenon for the Cauchy problem of an inhomogeneous fast diffusion system. Both the critical exponent and the second exponent are obtained. We observe that the inhomogeneous terms in the system substantially contribute to the critical exponent, in that the blow-up exponent region is obviously enlarged, with keeping the second critical exponent unchanged for small inhomogeneous sources.

  19. Impaired everyday memory associated with encephalopathy of severe malaria: the role of seizures and hippocampal damage

    Directory of Open Access Journals (Sweden)

    Fegan Greg W

    2009-12-01

    Full Text Available Abstract Background Seizures are common in children admitted with severe falciparum malaria and are associated with neuro-cognitive impairments. Prolonged febrile seizures are associated with hippocampal damage and impaired memory. It was hypothesized that severe malaria causes impaired everyday memory which may be associated with hippocampal damage. Methods An everyday memory battery was administered on 152 children with cerebral malaria (CM (mean age, 7 y 4 months [SD 13 months]; 77 males 156 children (mean age, 7 y 4 months [SD, 14 months]; 72 males with malaria plus complex seizures (MS and 179 children (mean age, 7 y 6 months [SD, 13 months]; 93 males unexposed to either condition. Results CM was associated with poorer everyday memory [95% CI, -2.46 to -0.36, p = 0.004] but not MS [95% CI, -0.91 to 1.16, p = 1.00] compared to unexposed children. Children with exposure to CM performed more poorly in recall [95% CI, -0.79 to -0.04, p = 0.024] and recognition subtests [95% CI, -0.90 to -0.17, p = 0.001] but not in prospective memory tests compared to controls. The health factors that predicted impaired everyday memory outcome in children with exposure to CM was profound coma [95% CI, 0.02 to 0.88, p = 0.037] and multiple episodes of hypoglycaemia [95% CI, 0.05 to 0.78, p = 0.020], but not seizures. Discussion The findings show that exposure to CM was associated with a specific impairment of everyday memory. Seizures commonly observed in severe malaria may not have a causal relationship with poor outcome, but rather be associated with profound coma and repeated metabolic insults (multi-hypoglycaemia that are strongly associated with impaired everyday memory.

  20. Severe Plasmodium falciparum malaria is associated with circulating ultra-large von Willebrand multimers and ADAMTS13 inhibition.

    LENUS (Irish Health Repository)

    Larkin, Deirdre

    2009-03-01

    Plasmodium falciparum infection results in adhesion of infected erythrocytes to blood vessel endothelium, and acute endothelial cell activation, together with sequestration of platelets and leucocytes. We have previously shown that patients with severe infection or fulminant cerebral malaria have significantly increased circulatory levels of the adhesive glycoprotein von Willebrand factor (VWF) and its propeptide, both of which are indices of endothelial cell activation. In this prospective study of patients from Ghana with severe (n = 20) and cerebral (n = 13) P. falciparum malaria, we demonstrate that increased plasma VWF antigen (VWF:Ag) level is associated with disproportionately increased VWF function. VWF collagen binding (VWF:CB) was significantly increased in patients with cerebral malaria and severe malaria (medians 7.6 and 7.0 IU\\/ml versus 1.9 IU\\/ml; p<0.005). This increased VWF:CB correlated with the presence of abnormal ultra-large VWF multimers in patient rather than control plasmas. Concomitant with the increase in VWF:Ag and VWF:CB was a significant persistent reduction in the activity of the VWF-specific cleaving protease ADAMTS13 (approximately 55% of normal; p<0.005). Mixing studies were performed using P. falciparum patient plasma and normal pooled plasma, in the presence or absence of exogenous recombinant ADAMTS13. These studies demonstrated that in malarial plasma, ADAMTS13 function was persistently inhibited in a time-dependent manner. Furthermore, this inhibitory effect was not associated with the presence of known inhibitors of ADAMTS13 enzymatic function (interleukin-6, free haemoglobin, factor VIII or thrombospondin-1). These novel findings suggest that severe P. falciparum infection is associated with acute endothelial cell activation, abnormal circulating ULVWF multimers, and a significant reduction in plasma ADAMTS13 function which is mediated at least in part by an unidentified inhibitor.

  1. Severe Plasmodium falciparum malaria is associated with circulating ultra-large von Willebrand multimers and ADAMTS13 inhibition.

    Directory of Open Access Journals (Sweden)

    Deirdre Larkin

    2009-03-01

    Full Text Available Plasmodium falciparum infection results in adhesion of infected erythrocytes to blood vessel endothelium, and acute endothelial cell activation, together with sequestration of platelets and leucocytes. We have previously shown that patients with severe infection or fulminant cerebral malaria have significantly increased circulatory levels of the adhesive glycoprotein von Willebrand factor (VWF and its propeptide, both of which are indices of endothelial cell activation. In this prospective study of patients from Ghana with severe (n = 20 and cerebral (n = 13 P. falciparum malaria, we demonstrate that increased plasma VWF antigen (VWF:Ag level is associated with disproportionately increased VWF function. VWF collagen binding (VWF:CB was significantly increased in patients with cerebral malaria and severe malaria (medians 7.6 and 7.0 IU/ml versus 1.9 IU/ml; p<0.005. This increased VWF:CB correlated with the presence of abnormal ultra-large VWF multimers in patient rather than control plasmas. Concomitant with the increase in VWF:Ag and VWF:CB was a significant persistent reduction in the activity of the VWF-specific cleaving protease ADAMTS13 (approximately 55% of normal; p<0.005. Mixing studies were performed using P. falciparum patient plasma and normal pooled plasma, in the presence or absence of exogenous recombinant ADAMTS13. These studies demonstrated that in malarial plasma, ADAMTS13 function was persistently inhibited in a time-dependent manner. Furthermore, this inhibitory effect was not associated with the presence of known inhibitors of ADAMTS13 enzymatic function (interleukin-6, free haemoglobin, factor VIII or thrombospondin-1. These novel findings suggest that severe P. falciparum infection is associated with acute endothelial cell activation, abnormal circulating ULVWF multimers, and a significant reduction in plasma ADAMTS13 function which is mediated at least in part by an unidentified inhibitor.

  2. Global cerebral blood flow and metabolism during acute hyperketonemia in the awake and anesthetized rat

    DEFF Research Database (Denmark)

    Linde, Rasmus; Hasselbalch, Steen G.; Topp, Simon; Paulson, Olaf B.; Madsen, Peter L.

    2006-01-01

    is not known. Alterations in several parameters may possibly explain the increase in CBF and the resetting of the relation between CBF and cerebral metabolism. To study this phenomenon further, we measured global CBF and global cerebral metabolism with the Kety-Schmidt technique in the wakeful rat...... before and during infusion of ketone bodies. During acute hyperketonemia (average concentration of beta-hydroxybutyrate: 6 mmol/L), global CBF increased 65% from 108 to 178 mL/100 g min and the cerebral metabolic rates for both oxygen and glucose remained constant. This resetting of the relation between...

  3. Altered environment and risk of malaria outbreak in South Andaman, Andaman & Nicobar Islands, India affected by tsunami disaster

    Directory of Open Access Journals (Sweden)

    Shriram AN

    2005-07-01

    Full Text Available Abstract Background Pools of salt water and puddles created by giant waves from the sea due to the tsunami that occurred on 26th December 2004 would facilitate increased breeding of brackish water malaria vector, Anopheles sundaicus. Land uplifts in North Andaman and subsidence in South Andaman have been reported and subsidence may lead to environmental disturbances and vector proliferation. This warrants a situation analysis and vector surveillance in the tsunami hit areas endemic for malaria transmitted by brackish water mosquito, An. sundaicus to predict the risk of outbreak. Methods An extensive survey was carried out in the tsunami-affected areas in Andaman district of the Andaman and Nicobar Islands, India to assess the extent of breeding of malaria vectors in the habitats created by seawater flooding. Types of habitats in relation to source of seawater inundation and frequency were identified. The salinity of the water samples and the mosquito species present in the larval samples collected from these habitats were recorded. The malaria situation in the area was also analysed. Results South Andaman, covering Port Blair and Ferrargunj sub districts, is still under the recurring phenomenon of seawater intrusion either directly from the sea or through a network of creeks. Both daily cycles of high tides and periodical spring tides continue to cause flooding. Low-lying paddy fields and fallow land, with a salinity ranging from 3,000 to 42,505 ppm, were found to support profuse breeding of An. sundaicus, the local malaria vector, and Anopheles subpictus, a vector implicated elsewhere. This area is endemic for both vivax and falciparum malaria. Malaria slide positivity rate has started increasing during post-tsunami period, which can be considered as an indication of risk of malaria outbreak. Conclusion Paddy fields and fallow land with freshwater, hitherto not considered as potential sites for An. sundaicus, are now major breeding sites due to

  4. Cerebral palsy and multiple births.

    OpenAIRE

    Pharoah, P. O.; Cooke, T

    1996-01-01

    AIM: To compare the birthweight specific prevalence of cerebral palsy in singleton and multiple births. METHODS: Registered births of babies with cerebral palsy born to mothers resident in the counties of Merseyside and Cheshire during the period 1982 to 1989 were ascertained. RESULTS: The crude prevalence of cerebral palsy was 2.3 per 1000 infant survivors in singletons, 12.6 in twins, and 44.8 in triplets. The prevalence of cerebral palsy rose with decreasing birthweight. The birthweight sp...

  5. Experimental Focal Cerebral Ischemia

    DEFF Research Database (Denmark)

    Christensen, Thomas

    2007-01-01

    Focal cerebral ischemia due to occlusion of a major cerebral artery is the cause of ischemic stroke which is a major reason of mortality, morbidity and disability in the populations of the developed countries. In the seven studies summarized in the thesis focal ischemia in rats induced by occlusion...... of the middle cerebral artery (MCAO) was used as an experimental model of ischemic stroke. MCAO produces an acute lesion consisting of an ischemic core or focus with severely reduced blood flow surrounded by a borderzone or ischemic penumbra with less pronounced blood flow reduction. Cells in the...... radical scavenger α-PBN on the periinfarct depolarizations and infarct volume was investigated. In study number six, the activity of the mitochondrial electron transport complexes I, II and IV was evaluated histochemically during reperfusion after MCAO in order to assess the possible role of mitochondrial...

  6. Cerebral hemodynamics in migraine

    DEFF Research Database (Denmark)

    Hachinski, V C; Olesen, Jes; Norris, J W;

    1977-01-01

    Clinical and angiographic findings in migraine are briefly reviewed in relation to cerebral hemodynamic changes shown by regional cerebral blood flow (rCBF) studies. Three cases of migraine studied by the intracarotid xenon 133 method during attacks are reported. In classic migraine, with typical...... prodromal symptoms, a decrease in cerebral blood flow has been demonstrated during the aura. Occasionally, this flow decrease persists during the headache phase. In common migraine, where such prodromata are not seen, a flow decrease has not been demonstrated. During the headache phase of both types of...... migraine, rCBF has usually been found to be normal or in the high range of normal values. The high values may represent postischemic hyperemia, but are probably more frequently secondary to arousal caused by pain. Thus, during the headache phase rCBF may be subnormal, normal or high. These findings do not...

  7. Cerebral abscess in children

    International Nuclear Information System (INIS)

    A cerebral abscess (CA) is a focal, infectious process only or multiple, located in the cerebral parenchyma that produces tisular lysis and it behaves like a lesion of space occupative, being a suppurative illness, who origin is a distant infection, or for continuity that studies initially as an area of focal cerebritis and it is developed to a collection surrounded purulent. At the moment they are perfecting technical and protocols diagnoses and therapeutic and measures for allow to control the natural history of the illness, making from the confrontation to this pathology a necessarily interdisciplinary complicated art, stiller in the infantile population, due to their difficulty in the diagnosis and the relevance of the same one. The paper includes epidemiology, etiology, risk factors, localization, pathology, clinic, diagnoses, treatment and diagnostic images

  8. Cerebral fat embolism

    International Nuclear Information System (INIS)

    A case of cerebral fat embolism is reported. A 18-year-old patient with multiple bone fractures was in semiconma immediately after an injury. Brain CT showed no brain swelling or intracranial hematoma. Hypoxemia and alcoholemia were noted on admission, which returned to normal without improvement of consciousness level. In addition, respiratory symptoms with positive radiographic changes, tachycardia, pyrexia, sudden drop in hemoglobin level, and sudden thrombocytopenia developed. These symptoms were compatible with Gurd's criteria of systemic fat embolism. Eight days after injury, multiple low density areas appeared on CT and disappeared within the subsequent two weeks, and subdural effusion with cerebral atrophy developed. These CT findings were not considered due to cerebral trauma. Diagnosis of cerebral fat embolism was made. The subdural effusion was drained. Neurologic and pulmonary recoveries took place slowly and one month following the injury the patient became alert and exhibited fully coordinated limb movement. The CT scans of the present case well corresponded with hitherto reported pathological findings. Petechiae in the white matter must have developed on the day of injury, which could not be detected by CT examination. It is suggested that some petechial regions fused to purpuras and then gradually resolved when they were detected as multiple low density areas on CT. CT in the purpuras phase would have shown these lesions as high density areas. These lesions must have healed with formation of tiny scars and blood pigment which were demonstrated as the disappearance of multiple low density areas by CT examination. Cerebral atrophy and subsequent subdural effusion developed as a result of demyelination. The patient took the typical clinical course of cerebral fat embolism and serial CT scans served for its assessment. (author)

  9. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge;

    2007-01-01

    were reported to have a congenital malformation. The majority (8.6% of all children) were diagnosed with a cerebral malformation. The most frequent types of cerebral malformations were microcephaly and hydrocephaly. Non-cerebral malformations were present in 97 CP children and in further 14 CP children...

  10. Insecticide Resistance Reducing Effectiveness of Malaria Control

    Centers for Disease Control (CDC) Podcasts

    2007-01-24

    Malaria prevention is increasingly insecticide based. Dr. John Gimnig, an entomologist with the Division of Parasitic Diseases, CDC, discusses evidence that mosquito resistance to insecticides, which is measured in the laboratory, could compromise malaria prevention in the field.  Created: 1/24/2007 by Emerging Infectious Diseases.   Date Released: 3/13/2007.

  11. Malaria vaccines: immunity, models and monoclonal antibodies

    DEFF Research Database (Denmark)

    Hviid, Lars; Barfod, Lea

    2008-01-01

    Although experts in the field have agreed on the malaria vaccine technology roadmap that should be followed (http://www.malariavaccineroadmap.net/), the path towards an effective malaria vaccine remains littered with intellectual and practical pot-holes. The animal models that are currently...

  12. Plasmodium falciparum Malaria, Southern Algeria, 2007

    OpenAIRE

    Boubidi, Saïd C.; Gassen, Ibrahim; Khechache, Yacine; Lamali, Karima; Tchicha, Boualem; Brengues, Cécile; Menegon, Michela; Severini, Carlo; Fontenille, Didier; Harrat, Zoubir

    2010-01-01

    An outbreak of Plasmodium falciparum malaria occurred in Tinzaouatine in southern Algeria in 2007. The likely vector, Anopheles gambiae mosquitoes, had not been detected in Algeria. Genes for resistance to chloroquine were detected in the parasite. The outbreak shows the potential for an increase in malaria vectors in Algeria.

  13. EPIDEMIC MALARIA AMONG TRANSMIGRANTS IN IRIAN JAYA

    Directory of Open Access Journals (Sweden)

    J. K. Baird

    2012-09-01

    Full Text Available Malaria merupakan masalah kesehatan yang penting untuk masyarakat transmigrasi di daerah endemisitas malaria tinggi seperti Irian Jaya. Di Arso, epidemi malaria timbul setelah dua sampai enam bulan sesudah tibanya transmigran baru. Dalam tiga bulan angka parasitemia bisa mencapai 70% dan hampir 10% dari transmigran mendapat malaria berat yang membutuhkan rujukan ke rumah sakit dalam enam bulan p< rtama. Usaha penanggulangan malaria di daerah seperti Arso menghadapi berbagai tantangan dan hambatan karena tingginya derajat resistensi parasit terhadap klorokuin, fasilitas dan kemampuan untuk diagnostik yang terbatas, sulitnya pengendalian vektor (An. punctulatus group dan tidak adanya strategi untuk menghilangkan sumber infeksi yang asimptomatik. Berbagai usaha yang dapat mengurangi risiko epidemi malaria di daerah transmigrasi Irian Jaya ialah antara lain pemberian profilaksis selama tiga bulan (selain klorokuin perlu dipertimbangkan pemberian primakuin bagi transmigran yang tidak hamil dan tidak menderita defisiensi G-6-PD, peningkatan fasilitas diagnostik dan pengobatan/termasuk rujukan untuk kasus malaria berat, pemakaian kelambu; penemuan kasus aktif untuk menghilangkan gametocytemia yang asimptomatik (selama enam bulan serta penyuluhan dan partisipasi masyarakat dalam pemberantasan malaria (termasuk pembinaan kader kesehatan. Untuk melaksanakan kegiatan tersebut di atas perlu disediakan tenaga dan sumber dana yang khusus.

  14. PLASMODIUM MALARIAE INFECTION BOOSTS PLASMODIUM FALCIPARUM GAMETOCYTE PRODUCTION

    OpenAIRE

    McKenzie, F. Ellis; Jeffery, Geoffrey M.; Collins, William E.

    2002-01-01

    We analyzed records of malariotherapy patients sequentially or simultaneously inoculated with Plasmodium falciparum and Plasmodium malariae. Gametocyte production was enhanced in P. falciparum by prior or concurrent P. malariae infection but diminished or unaffected in P. malariae by P. falciparum. Conversely, asexual-form production was diminished in P. malariae but unaffected in P. falciparum.

  15. Hitting Hotspots: Spatial Targeting of Malaria for Control and Elimination

    NARCIS (Netherlands)

    Bousema, T.; Griffin, J.T.; Sauerwein, R.W.; Smith, D.L.; Churcher, T.S.; Takken, W.; Ghani, A.; Drakeley, C.; Gosling, R.

    2012-01-01

    Current malaria elimination guidelines are based on the concept that malaria transmission becomes heterogeneous in the later phases of malaria elimination [1]. In the pre-elimination and elimination phases, interventions have to be targeted to entire villages or towns with higher malaria incidence u

  16. Prevalence of malaria parasites among blood donors in Kaduna, Nigeria

    Directory of Open Access Journals (Sweden)

    Douglas D. Garba

    2016-06-01

    Conclusions: The prevalence of malaria parasites among blood donors was 7.5% Blood donors should be routinely screened for malaria parasites and the blood marked negative or positive as the case may be. Recipients of malaria parasites positive blood should be given prophylactic treatment to prevent transfusion related malaria (TRM. [Int J Res Med Sci 2016; 4(6.000: 2112-2119

  17. SIT for African malaria vectors: Epilogue

    Directory of Open Access Journals (Sweden)

    Townson Harold

    2009-11-01

    Full Text Available Abstract As a result of increased support and the diligent application of new and conventional anti-malaria tools, significant reductions in malaria transmission are being accomplished. Historical and current evolutionary responses of vectors and parasites to malaria interventions demonstrate that it is unwise to assume that a limited suite of tools will remain effective indefinitely, thus efforts to develop new interventions should continue. This collection of manuscripts surveys the prospects and technical challenges for applying a novel tool, the sterile insect technique (SIT, against mosquitoes that transmit malaria. The method has been very successful against many agricultural pest insects in area-wide programs, but demonstrations against malaria vectors have not been sufficient to determine its potential relative to current alternatives, much of which will hinge ultimately upon cost. These manuscripts provide an overview of current efforts to develop SIT and identify key research issues that remain.

  18. Cost of malaria control in Sri Lanka

    DEFF Research Database (Denmark)

    Konradsen, F; Steele, P; Perera, D;

    1999-01-01

    The study provides estimates of the cost of various malaria control measures in an area of North-Central Province of Sri Lanka where the disease is endemic. We assumed that each measure was equally effective. In these terms, impregnating privately purchased bednets with insecticide was estimated to...... relatively large catchment area (Rs 71 (US$ 1.29) per malaria case treated). Mobile clinics (Rs 153 (US$ 2.78) per malaria case treated) and a village treatment centre (Rs 112 (US$ 2.04)) per malaria case treated) were more expensive options for the government, but were considerably cheaper for households...... than the traditional hospital facilities. This information can guide health planners and government decision-makers in choosing the most appropriate combination of curative and preventive measures to control malaria. However, the option that is cheapest for the government may not be so for the...

  19. Malaria parasite interactions with the human host

    Directory of Open Access Journals (Sweden)

    Pouniotis D

    2004-01-01

    Full Text Available The interaction between the malaria parasite and the human host involves a number of interactions that result in the parasite evading the human immune system. Since the stages of the malaria lifecycle are complex, this allows the use of various immune evasion strategies by the malaria parasite and has major implications in the development of a vaccine for malaria endemic areas. The present review highlights key host:parasite interactions. Plasmodia puts selection pressure on human gene frequencies, and studies into host genetic factors such as the Duffy blood group and sickle cell anaemia offer insight into the host- parasite relationship. In addition, parasite interactions with the different effector arms of the immune system can result in altered peptide ligand (APL antagonism which alters the immune response from a pro- to an anti-inflammatory T cell response. Recent insights into the interaction between professional antigen presenting cells, dendritic cells (DCs, and malaria parasites is discussed in detail.

  20. Risk behavior in malaria in Malaysia.

    Science.gov (United States)

    Arasu, G D

    1992-01-01

    The risk behavior in malaria has been identified as one of the factors contributing to malaria in Malaysia. The occurrence of malaria among illegal immigrants and indigenous groups, staying in risk prone areas where conditions are favorable for transmission, highlights the behavior pattern of these groups. In these areas the usual anti-malarial activities are less effective and thus there is a need to identify control measures suited to that particular condition and environment and to community groups. Some of the determinants contributing to the increase in malaria cases like man-vector contact, non-compliance to drugs, complications of the disease, and factors interfering with malaria control measures, factors favoring transmission and proposals to modify risk behavior, which can be applied in an endeavor to control the diseases, have been discussed. PMID:1341845

  1. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Patients having cerebral atrophic and degenerative changes following hypoglycemia, cerebral contusion, or cerebral hypoxia including cerebrovascular disorders were reported. Description was made as to cerebral changes visualized on CT images and clinical courses of a patient who revived 10 minutes after heart stoppage during neurosurgery, a newborn with asphyxia, a patient with hypoglycemia, a patient who suffered from asphyxia by an accident 10 years before, a patient with carbon monoxide poisoning at an acute stage, a patient who had carbon monoxide poisoning 10 years before, a patient with diffuse cerebral ischemic changes, a patient with cerebral edema around metastatic tumor, a patient with respiration brain, a patient with neurological sequelae after cerebral contusion, a patient who had an operation to excise right parietal lobe artery malformation, and a patient who was shooted by a machine gun and had a lead in the brain for 34 years. (Tsunoda, M.)

  2. Important advances in malaria vaccine research

    Directory of Open Access Journals (Sweden)

    Priyanka Jadhav

    2012-01-01

    Full Text Available Malaria is one of the most widespread parasitic infection in Asian countries affecting the poor of the poor. In an effort to develop an effective vaccine for the treatment of malaria, various attempts are being made worldwide. If successful, such a vaccine can be effective for treatment of both Plasmodium vivax and Plasmodium falciparum. This would also be able to avoid complications such as drug resistance, resistance to insecticides, nonadherence to the treatment schedule, and eventually high cost of treatment in the resource-limited settings. In the current compilation, the details from the literature were collected by using PubMed and Medline as search engines and searched for terms such as malaria, vaccine, and malaria treatment. This review collates and provides glimpses of the information on the recent malaria vaccine development. The reader will be taken through the historical perspective followed by the approaches to the malaria vaccine development from pre-erythrocytic stage vaccines, asexual stage vaccines, transmission blocking vaccines, etc. Looking at the current scenario of the malaria and treatment strategies, it is an absolute need of an hour that an effective malaria vaccine should be developed. This would bring a revolutionary breakthrough in the treatment modalities especially when there is increasing emergence of resistance to existing drug therapy. It would be of great purpose to serve those living in malaria endemic region and also for travelers which are nonimmune and coming to malaria endemic region. As infection by P. vivax is more prevalent in India and other Asian subcontinent and is often prominent in areas where elimination is being attempted, special consideration is required of the role of vaccines in blocking transmission, regardless of the stages being targeted. Development of vaccines is feasible but with the support of private sector and government organization in terms of regulatory and most importantly

  3. Challenges for malaria elimination in Brazil.

    Science.gov (United States)

    Ferreira, Marcelo U; Castro, Marcia C

    2016-01-01

    Brazil currently contributes 42 % of all malaria cases reported in the Latin America and the Caribbean, a region where major progress towards malaria elimination has been achieved in recent years. In 2014, malaria burden in Brazil (143,910 microscopically confirmed cases and 41 malaria-related deaths) has reached its lowest levels in 35 years, Plasmodium falciparum is highly focal, and the geographic boundary of transmission has considerably shrunk. Transmission in Brazil remains entrenched in the Amazon Basin, which accounts for 99.5 % of the country's malaria burden. This paper reviews major lessons learned from past and current malaria control policies in Brazil. A comprehensive discussion of the scientific and logistic challenges that may impact malaria elimination efforts in the country is presented in light of the launching of the Plan for Elimination of Malaria in Brazil in November 2015. Challenges for malaria elimination addressed include the high prevalence of symptomless and submicroscopic infections, emerging anti-malarial drug resistance in P. falciparum and Plasmodium vivax and the lack of safe anti-relapse drugs, the largely neglected burden of malaria in pregnancy, the need for better vector control strategies where Anopheles mosquitoes present a highly variable biting behaviour, human movement, the need for effective surveillance and tools to identify foci of infection in areas with low transmission, and the effects of environmental changes and climatic variability in transmission. Control actions launched in Brazil and results to come are likely to influence control programs in other countries in the Americas. PMID:27206924

  4. Clinical presentation of severe malaria due plasmodiun falciparum. casecontrol study in Tumaco and Turbo (Colombia. Clínica de la malaria complicada debida a P. falciparum Estudio de casos y controles en Tumaco y Turbo (Colombia

    Directory of Open Access Journals (Sweden)

    Jaime Carmona Fonseca

    2006-04-01

    Full Text Available Background: Latin American studies on severe falciparum malaria are scarce, therefore, the pattern of complications of the region is uknown. Objectives. To identify characterize severe malaria in patients from Tumaco (Nariño and Turbo (Antioquia in Colombia. Methods. The 2000 World Health Organization criteria for complicated malaria were applied in a cases and controls study. Results. 64 cases (P falciparum complicated malaria and 135 controls (P falciparum uncomplicated malaria were included. The time of evolution of the disease (mean 5.6 days in cases and 5.9 in the controls and the frequency of most symptoms were similar in both groups (p>0.05. However, respiratory distress and jaundice was more frequent in the cases (p<0.05. The mean glycemia and creatinina values were similar in both groups; hemoglobin and platelet count were lower in the cases (p<0.05 when compared to controls. On the other hand, blood ureic nitrogen, aspartatoaminotransferase, and total and direct bilirrubin were lower in controls (p<0.05. The frequency of complications in the cases was as follows: hyperparasitaemia 48%, liver dysfunction 44%, acute respiratory distress syndrome 9%, kidney failure 6%, severe thrombocytopenia 5%, severe anemia 3%, cerebral malaria 3% and severe hipoglycemia 2%. The WHO criteria for severe malaria were compared with others and the implications are discussed. Antecedentes y problema: son muy pocos los estudios latinoamericanos sobre malaria por Plasmodium falciparum (P falciparum complicada y se requiere estudiarla para identificar un patrón propio. OBJETIVOS. Identificar las complicaciones presentes en pacientes de Tumaco (Nariño y Turbo (Antioquia en Colombia, con malaria por P falciparum. MÉTODOS. Diseño de casos y controles. Se aplicaron los criterios diagnósticos de complicación OMS-2000 (Organización Mundial de la Salud. RESULTADOS. Se captaron 64 casos (con malaria por P. falciparum complicada y 135 controles (con malaria por

  5. Phase transition phenomenon: A compound measure analysis

    Science.gov (United States)

    Kang, Bo Soo; Park, Chanhi; Ryu, Doojin; Song, Wonho

    2015-06-01

    This study investigates the well-documented phenomenon of phase transition in financial markets using combined information from both return and volume changes within short time intervals. We suggest a new measure for the phase transition behaviour of markets, calculated as a return distribution conditional on local variance in volume imbalance, and show that this measure successfully captures phase transition behaviour under various conditions. We analyse the intraday trade and quote dataset from the KOSPI 200 index futures, which includes detailed information on the original order size and the type of each initiating investor. We find that among these two competing factors, the submitted order size yields more explanatory power on the phenomenon of market phase transition than the investor type.

  6. The phenomenon of fluorescence in immunosensors.

    Science.gov (United States)

    Kłos-Witkowska, Aleksandra

    2016-01-01

    The phenomenon of fluorescence in immunosensors is described in this paper. Both structure and characteristics of biosensors and immunosensors are presented. Types of immunosensors and the response of bioreceptor layers to the reaction with analytes as well as measurements of electrochemical, piezoelectric and optical parameters in immunosensors are also presented. In addition, detection techniques used in studies of optical immunosensors based on light-matter interactions (absorbance, reflectance, dispersion, emission) such as: UV/VIS spectroscopy, reflectometric interference spectroscopy (RIfs), surface plasmon resonance (SPR), optical waveguide light-mode spectroscopy (OWLS), fluorescence spectroscopy. The phenomenon of fluorescence in immunosensors and standard configurations of immunoreactions between an antigen and an antibody (direct, competitive, sandwich, displacement) is described. Fluorescence parameters taken into account in analyses and fluorescence detection techniques used in research of immunosensors are presented. Examples of immunosensor applications are given. PMID:27192088

  7. Dissymmetric flow phenomenon in a multistrand tundish

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    The dissymmetric flow phenomenon exists in a symmetric multistrand tundish. It was studied by the physical simulation experiment. The fundamental flow characteristic of dissymmetry was analyzed. The asymmetry of the flow field, the temperature field, and the inclusions distribution without flow-control devices (FCDs) were compared with those with FCDs. It is proved that the asymmetry of the flow and temperature field along the outlets at the long range is more obvious. The symmetric FCDs installation has a slight effect on the dissymmetric temperature field, simultaneously, the symmetry of the average residence time and the fluid flow pattern has improved, and the fluid flow in the tundish has been more reasonable. In case of a symmetric multistrand tundish having a large volume, the influence of the dissymmetric phenomenon should be considered and the flow behaviors in the whole tundish should be studied completely.

  8. Multiple steady state phenomenon in martensitic transformation

    Institute of Scientific and Technical Information of China (English)

    2001-01-01

    Based on the basic facts that the martensitic transformation is a physical phenomenon which occurs in non-equilibrium conditions and there exists the feedback mechanism in the martensitic transformation, the dynamical processes of the isothermal and athermal martensitic transformations were analyzed by using nonlinear theory and a bifurcation theory model was established. It is shown that a multiple steady state phenomenon can take place as austenite is cooled, and the transitions of the steady state temperature between the branches of stable steady states can be considered the transformation from austenite to martensite. This model can estimate the starting temperature of the martensitic transformation and explain some experimental features of the martensitic transformation such as the effects of cooling rate, fluctuation and austenitic grain size on the martensitic transformation.

  9. Diffusion phenomenon for linear dissipative wave equations

    KAUST Repository

    Said-Houari, Belkacem

    2012-01-01

    In this paper we prove the diffusion phenomenon for the linear wave equation. To derive the diffusion phenomenon, a new method is used. In fact, for initial data in some weighted spaces, we prove that for {equation presented} decays with the rate {equation presented} [0,1] faster than that of either u or v, where u is the solution of the linear wave equation with initial data {equation presented} [0,1], and v is the solution of the related heat equation with initial data v 0 = u 0 + u 1. This result improves the result in H. Yang and A. Milani [Bull. Sci. Math. 124 (2000), 415-433] in the sense that, under the above restriction on the initial data, the decay rate given in that paper can be improved by t -γ/2. © European Mathematical Society.

  10. Love Phenomenon and Neurobiology of Love Relations

    OpenAIRE

    Tufan, Ali Evren; Yaluğ, İrem

    2010-01-01

    The biology; especially the neurobiological features of the �love� phenomenon has recently started to attract attention. Love relations and attachment, which is closely related with them, are known to be important in health and disease. Love and love relations are found to be complex neurobiological phenomena based on activation of the limbic system of the brain. Those processes involve oxytocin, vasopressin, dopamine and serotonergic functions. Additionally, endorphine ...

  11. Phenomenon, noumenon, and mind in Kant

    OpenAIRE

    Alejandro Rosas

    1996-01-01

    The Cartesian substantial dualism and the mind-body problem provoked in the Modern Times a monist reaction that eliminated the ontological dualist interaction and conceived the problem as a conflict between explanatory discourses. Kant introduces the distinction between phenomenon and noumenon as one of perspective, with the intention of solving the conflict between materialist and mentalist explanations. However, he does not consistently place the mind in the noumenic perspective and thus bl...

  12. 2. The Central American gang phenomenon

    OpenAIRE

    Does, Antonia

    2013-01-01

    2.1. Differentiating between pandillas and maras Youth gangs have existed since the 1960s and 1970s in Central America. However, there are different types of Central American gangs and thus one has to distinguish between pandillas and maras. The former are localized, homegrown gangs, which are “direct inheritors” (Jütersonke, Rodgers & Muggah 2009: 379) of the gangs that have historically characterized Central American societies, while the latter are a more recent phenomenon with transnationa...

  13. NANOLEAKAGE PHENOMENON ON DEPROTEINIZED HUMAN DENTIN

    OpenAIRE

    Patrícia de Britto Pereira Garcia Duarte; Eduardo Moreira da Silva

    2007-01-01

    OBJECTIVE: The purpose of this study was to evaluate the influence of dentin deproteinization on the nanoleakage phenomenon. MATERIAL AND METHODS: Class V cavities were prepared in 12 human molars with cervical margins located in dentin. The cavities were assigned to 2 groups (n=6) according to dentin treatment: Group I - dentin treated in accordance with the manufacturer's instructions and Group II - dentin treated following the manufacturer's instructions + 10% NaOCl. Each group was sub-div...

  14. Prebiotic homochirality as a critical phenomenon.

    Science.gov (United States)

    Gleiser, Marcelo; Thorarinson, Joel

    2006-12-01

    The development of prebiotic homochirality on early-Earth or another planetary platform may be viewed as a critical phenomenon. It is shown, in the context of spatio-temporal polymerization reaction networks, that environmental effects--be they temperature surges or other external disruptions--may destroy any net chirality previously produced. In order to understand the emergence of prebiotic homochirality it is important to model the coupling of polymerization reaction networks to different planetary environments. PMID:17120129

  15. Prebiotic Homochirality as a Critical Phenomenon

    CERN Document Server

    Gleiser, M; Gleiser, Marcelo; Thorarinson, Joel

    2006-01-01

    The development of prebiotic homochirality on early-Earth or another planetary platform may be viewed as a critical phenomenon. It is shown, in the context of spatio-temporal polymerization reaction networks, that environmental effects -- be them temperature surges or other external disruptions -- may destroy any net chirality previously produced. In order to understand the emergence of prebiotic homochirality it is important to model the coupling of polymerization reaction networks to different planetary environments.

  16. Prebiotic Homochirality as a Critical Phenomenon

    OpenAIRE

    Gleiser, Marcelo; Thorarinson, Joel

    2006-01-01

    The development of prebiotic homochirality on early-Earth or another planetary platform may be viewed as a critical phenomenon. It is shown, in the context of spatio-temporal polymerization reaction networks, that environmental effects -- be them temperature surges or other external disruptions -- may destroy any net chirality previously produced. In order to understand the emergence of prebiotic homochirality it is important to model the coupling of polymerization reaction networks to differ...

  17. Cyberbullying as a modern phenomenon of ICT

    OpenAIRE

    Vlk, Jan

    2013-01-01

    This bachelor work summarizes the problem known as cyberbullying. It is a problem about last two decades, coupled with the rapid development of communication technology and the rapprochement of communications equipment to children and youth. Cyberbullying is the phenomenon of limiting user rights through the Internet. Typically it is the ridicule, humiliation and reducing of user dignity. The work monitors cyberbullying from the perspective of the aggressor (producer) and victims. The proces...

  18. Tax Culture as Tax Administration Staff Phenomenon

    OpenAIRE

    Viktor Synchak

    2013-01-01

    The concept of the tax culture has been grounded. Various approaches to the tax culture have been highlighted. The ambiguous aspects of the tax culture approaches and interpretation have been pointed out. The authors have also given the definition of the tax body officials' culture. The tax culture has been defined as a special kind of tax service employee's culture. The necessity of the tax culture phenomenon to be familiarized with by every tax official prior to their employment has been pr...

  19. THE LUXURY PHENOMENON - THE GLOBALIZATION OF VARIETY

    OpenAIRE

    Murali Murti

    2010-01-01

    Our contemporary understanding of globalization is an increasing interlinking and interdependence of national economies within a global economy. This view of globalization has become associated with large corporations driven by their own immediate self-interests. This process is seen as leading to an increasingly homogenous global culture. This can be described as the globalization of uniformity. The globalization of uniformity is most often identified with the phenomenon of outsourcing, and ...

  20. Animal Rights as a Mainstream Phenomenon

    OpenAIRE

    Rollin, Bernard E.

    2011-01-01

    Simple Summary The twentieth century has witnessed a bewildering array of ethical revolutions, from civil rights to environmentalism to feminism. Often ignored is the rise of massive societal concern across the world regarding animal treatment. Regulation of animal research exists in virtually all western countries, and reform of “factory farming” is regnant in Europe and rapidly emerging in the United States. Opponents of concern for animals often dismiss the phenomenon as rooted in emotion ...