WorldWideScience

Sample records for discriminate cerebral malaria

  1. Somatosensory discrimination deficits following pediatric cerebral malaria.

    Science.gov (United States)

    Dugbartey, A T; Spellacy, F J; Dugbartey, M T

    1998-09-01

    Pathologic studies of central nervous system damage in human falciparum malaria indicate primary localization in the cerebral white matter. We report a sensory-perceptual investigation of 20 Ghanaian children with a recent history of cerebral malaria who were age-, gender-, and education-matched with 20 healthy control subjects. Somatosensory examinations failed to show any evidence of hemianesthesia, pseudohemianesthesia, or extinction to double simultaneous tactile stimulation. While unilateral upper limb testing revealed intact unimanual tactile roughness discrimination, bimanual tactile discrimination, however, was significantly impaired in the cerebral malaria group. A strong negative correlation (r = -0.72) between coma duration and the bimanual tactile roughness discrimination test was also found. An inefficiency in the integrity of callosal fibers appear to account for our findings, although alternative subcortical mechanisms known to be involved in information transfer across the cerebral hemispheres may be compromised as well.

  2. Malaria cerebral Cerebral malaria

    Directory of Open Access Journals (Sweden)

    Carlos Hugo Zapata Zapata

    2003-03-01

    Full Text Available La malaria Cerebral (MC es la complicación más frecuente de la malaria por P. falciparum; aproximadamente el 90% de las personas que la han padecido se recuperan completamente sin secuelas neurológicas. Aún no se conoce con claridad su patogénesis pero se han postulado cuatro hipótesis o mecanismos posibles: 1 citoadherencia y secuestro de glóbulos rojos parasitados en la microvasculatura cerebral; 2 formación de rosetas y aglutinación de glóbulos rojos parasitados; 3 producción de citoquinas y activación de segundos mensajeros y, 4 apertura de la barrera hematoencefálica. Sin embargo, queda un interrogante sin resolver aún: ¿qué proceso se lleva a cabo para que el parásito, desde el espacio microvascular, pueda interferir transitoriamente con la función cerebral? Recientemente se ha utilizado el precursor de la proteína b-Amiloide como un marcador de daño neuronal en MC; este precursor será de gran ayuda en futuras investigaciones realizadas en nuestro medio que aporten información para comprender la patogénesis de la MC. Is the most common complication of P. falciparum malaria; nearly 90% of people who have suffered CM can recover without neurological problems. Currently there are four hypotheses that explain pathogenesis of CM: cytoadherence and sequestering of parasitized red blood cells to cerebral capillaries; rosette formation and parasitized red blood cells agglutination; production of cytokines and activation of second messengers and opening of the blood-brain barrier. However the main question remains to be answered; how the host-parasite interaction in the vascular space interferes transiently with cerebral function? Recently, the beta amyloid precursor peptide has been employed as marker of neural injury in CM. It is expected that the beta amyloid precursor peptide will help to understand the pathogenesis of CM in complicated patients of endemic areas of Colombia.

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

    Directory of Open Access Journals (Sweden)

    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. Cerebral malaria: susceptibility weighted MRI

    Directory of Open Access Journals (Sweden)

    Vinit Baliyan

    2015-03-01

    Full Text Available Cerebral malaria is one of the fatal complications of Plasmodium falciparum infection. Pathogenesis involves cerebral microangiopathy related to microvascular plugging by infected red blood cells. Conventional imaging with MRI and CT do not reveal anything specific in case of cerebral malaria. Susceptibility weighted imaging, a recent advance in the MRI, is very sensitive to microbleeds related to microangiopathy. Histopathological studies in cerebral malaria have revealed microbleeds in brain parenchyma secondary to microangiopathy. Susceptibility weighted imaging, being exquisitely sensitive to microbleeds may provide additional information and improve the diagnostic accuracy of MRI in cerebral malaria.

  5. Recent Experiences with Severe and Cerebral Malaria

    African Journals Online (AJOL)

    1974-06-29

    Jun 29, 1974 ... Malaria admissions. Cerebral malaria ... Cerebral signs. Haemoglobin below 10 g/100 ml (not all tested). Enlarged tender liver or jaundice, or both ... articl~ by H. Smitskamp and F. H. Wolthuis entitled 'New concepts in treatment of malaria with malignant tertian cerebral involvement' which appeared in the ...

  6. Gluconeogenesis and fasting in cerebral malaria

    NARCIS (Netherlands)

    van Thien, H.; Ackermans, M. T.; Weverling, G. J.; Dang Vinh, T.; Endert, E.; Kager, P. A.; Sauerwein, H. P.

    2004-01-01

    BACKGROUND: In healthy subjects after an overnight fast, glucose production is for approximately 50% derived from glycogenolysis. If the fast is prolonged, glucose production decreases due to a decline in glycogenolysis, while gluconeogenesis remains stable. In cerebral malaria, glucose production

  7. 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

    2010-01-01

    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...

  8. Residual neurologic sequelae after childhood cerebral malaria

    NARCIS (Netherlands)

    van Hensbroek, M. B.; Palmer, A.; Jaffar, S.; Schneider, G.; Kwiatkowski, D.

    1997-01-01

    Cerebral malaria is an important cause of pediatric hospital admissions in the tropics. It commonly leads to neurologic sequelae, but the risk factors for this remain unclear and the long-term outcome unknown. The purpose of this study was to identify the common forms of neurologic sequelae that

  9. Magnetic Resonance Features of Cerebral Malaria

    Energy Technology Data Exchange (ETDEWEB)

    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

  10. Magnetic Resonance Features of Cerebral Malaria

    International Nuclear Information System (INIS)

    Yadav, P.; Sharma, R.; Kumar, S.; Kumar, U.

    2008-01-01

    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/mm 2 , 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

  11. Low plasma bicarbonate predicts poor outcome of cerebral malaria ...

    African Journals Online (AJOL)

    Malaria remains a major cause of morbidity and mortality in many sub Saharan countries and cerebral malaria is widely recognised as one of its most fatal forms. We studied the predictive value of routine biochemical laboratory indices in predicting the outcome of cerebral malaria in 50 Nigerian children ages 9 months to 6 ...

  12. Case report Malaria: A cerebral approach | Court | Continuing ...

    African Journals Online (AJOL)

    An increasing number of patients with severe complicated Plasmodium falciparum malaria are presenting to South African hospitals, having travelled through malariaendemic countries from Central and East Africa. This report concerns an immigrant from Pakistan who developed severe cerebral malaria.

  13. Affinity proteomics reveals elevated muscle proteins in plasma of children with cerebral malaria.

    Directory of Open Access Journals (Sweden)

    Julie Bachmann

    2014-04-01

    Full Text Available Systemic inflammation and sequestration of parasitized erythrocytes are central processes in the pathophysiology of severe Plasmodium falciparum childhood malaria. However, it is still not understood why some children are more at risks to develop malaria complications than others. To identify human proteins in plasma related to childhood malaria syndromes, multiplex antibody suspension bead arrays were employed. Out of the 1,015 proteins analyzed in plasma from more than 700 children, 41 differed between malaria infected children and community controls, whereas 13 discriminated uncomplicated malaria from severe malaria syndromes. Markers of oxidative stress were found related to severe malaria anemia while markers of endothelial activation, platelet adhesion and muscular damage were identified in relation to children with cerebral malaria. These findings suggest the presence of generalized vascular inflammation, vascular wall modulations, activation of endothelium and unbalanced glucose metabolism in severe malaria. The increased levels of specific muscle proteins in plasma implicate potential muscle damage and microvasculature lesions during the course of cerebral malaria.

  14. Advances in the management of cerebral malaria in adults

    DEFF Research Database (Denmark)

    Mishra, Saroj K; Wiese, Lothar

    2009-01-01

    PURPOSE OF REVIEW: Cerebral malaria continues to be a substantial cause of death and disability worldwide. Although many studies deal with cerebral malaria in children, only very few pertain to adults. Presence of multiorgan failure makes the prognosis poor. Various mechanisms in the pathogenesis...... of cerebral malaria and the role of adjuvant therapy will be discussed. RECENT FINDINGS: Artemisinin-based therapies have improved antiparasitic treatment, but in-hospital mortality still remains high, as do neurological sequelae. Several recent studies have given new insights in the pathophysiology...... of cerebral malaria particularly the role of immune mechanisms in disease progression. Recent findings have identified several potential candidates for adjuvant neuroprotective treatment. Recombinant human erythropoietin has shown beneficial effect in experimental cerebral malaria and will soon enter...

  15. Neurocognitive sequelae of cerebral malaria in adults: a pilot study in Benguela Central Hospital, Angola.

    Science.gov (United States)

    Peixoto, Bruno; Kalei, Isabel

    2013-07-01

    To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

  16. Ophthalmologic identification of cerebral malaria in adults

    Directory of Open Access Journals (Sweden)

    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.

  17. Lactate transport and receptor actions in cerebral malaria

    DEFF Research Database (Denmark)

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

    2014-01-01

    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...

  18. Estimating sequestered parasite population dynamics in cerebral malaria

    NARCIS (Netherlands)

    Gravenor, M. B.; van Hensbroek, M. B.; Kwiatkowski, D.

    1998-01-01

    Clinical investigation of malaria is hampered by the lack of a method for estimating the number of parasites that are sequestered in the tissues, for it is these parasites that are thought to be crucial to the pathogenesis of life-threatening complications such as cerebral malaria. We present a

  19. Evoked potentials in pediatric cerebral malaria

    Directory of Open Access Journals (Sweden)

    Minal Bhanushali

    2011-12-01

    Full Text Available Cortical evoked potentials (EP provide localized data regarding brain function and may offer prognostic information and insights into the pathologic mechanisms of malariamediated cerebral injury. As part of a prospective cohort study, we obtained somatosensory evoked potentials (SSEPs and brainstem auditory EPs (AEPs within 24 hours of admission on 27 consecutive children admitted with cerebral malaria (CM. Children underwent follow-up for 12 months to determine if they had any long term neurologic sequelae. EPs were obtained in 27 pediatric CM admissions. Two children died. Among survivors followed an average of 514 days, 7/25 (28.0% had at least one adverse neurologic outcome. Only a single subject had absent cortical EPs on admission and this child had a good neurologic outcome. Among pediatric CM survivors, cortical EPs are generally intact and do not predict adverse neurologic outcomes. Further study is needed to determine if alterations in cortical EPs can be used to predict a fatal outcome in CM.

  20. Gene expression analysis reveals early changes in several molecular pathways in cerebral malaria-susceptible mice versus cerebral malaria-resistant mice

    Directory of Open Access Journals (Sweden)

    Grau Georges E

    2007-12-01

    Full Text Available Abstract Background Microarray analyses allow the identification and assessment of molecular signatures in whole tissues undergoing pathological processes. To better understand cerebral malaria pathogenesis, we investigated intra-cerebral gene-expression profiles in well-defined genetically cerebral malaria-resistant (CM-R and CM-susceptible (CM-S mice, upon infection by Plasmodium berghei ANKA (PbA. We investigated mouse transcriptional responses at early and late stages of infection by use of cDNA microarrays. Results Through a rigorous statistical approach with multiple testing corrections, we showed that PbA significantly altered brain gene expression in CM-R (BALB/c, and in CM-S (CBA/J and C57BL/6 mice, and that 327 genes discriminated between early and late infection stages, between mouse strains, and between CM-R and CM-S mice. We further identified 104, 56, 84 genes with significant differential expression between CM-R and CM-S mice on days 2, 5, and 7 respectively. The analysis of their functional annotation indicates that genes involved in metabolic energy pathways, the inflammatory response, and the neuroprotection/neurotoxicity balance play a major role in cerebral malaria pathogenesis. In addition, our data suggest that cerebral malaria and Alzheimer's disease may share some common mechanisms of pathogenesis, as illustrated by the accumulation of β-amyloid proteins in brains of CM-S mice, but not of CM-R mice. Conclusion Our microarray analysis highlighted marked changes in several molecular pathways in CM-S compared to CM-R mice, particularly at early stages of infection. This study revealed some promising areas for exploration that may both provide new insight into the knowledge of CM pathogenesis and the development of novel therapeutic strategies.

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

    Energy Technology Data Exchange (ETDEWEB)

    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.

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

    International Nuclear Information System (INIS)

    Potchen, Michael J.; Birbeck, Gretchen L.; DeMarco, J. Kevin; Kampondeni, Sam D.; Beare, Nicholas; Molyneux, Malcolm E.; Taylor, Terrie E.

    2010-01-01

    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.

  3. Breaking down brain barrier breaches in cerebral malaria

    DEFF Research Database (Denmark)

    Petersen, Jens E V; Lavstsen, Thomas; Craig, Alister

    2016-01-01

    Recent findings have linked brain swelling to death in cerebral malaria (CM). These observations have prompted a number of investigations into the mechanisms of this pathology with the goal of identifying potential therapeutic targets. In this issue of the JCI, Gallego-Delgado and colleagues...

  4. Severe anaemia in childhood cerebral malaria is associated with ...

    African Journals Online (AJOL)

    Background: Severe anaemia in children with cerebral malaria has been associated with respiratory distress secondary to lactic acidosis and/or hypoxia. The ensuing metabolic derangement may further depress the level of consciousness culminating in presentation with profound coma. This association has poorly been ...

  5. Neurological sequelae in survivors of cerebral malaria | Oluwayemi ...

    African Journals Online (AJOL)

    Introduction: Cerebral malaria is a common cause of neurological sequelae and death in childhood. Information on persistent neurological sequelae post hospital discharge and their predisposing factors are scarce. Methods: This is a prospective study describing persisting neurological impairments post discharge among ...

  6. The systemic pathology of cerebral malaria in African children

    Directory of Open Access Journals (Sweden)

    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.

  7. Evidence from a natural experiment that malaria parasitemia is pathogenic in retinopathy-negative cerebral malaria.

    Science.gov (United States)

    Small, Dylan S; Taylor, Terrie E; Postels, Douglas G; Beare, Nicholas Av; Cheng, Jing; MacCormick, Ian Jc; Seydel, Karl B

    2017-06-07

    Cerebral malaria (CM) can be classified as retinopathy-positive or retinopathy-negative, based on the presence or absence of characteristic retinal features. While malaria parasites are considered central to the pathogenesis of retinopathy-positive CM, their contribution to retinopathy-negative CM is largely unknown. One theory is that malaria parasites are innocent bystanders in retinopathy-negative CM and the etiology of the coma is entirely non-malarial. Because hospitals in malaria-endemic areas often lack diagnostic facilities to identify non-malarial causes of coma, it has not been possible to evaluate the contribution of malaria infection to retinopathy-negative CM. To overcome this barrier, we studied a natural experiment involving genetically inherited traits, and find evidence that malaria parasitemia does contribute to the pathogenesis of retinopathy-negative CM. A lower bound for the fraction of retinopathy-negative CM that would be prevented if malaria parasitemia were to be eliminated is estimated to be 0.93 (95% confidence interval: 0.68, 1).

  8. A quantitative brain map of experimental cerebral malaria pathology.

    Directory of Open Access Journals (Sweden)

    Patrick Strangward

    2017-03-01

    Full Text Available The murine model of experimental cerebral malaria (ECM has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM. However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome. We demonstrate that the accumulation of parasitised red blood cells (pRBCs in brain capillaries is a specific feature of ECM that is not observed during mild murine malaria infections. Critically, we show that individual pRBCs appear to occlude murine brain capillaries during ECM. As pRBC-mediated congestion of brain microvessels is a hallmark of HCM, this suggests that the impact of parasite accumulation on cerebral blood flow may ultimately be similar in mice and humans during ECM and HCM, respectively. Additionally, we demonstrate that cerebrovascular CD8+ T-cells appear to co-localise with accumulated pRBCs, an event that corresponds with development of widespread vascular leakage. As in HCM, we show that vascular leakage is not dependent on extensive vascular destruction. Instead, we show that vascular leakage is associated with alterations in transcellular and paracellular transport mechanisms. Finally, as in HCM, we observed axonal injury and demyelination in ECM adjacent to diverse vasculopathies. Collectively, our data therefore shows that, despite very different presentation, and apparently distinct mechanisms, of parasite accumulation, there appear to be a number of comparable features of cerebral pathology in mice and in humans during ECM and HCM, respectively. Thus, when used appropriately, the ECM model may be useful for studying specific pathological features of HCM.

  9. A quantitative brain map of experimental cerebral malaria pathology.

    Science.gov (United States)

    Strangward, Patrick; Haley, Michael J; Shaw, Tovah N; Schwartz, Jean-Marc; Greig, Rachel; Mironov, Aleksandr; de Souza, J Brian; Cruickshank, Sheena M; Craig, Alister G; Milner, Danny A; Allan, Stuart M; Couper, Kevin N

    2017-03-01

    The murine model of experimental cerebral malaria (ECM) has been utilised extensively in recent years to study the pathogenesis of human cerebral malaria (HCM). However, it has been proposed that the aetiologies of ECM and HCM are distinct, and, consequently, no useful mechanistic insights into the pathogenesis of HCM can be obtained from studying the ECM model. Therefore, in order to determine the similarities and differences in the pathology of ECM and HCM, we have performed the first spatial and quantitative histopathological assessment of the ECM syndrome. We demonstrate that the accumulation of parasitised red blood cells (pRBCs) in brain capillaries is a specific feature of ECM that is not observed during mild murine malaria infections. Critically, we show that individual pRBCs appear to occlude murine brain capillaries during ECM. As pRBC-mediated congestion of brain microvessels is a hallmark of HCM, this suggests that the impact of parasite accumulation on cerebral blood flow may ultimately be similar in mice and humans during ECM and HCM, respectively. Additionally, we demonstrate that cerebrovascular CD8+ T-cells appear to co-localise with accumulated pRBCs, an event that corresponds with development of widespread vascular leakage. As in HCM, we show that vascular leakage is not dependent on extensive vascular destruction. Instead, we show that vascular leakage is associated with alterations in transcellular and paracellular transport mechanisms. Finally, as in HCM, we observed axonal injury and demyelination in ECM adjacent to diverse vasculopathies. Collectively, our data therefore shows that, despite very different presentation, and apparently distinct mechanisms, of parasite accumulation, there appear to be a number of comparable features of cerebral pathology in mice and in humans during ECM and HCM, respectively. Thus, when used appropriately, the ECM model may be useful for studying specific pathological features of HCM.

  10. 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...

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

    Directory of Open Access Journals (Sweden)

    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.

  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. 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

    -back regulation of TNF, stimulates bone-marrow function in vitro and counteracts anaemia in mice. We investigated the associations of these cytokines with malarial anaemia. METHODS: We enrolled 175 African children with malaria into two studies in 1995 and 1996. In the first study, children were classified...... as having severe anaemia (n=10), uncomplicated malaria (n=26), or cerebral anaemia (n=41). In the second study, patients were classified as having cerebral malaria (n=33) or being fully conscious (n=65), and the two groups were subdivided by measured haemoglobin as normal (>110 g/L), moderate anaemia (60...... anaemia was 270 pg/mL (95% CI 152-482) compared with 725 pg/mL (465-1129) in uncomplicated malaria and 966 pg/mL (612-1526) in cerebral malaria (pcerebral...

  14. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Science.gov (United States)

    Mergani, Adil; Khamis, Ammar H; Fatih Hashim, E L; Gumma, Mohamed; Awadelseed, Bella; Elwali, Nasr Eldin M A; Haboor, Ali Babikir

    2015-09-01

    Cerebral malaria is considered a leading cause of neuro-disability in sub-Saharan Africa among children and about 25% of survivors have long-term neurological and cognitive deficits or epilepsy. Their development was reported to be associated with protracted seizures, deep and prolonged coma. The study was aimed to determine the discharge pattern and to identify potential and informative predictors of neurological sequelae at discharge, complicating childhood cerebral malaria in central Sudan. A cross-sectional prospective study was carried out during malaria transmission seasons from 2000 to 2004 in Wad Medani, Sinnar and Singa hospitals, central Sudan. Children suspected of having cerebral malaria were examined and diagnosed by a Pediatrician for clinical, laboratory findings and any neurological complications. Univariate and multiple regression model analysis were performed to evaluate the association of clinical and laboratory findings with occurrence of neurological complications using the SPSS. Out of 940 examined children, only 409 were diagnosed with cerebral malaria with a mean age of 6.1 ± 3.3 yr. The mortality rate associated with the study was 14.2% (58) and 18.2% (64) of survivors (351) had neurological sequelae. Abnormal posture, either decerebration or decortication, focal convulsion and coma duration of >48 h were significant predictors for surviving from cerebral malaria with a neurological sequelae in children from central Sudan by Univariate analysis. Multiple logistic regression model fitting these variables, revealed 39.6% sensitivity for prediction of childhood cerebral malaria survivors with neurological sequelae (R² = 0.396; p=0.001). 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.

  17. Clinical profile of cerebral malaria at a secondary care hospital

    Directory of Open Access Journals (Sweden)

    Jency Maria Koshy

    2014-01-01

    Full Text Available Introduction: Cerebral malaria (CM is one of the most common causes for non-traumatic encephalopathy in the world. It affects both the urban and rural population. It is a challenge to treat these patients in a resource limited setting; where majority of these cases present. Materials and Methods: This was a prospective study carried out from September 2005 to December 2006 at Jiwan Jyoti Christian Hospital in Eastern Uttar Pradesh in India. This is a secondary level care with limited resources. We studied the clinical profile, treatment and outcome of all the patients above the age of 14 years diagnosed with CM. Results: There were a total of 53 patients with CM of which 38 (71.7% of them were females. Among them, 35 (66% patients were less than 30 years of age. The clinical features noted were seizure (39.62%, anemia (84.9%, icterus (16.98%, hypotension (13.2%, bleeding (3.7%, hepatomegaly (5.66%, splenomegaly (5.66%, non-cardiogenic pulmonary edema (16.98% and renal dysfunction (37.36%. Co-infection with Plasmodium vivax was present in 13 (24.53% of them. Treatment received included artesunin compounds or quinine. Median time of defervescence was 2 (interquartile range1-3. Complete recovery was achieved in 43 (81% of them. Two (3.7% of them died. Conclusion: CM, once considered to be a fatal disease has shown remarkable improvement in the outcome with the wide availability of artesunin and quinine components. To combat the malaria burden, physicians in resource limited setting should be well trained to manage these patients especially in the endemic areas. The key to management is early diagnosis and initiation of treatment based on a high index of suspicion. Anticipation and early recognition of the various complications are crucial.

  18. 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

    . In this study, we analyzed the transcriptomes of isolates obtained from asymptomatic carriers and patients with uncomplicated or cerebral malaria. We also investigated the transcriptomes of 3D7 clone and 3D7-Lib that expresses severe malaria associated-variant surface antigen. Our findings revealed a specific...... up-regulation of genes involved in pathogenesis, adhesion to host cell, and erythrocyte aggregation in parasites from patients with cerebral malaria and 3D7-Lib, compared to parasites from asymptomatic carriers and 3D7, respectively. However, we did not find any significant difference between...... and their neighboring rif genes in 3D7-lib. Therefore, more investigations are needed to analyze the effective role of these genes during malaria infection to provide with new knowledge on malaria pathology. In addition, concomitant regulation of genes within the chromosomal neighborhood suggests a common mechanism...

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

    Directory of Open Access Journals (Sweden)

    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

  20. Differential microRNA expression in experimental cerebral and noncerebral malaria

    DEFF Research Database (Denmark)

    El-Assaad, Fatima; Hempel, Casper; Combes, Valéry

    2011-01-01

    berghei ANKA (PbA), which causes cerebral malaria (CM), or Plasmodium berghei K173 (PbK), which causes severe malaria but without cerebral complications, termed non-CM. The differential expression profiles of selected miRNAs (let-7i, miR-27a, miR-150, miR-126, miR-210, and miR-155) were analyzed in mouse...... acute malaria. To investigate the involvement of let-7i, miR-27a, and miR-150 in CM-resistant mice, we assessed the expression levels in gamma interferon knockout (IFN-¿(-/-)) mice on a C57BL/6 genetic background. The expression of let-7i, miR-27a, and miR-150 was unchanged in both wild-type (WT...... a regulatory role in the pathogenesis of severe malaria....

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    Yakhya Dieye

    2016-05-01

    Full Text Available 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.

  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

    2011-01-01

    observed in mice without CM, and hypoxia seemed to be confined to neuronal cell somas. PARP-1-deficient mice were not protected against CM, which argues against a role for cytopathic hypoxia. Erythropoietin therapy reversed the development of CM and substantially reduced the degree of neural hypoxia......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....... These findings demonstrate cerebral hypoxia in malaria, strongly associated with cerebral dysfunction and a possible target for adjunctive therapy....

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

    Directory of Open Access Journals (Sweden)

    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.

  5. Blantyre Malaria Project Epilepsy Study (BMPES) of neurological outcomes in retinopathy-positive paediatric cerebral malaria survivors: a prospective cohort study.

    Science.gov (United States)

    Birbeck, Gretchen L; Molyneux, Malcolm E; Kaplan, Peter W; Seydel, Karl B; Chimalizeni, Yamikani F; Kawaza, Kondwani; Taylor, Terrie E

    2010-12-01

    Cerebral malaria, a disorder characterised by coma, parasitaemia, and no other evident cause of coma, is challenging to diagnose definitively in endemic regions that have high rates of asymptomatic parasitaemia and limited neurodiagnostic facilities. A recently described malaria retinopathy improves diagnostic specificity. We aimed to establish whether retinopathy-positive cerebral malaria is a risk factor for epilepsy or other neurodisabilities. Between 2005 and 2007, we did a prospective cohort study of survivors of cerebral malaria with malaria retinopathy in Blantyre, Malawi. Children with cerebral malaria were identified at the time of their index admission and age-matched to concurrently admitted children without coma or nervous system infection. Initially matching of cases to controls was 1:1 but, in 2006, enrolment criteria for cerebral malaria survivors were revised to limit inclusion to children with cerebral malaria and retinopathy on the basis of indirect ophthalmoscopic examination; matching was then changed to 1:2 and the revised inclusion criteria were applied retrospectively for children enrolled previously. Clinical assessments at discharge and standardised nurse-led follow-up every 3 months thereafter were done to identify children with new seizure disorders or other neurodisabilities. A Kaplan-Meier survival analysis was done for incident epilepsy. 132 children with retinopathy-positive cerebral malaria and 264 age-matched, non-comatose controls were followed up for a median of 495 days (IQR 195-819). 12 of 132 cerebral malaria survivors developed epilepsy versus none of 264 controls (odds ratio [OR] undefined; pepilepsy in children with cerebral malaria were a higher maximum temperature (39·4°C [SD 1·2] vs 38·5°C [1·1]; p=0·01) and acute seizures (11/12 vs 76/120; OR 6·37, 95% CI 1·02-141·2), and male sex was a risk factor for new neurodisabilities (20/28 vs 38/93; OR 3·62, 1·44-9·06). Almost a third of retinopathy-positive cerebral

  6. Glucose production and gluconeogenesis in adults with cerebral malaria

    NARCIS (Netherlands)

    van Thien, H.; Ackermans, M. T.; Dekker, E.; Thanh Chien, V. O.; Le, T.; Endert, E.; Kager, P. A.; Romijn, J. A.; Sauerwein, H. P.

    2001-01-01

    Hypoglycaemia is an important complication in severe malaria, ascribed to an inhibition of gluconeogenesis. However, the only data available suggested that in severe malaria, total glucose production is increased. We measured glucose production and gluconeogenesis after an overnight fast in all

  7. Effect of vitamin A adjunct therapy for cerebral malaria in children ...

    African Journals Online (AJOL)

    Objective: To determine the effect of vitamin A supplementation on treatment outcome of cerebral malaria Methods: In this randomised double-blind placebo controlled clinical trial we ... Conclusions: Vitamin A as adjunct therapy did not significantly reduce coma duration but there were fewer deaths in the vitamin A arm.

  8. 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

    The pathogenesis of cerebral malaria (CM) includes compromised microvascular perfusion, increased inflammation, cytoadhesion, and endothelial activation. These events cause blood-brain barrier disruption and neuropathology and associations with the vascular endothelial growth factor (VEGF) signal...

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    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.

  11. 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

    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...

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

    DEFF Research Database (Denmark)

    Della Valle, Brian William; Hempel, Casper; Staalsoe, Trine

    2016-01-01

    (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...... were quantified. RESULTS: The development and progression of ECM was not affected by liraglutide. Indeed, although ROS/RNS were increased in peripheral organs, ROS/RNS generation was not present in the brain. Interestingly, CREB was activated in the ECM brain and may protect against ROS/RNS stress...

  13. Increased eosinophil activity in acute Plasmodium falciparum infection - association with cerebral malaria

    DEFF Research Database (Denmark)

    Kurtzhals, J A; Reimert, C M; Tette, E

    1998-01-01

    To assess the eosinophil response to Plasmodium falciparum infection a cohort of initially parasite-free Ghanaian children was followed for 3 months. Seven of nine children who acquired an asymptomatic P. falciparum infection showed increase in eosinophil counts, while a decrease was found in seven...... of nine children with symptomatic malaria, and no change was observed in 14 children who remained parasite-free. In a hospital-based study, paediatric patients with cerebral malaria (CM), severe anaemia (SA), or uncomplicated malaria (UM) had uniformly low eosinophil counts during the acute illness...... followed by eosinophilia 30 days after cure. Plasma levels of eosinophil cationic protein (ECP) and eosinophil protein X (EPX) were measured as indicators of eosinophil activation. In spite of the low eosinophil counts, ECP levels were increased on day 0 and significantly higher in patients with CM...

  14. Prevention of murine cerebral malaria by low-dose cyclosporin A.

    Science.gov (United States)

    Grau, G E; Gretener, D; Lambert, P H

    1987-08-01

    The effects of cyclosporin A (CsA) were investigated in an experimental model of cerebral malaria. In this model, Plasmodium berghei ANKA-infected CBA/Ca mice develop a clinically and histologically characterized neurological syndrome which is considered to be the result of immunopathological reactions mediated by L3T4+ T cells. It was shown that CsA displayed a strong protective effect on neurological complications when given at a dose 1 mg/kg/day for 5 consecutive days (Days 4-8), which had no effect on the parasite. Paradoxically, this protection against neurological complications was not seen when parasiticidal doses were used during this limited 5-day period. A similar protective effect was observed with two CsA derivatives, C5-34 and H7-94. The mechanisms by which CsA and the two derivatives could prevent murine cerebral malaria are unknown but can be related to exquisite effects on some lymphocyte functions. In view of these results, it might be conceivable to investigate the benefits of using low doses of CsA in man, in conjunction with the classical antiparasite therapy, for the management of cerebral malaria.

  15. STUDY OF CEREBRAL MALARIA IN PREGNANCY IN A TERTIARY CARE HOSPITAL OF EASTERN ODISHA

    Directory of Open Access Journals (Sweden)

    Bidyut Prava Das

    2017-05-01

    Full Text Available BACKGROUND The present work aimed at the clinical mode of presentation, degree of parasitaemia, complications and prognostic trends of pregnant women in cerebral malaria. Evaluation of mortality in different trimesters, varied complications and comparison with nonpregnant women was done. MATERIALS AND METHODS Thirty three pregnant women with cerebral malaria were studied. Twenty nonpregnant such cases of reproductive age group admitted to Department of Medicine, S.C.B. Medical College, Cuttack, Odisha, were taken as control. The cases were taken in random order. RESULTS Maximum numbers of cases (45.45% were primigravidae in second trimester of pregnancy. They exhibited higher incidence of anaemia and parasitaemia (2-10%, resulting in abortion and premature labour. CONCLUSION All the cases of cerebral malaria were found to be anaemic, but the severity of anaemia was more pronounced in primi (21% as compared to multigravidae (6.4%. High parasitaemia associated with leucocytosis (27.27% resulted in poor prognosis. Hypoglycaemia (15.15%, high level of urea, creatinine and alteration in parameters of liver function test further complicated the scenario leading to multiorgan failure. Recovery in cases of primigravidae was prolonged as compared to multigravidae.

  16. Structure-guided identification of a family of dual receptor-binding PfEMP1 that is associated with cerebral malaria

    DEFF Research Database (Denmark)

    Lennartz, Frank; Adams, Yvonne; Bengtsson, Anja

    2017-01-01

    Cerebral malaria is a deadly outcome of infection by Plasmodium falciparum, occurring when parasite-infected erythrocytes accumulate in the brain. These erythrocytes display parasite proteins of the PfEMP1 family that bind various endothelial receptors. Despite the importance of cerebral malaria...

  17. PPARγ agonists improve survival and neurocognitive outcomes in experimental cerebral malaria and induce neuroprotective pathways in human malaria.

    Directory of Open Access Journals (Sweden)

    Lena Serghides

    2014-03-01

    Full Text Available Cerebral malaria (CM is associated with a high mortality rate, and long-term neurocognitive impairment in approximately one third of survivors. Adjunctive therapies that modify the pathophysiological processes involved in CM may improve outcome over anti-malarial therapy alone. PPARγ agonists have been reported to have immunomodulatory effects in a variety of disease models. Here we report that adjunctive therapy with PPARγ agonists improved survival and long-term neurocognitive outcomes in the Plasmodium berghei ANKA experimental model of CM. Compared to anti-malarial therapy alone, PPARγ adjunctive therapy administered to mice at the onset of CM signs, was associated with reduced endothelial activation, and enhanced expression of the anti-oxidant enzymes SOD-1 and catalase and the neurotrophic factors brain derived neurotrophic factor (BDNF and nerve growth factor (NGF in the brains of infected mice. Two months following infection, mice that were treated with anti-malarials alone demonstrated cognitive dysfunction, while mice that received PPARγ adjunctive therapy were completely protected from neurocognitive impairment and from PbA-infection induced brain atrophy. In humans with P. falciparum malaria, PPARγ therapy was associated with reduced endothelial activation and with induction of neuroprotective pathways, such as BDNF. These findings provide insight into mechanisms conferring improved survival and preventing neurocognitive injury in CM, and support the evaluation of PPARγ agonists in human CM.

  18. Cerebrospinal fluid markers to distinguish bacterial meningitis from cerebral malaria in children [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    James M. Njunge

    2017-09-01

    Full Text Available Background. Few hospitals in high malaria endemic countries in Africa have the diagnostic capacity for clinically distinguishing acute bacterial meningitis (ABM from cerebral malaria (CM. As a result, empirical use of antibiotics is necessary. A biochemical marker of ABM would facilitate precise clinical diagnosis and management of these infections and enable rational use of antibiotics. Methods. We used label-free protein quantification by mass spectrometry to identify cerebrospinal fluid (CSF markers that distinguish ABM (n=37 from CM (n=22 in Kenyan children. Fold change (FC and false discovery rates (FDR were used to identify differentially expressed proteins. Subsequently, potential biomarkers were assessed for their ability to discriminate between ABM and CM using receiver operating characteristic (ROC curves. Results. The host CSF proteome response to ABM (Haemophilus influenza and Streptococcus pneumoniae is significantly different to CM. Fifty two proteins were differentially expressed (FDR<0.01, Log FC≥2, of which 83% (43/52 were upregulated in ABM compared to CM. Myeloperoxidase and lactotransferrin were present in 37 (100% and 36 (97% of ABM cases, respectively, but absent in CM (n=22. Area under the ROC curve (AUC, sensitivity, and specificity were assessed for myeloperoxidase (1, 1, and 1; 95% CI, 1-1 and lactotransferrin (0.98, 0.97, and 1; 95% CI, 0.96-1. Conclusion. Myeloperoxidase and lactotransferrin have a high potential to distinguish ABM from CM and thereby improve clinical management. Their validation requires a larger cohort of samples that includes other bacterial aetiologies of ABM.

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

    Directory of Open Access Journals (Sweden)

    Edwin E. Eseigbe

    2012-01-01

    Full Text Available 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 formal health facility 24 (72.7%, patent medicine seller 12 (36.4%, home treatment 10 (30.3%, and herbal concoction 6 (18.2% with majority 24 (72.7% using more than one option. Antimalarial therapy was instituted in 25 (75.6% of the cases. Mortality was significantly associated with the use of herbal concoction, treatment at a formal health facility and patent medicine seller, multiple convulsions, age less than 5 years, and noninstitution of antimalarial therapy before presentation. The study showed use of inappropriate health care options by caregivers and highlighted the need to pursue an awareness drive among caregivers on the use of health care options.

  20. Protective or pathogenic effects of vascular endothelial growth factor (VEGF) as potential biomarker in cerebral malaria.

    Science.gov (United States)

    Canavese, Miriam; Spaccapelo, Roberta

    2014-03-01

    Cerebral malaria (CM) is the major lethal complication of Plasmodium falciparum infection. It is characterized by persistent coma along with symmetrical motor signs. Several clinical, histopathological, and laboratory studies have suggested that cytoadherence of parasitized erythrocytes, neural injury by malarial toxin, and excessive inflammatory cytokine production are possible pathogenic mechanisms. Although the detailed pathophysiology of CM remains unsolved, it is thought that the binding of parasitized erythrocytes to the cerebral endothelia of microvessels, leading to their occlusion and the consequent angiogenic dysregulation play a key role in the disease pathogenesis. Recent evidences showed that vascular endothelial growth factor (VEGF) and its receptor-related molecules are over-expressed in the brain tissues of CM patients, as well as increased levels of VEGF are detectable in biologic samples from malaria patients. Whether the modulation of VEGF is causative agent of CM mortality or a specific phenotype of patients with susceptibility to fatal CM needs further evaluation. Currently, there is no biological test available to confirm the diagnosis of CM and its complications. It is hoped that development of biomarkers to identify patients and potential risk for adverse outcomes would greatly enhance better intervention and clinical management to improve the outcomes. We review and discuss here what it is currently known in regard to the role of VEGF in CM as well as VEGF as a potential biomarker.

  1. Vß profiles in African children with acute cerebral or uncomplicated malaria: very focused changes among a remarkable global stability

    DEFF Research Database (Denmark)

    Loizon, Séverine; Boeuf, Philippe; Tetteh, John K A

    2007-01-01

    T cells are thought to play a critical role in cerebral malaria pathogenesis. However, available evidences are restricted to rodent models in which V beta specific T cell expansion has been associated with neurological syndrome suggesting involvement of superantigens or dominant antigens. Using f...

  2. Minocycline prevents cerebral malaria, confers neuroprotection and increases survivability of mice during Plasmodium berghei ANKA infection.

    Science.gov (United States)

    Apoorv, Thittayil Suresh; Babu, Phanithi Prakash

    2017-02-01

    Cerebral malaria (CM) is a neurological complication arising due to Plasmodium falciparum or Plasmodium vivax infection. Minocycline, a semi-synthetic tetracycline, has been earlier reported to have a neuroprotective role in several neurodegenerative diseases. In this study, we investigated the effect of minocycline treatment on the survivability of mice during experimental cerebral malaria (ECM). The currently accepted mouse model, C57BL/6 mice infected with Plasmodium berghei ANKA, was used for the study. Infected mice were treated with an intra-peritoneal dose of minocycline hydrochloride, 45mg/kg daily for ten days that led to parasite clearance in blood, brain, liver and spleen on 7th day post-infection; and the mice survived until experiment ended (90days) without parasite recrudescence. Evans blue extravasation assay showed that blood-brain barrier integrity was maintained by minocycline. The tumor necrosis factor-alpha protein level and caspase activity, which is related to CM pathogenesis, was significantly reduced in the minocycline-treated group. Fluoro-Jade® C and hematoxylin-eosin staining of the brains of minocycline group revealed a decrease in degenerating neurons and absence of hemorrhages respectively. Minocycline treatment led to decrease in gene expressions of inflammatory mediators like interferon-gamma, CXCL10, CCL5, CCL2; receptors CXCR3 and CCR2; and hence decrease in T-cell-mediated cerebral inflammation. We also proved that this reduction in gene expressions is irrespective of the anti-parasitic property of minocycline. The distinct ability of minocycline to modulate gene expressions of CXCL10 and CXCR3 makes it effective than doxycycline, a tetracycline used as chemoprophylaxis. Our study shows that minocycline is highly effective in conferring neuroprotection during ECM. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. High plasma levels of soluble intercellular adhesion molecule (ICAM)-1 are associated with cerebral malaria.

    Science.gov (United States)

    Adukpo, Selorme; Kusi, Kwadwo A; Ofori, Michael F; Tetteh, John K A; Amoako-Sakyi, Daniel; Goka, Bamenla Q; Adjei, George O; Edoh, Dominic A; Akanmori, Bartholomew D; Gyan, Ben A; Dodoo, Daniel

    2013-01-01

    Cerebral malaria (CM) is responsible for most of the malaria-related deaths in children in sub-Saharan Africa. Although, not well understood, the pathogenesis of CM involves parasite and host factors which contribute to parasite sequestration through cytoadherence to the vascular endothelium. Cytoadherence to brain microvasculature is believed to involve host endothelial receptor, CD54 or intercellular adhesion molecule (ICAM)-1, while other receptors such as CD36 are generally involved in cytoadherence of parasites in other organs. We therefore investigated the contributions of host ICAM-1 expression and levels of antibodies against ICAM-1 binding variant surface antigen (VSA) on parasites to the development of CM. Paediatric malaria patients, 0.5 to 13 years were recruited and grouped into CM and uncomplicated malaria (UM) patients, based on well defined criteria. Standardized ELISA protocol was used to measure soluble ICAM-1 (sICAM-1) levels from acute plasma samples. Levels of IgG to CD36- or ICAM-1-binding VSA were measured by flow cytometry during acute and convalescent states. Wilcoxon sign rank-test analysis to compare groups revealed association between sICAM-1 levels and CM (p0.05). Median levels of antibodies to CD36-binding VSAs were also comparable between acute and convalescent samples within any patient group. Median levels of antibodies to ICAM-1-binding VSAs were however significantly lower at admission time than during recovery in both groups. High levels of sICAM-1 were associated with CM, and the sICAM-1 levels may reflect expression levels of the membrane bound form. Anti-VSA antibody levels to ICAM-binding parasites was more strongly associated with both UM and CM than antibodies to CD36 binding parasites. Thus, increasing host sICAM-1 levels were associated with CM whilst antibodies to parasite expressing non-ICAM-1-binding VSAs were not.

  4. High plasma levels of soluble intercellular adhesion molecule (ICAM-1 are associated with cerebral malaria.

    Directory of Open Access Journals (Sweden)

    Selorme Adukpo

    Full Text Available BACKGROUND: Cerebral malaria (CM is responsible for most of the malaria-related deaths in children in sub-Saharan Africa. Although, not well understood, the pathogenesis of CM involves parasite and host factors which contribute to parasite sequestration through cytoadherence to the vascular endothelium. Cytoadherence to brain microvasculature is believed to involve host endothelial receptor, CD54 or intercellular adhesion molecule (ICAM-1, while other receptors such as CD36 are generally involved in cytoadherence of parasites in other organs. We therefore investigated the contributions of host ICAM-1 expression and levels of antibodies against ICAM-1 binding variant surface antigen (VSA on parasites to the development of CM. METHODOLOGY/PRINCIPAL FINDINGS: Paediatric malaria patients, 0.5 to 13 years were recruited and grouped into CM and uncomplicated malaria (UM patients, based on well defined criteria. Standardized ELISA protocol was used to measure soluble ICAM-1 (sICAM-1 levels from acute plasma samples. Levels of IgG to CD36- or ICAM-1-binding VSA were measured by flow cytometry during acute and convalescent states. Wilcoxon sign rank-test analysis to compare groups revealed association between sICAM-1 levels and CM (p0.05. Median levels of antibodies to CD36-binding VSAs were also comparable between acute and convalescent samples within any patient group. Median levels of antibodies to ICAM-1-binding VSAs were however significantly lower at admission time than during recovery in both groups. CONCLUSIONS/SIGNIFICANCE: High levels of sICAM-1 were associated with CM, and the sICAM-1 levels may reflect expression levels of the membrane bound form. Anti-VSA antibody levels to ICAM-binding parasites was more strongly associated with both UM and CM than antibodies to CD36 binding parasites. Thus, increasing host sICAM-1 levels were associated with CM whilst antibodies to parasite expressing non-ICAM-1-binding VSAs were not.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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

  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. Depth discrimination in acousto-optic cerebral blood flow measurement simulation

    Science.gov (United States)

    Tsalach, A.; Schiffer, Z.; Ratner, E.; Breskin, I.; Zeitak, R.; Shechter, R.; Balberg, M.

    2016-03-01

    Monitoring cerebral blood flow (CBF) is crucial, as inadequate perfusion, even for relatively short periods of time, may lead to brain damage or even death. Thus, significant research efforts are directed at developing reliable monitoring tools that will enable continuous, bed side, simple and cost-effective monitoring of CBF. All existing non invasive bed side monitoring methods, which are mostly NIRS based, such as Laser Doppler or DCS, tend to underestimate CBF in adults, due to the indefinite effect of extra-cerebral tissues on the obtained signal. If those are to find place in day to day clinical practice, the contribution of extra-cerebral tissues must be eliminated and data from the depth (brain) should be extracted and discriminated. Recently, a novel technique, based on ultrasound modulation of light was developed for non-invasive, continuous CBF monitoring (termed ultrasound-tagged light (UTL or UT-NIRS)), and shown to correlate with readings of 133Xe SPECT and laser Doppler. We have assembled a comprehensive computerized simulation, modeling this acousto-optic technique in a highly scattering media. Using the combination of light and ultrasound, we show how depth information may be extracted, thus distinguishing between flow patterns taking place at different depths. Our algorithm, based on the analysis of light modulated by ultrasound, is presented and examined in a computerized simulation. Distinct depth discrimination ability is presented, suggesting that using such method one can effectively nullify the extra-cerebral tissues influence on the obtained signals, and specifically extract cerebral flow data.

  10. Doxycycline inhibits experimental cerebral malaria by reducing inflammatory immune reactions and tissue-degrading mediators.

    Directory of Open Access Journals (Sweden)

    Kim E Schmidt

    Full Text Available Malaria ranks among the most important infectious diseases worldwide and affects mostly people living in tropical countries. Mechanisms involved in disease progression are still not fully understood and specific treatments that might interfere with cerebral malaria (CM are limited. Here we show that administration of doxycycline (DOX prevented experimental CM (ECM in Plasmodium berghei ANKA (PbA-infected C57BL/6 wildtype (WT mice in an IL-10-independent manner. DOX-treated mice showed an intact blood-brain barrier (BBB and attenuated brain inflammation. Importantly, if WT mice were infected with a 20-fold increased parasite load, they could be still protected from ECM if they received DOX from day 4-6 post infection, despite similar parasitemia compared to control-infected mice that did not receive DOX and developed ECM. Infiltration of T cells and cytotoxic responses were reduced in brains of DOX-treated mice. Analysis of brain tissue by RNA-array revealed reduced expression of chemokines and tumour necrosis factor (TNF in brains of DOX-treated mice. Furthermore, DOX-administration resulted in brains of the mice in reduced expression of matrix metalloproteinase 2 (MMP2 and granzyme B, which are both factors associated with ECM pathology. Systemic interferon gamma production was reduced and activated peripheral T cells accumulated in the spleen in DOX-treated mice. Our results suggest that DOX targeted inflammatory processes in the central nervous system (CNS and prevented ECM by impaired brain access of effector T cells in addition to its anti-parasitic effect, thereby expanding the understanding of molecular events that underlie DOX-mediated therapeutic interventions.

  11. Doxycycline inhibits experimental cerebral malaria by reducing inflammatory immune reactions and tissue-degrading mediators.

    Science.gov (United States)

    Schmidt, Kim E; Kuepper, Janina M; Schumak, Beatrix; Alferink, Judith; Hofmann, Andrea; Howland, Shanshan W; Rénia, Laurent; Limmer, Andreas; Specht, Sabine; Hoerauf, Achim

    2018-01-01

    Malaria ranks among the most important infectious diseases worldwide and affects mostly people living in tropical countries. Mechanisms involved in disease progression are still not fully understood and specific treatments that might interfere with cerebral malaria (CM) are limited. Here we show that administration of doxycycline (DOX) prevented experimental CM (ECM) in Plasmodium berghei ANKA (PbA)-infected C57BL/6 wildtype (WT) mice in an IL-10-independent manner. DOX-treated mice showed an intact blood-brain barrier (BBB) and attenuated brain inflammation. Importantly, if WT mice were infected with a 20-fold increased parasite load, they could be still protected from ECM if they received DOX from day 4-6 post infection, despite similar parasitemia compared to control-infected mice that did not receive DOX and developed ECM. Infiltration of T cells and cytotoxic responses were reduced in brains of DOX-treated mice. Analysis of brain tissue by RNA-array revealed reduced expression of chemokines and tumour necrosis factor (TNF) in brains of DOX-treated mice. Furthermore, DOX-administration resulted in brains of the mice in reduced expression of matrix metalloproteinase 2 (MMP2) and granzyme B, which are both factors associated with ECM pathology. Systemic interferon gamma production was reduced and activated peripheral T cells accumulated in the spleen in DOX-treated mice. Our results suggest that DOX targeted inflammatory processes in the central nervous system (CNS) and prevented ECM by impaired brain access of effector T cells in addition to its anti-parasitic effect, thereby expanding the understanding of molecular events that underlie DOX-mediated therapeutic interventions.

  12. Phosphatidylinositol 3-Kinase γ is required for the development of experimental cerebral malaria.

    Directory of Open Access Journals (Sweden)

    Norinne Lacerda-Queiroz

    Full Text Available Experimental cerebral malaria (ECM is characterized by a strong immune response, with leukocyte recruitment, blood-brain barrier breakdown and hemorrhage in the central nervous system. Phosphatidylinositol 3-kinase γ (PI3Kγ is central in signaling diverse cellular functions. Using PI3Kγ-deficient mice (PI3Kγ-/- and a specific PI3Kγ inhibitor, we investigated the relevance of PI3Kγ for the outcome and the neuroinflammatory process triggered by Plasmodium berghei ANKA (PbA infection. Infected PI3Kγ-/- mice had greater survival despite similar parasitemia levels in comparison with infected wild type mice. Histopathological analysis demonstrated reduced hemorrhage, leukocyte accumulation and vascular obstruction in the brain of infected PI3Kγ-/- mice. PI3Kγ deficiency also presented lower microglial activation (Iba-1+ reactive microglia and T cell cytotoxicity (Granzyme B expression in the brain. Additionally, on day 6 post-infection, CD3+CD8+ T cells were significantly reduced in the brain of infected PI3Kγ-/- mice when compared to infected wild type mice. Furthermore, expression of CD44 in CD8+ T cell population in the brain tissue and levels of phospho-IkB-α in the whole brain were also markedly lower in infected PI3Kγ-/- mice when compared with infected wild type mice. Finally, AS605240, a specific PI3Kγ inhibitor, significantly delayed lethality in infected wild type mice. In brief, our results indicate a pivotal role for PI3Kγ in the pathogenesis of ECM.

  13. CD8+ T Cells Induce Fatal Brainstem Pathology during Cerebral Malaria via Luminal Antigen-Specific Engagement of Brain Vasculature.

    Directory of Open Access Journals (Sweden)

    Phillip A Swanson

    2016-12-01

    Full Text Available Cerebral malaria (CM is a severe complication of Plasmodium falciparum infection that results in thousands of deaths each year, mostly in African children. The in vivo mechanisms underlying this fatal condition are not entirely understood. Using the animal model of experimental cerebral malaria (ECM, we sought mechanistic insights into the pathogenesis of CM. Fatal disease was associated with alterations in tight junction proteins, vascular breakdown in the meninges / parenchyma, edema, and ultimately neuronal cell death in the brainstem, which is consistent with cerebral herniation as a cause of death. At the peak of ECM, we revealed using intravital two-photon microscopy that myelomonocytic cells and parasite-specific CD8+ T cells associated primarily with the luminal surface of CNS blood vessels. Myelomonocytic cells participated in the removal of parasitized red blood cells (pRBCs from cerebral blood vessels, but were not required for the disease. Interestingly, the majority of disease-inducing parasite-specific CD8+ T cells interacted with the lumen of brain vascular endothelial cells (ECs, where they were observed surveying, dividing, and arresting in a cognate peptide-MHC I dependent manner. These activities were critically dependent on IFN-γ, which was responsible for activating cerebrovascular ECs to upregulate adhesion and antigen-presenting molecules. Importantly, parasite-specific CD8+ T cell interactions with cerebral vessels were impaired in chimeric mice rendered unable to present EC antigens on MHC I, and these mice were in turn resistant to fatal brainstem pathology. Moreover, anti-adhesion molecule (LFA-1 / VLA-4 therapy prevented fatal disease by rapidly displacing luminal CD8+ T cells from cerebrovascular ECs without affecting extravascular T cells. These in vivo data demonstrate that parasite-specific CD8+ T cell-induced fatal vascular breakdown and subsequent neuronal death during ECM is associated with luminal, antigen

  14. Malaria

    Science.gov (United States)

    ... less than the risk of catching this infection. Chloroquine has been the drug of choice for protecting against malaria. But because of resistance, it is now only suggested for use in areas where Plasmodium vivax , P. oval , and ...

  15. Malaria

    Science.gov (United States)

    ... bites you, the parasite can get into your blood. The parasite lays eggs, which develop into more parasites. They ... cells until you get very sick. Because the parasites live in the blood, malaria can also be spread through other ways. ...

  16. Automated Detection of Malarial Retinopathy in Digital Fundus Images for Improved Diagnosis in Malawian Children with Clinically Defined Cerebral Malaria

    Science.gov (United States)

    Joshi, Vinayak; Agurto, Carla; Barriga, Simon; Nemeth, Sheila; Soliz, Peter; MacCormick, Ian J.; Lewallen, Susan; Taylor, Terrie E.; Harding, Simon P.

    2017-02-01

    Cerebral malaria (CM), a complication of malaria infection, is the cause of the majority of malaria-associated deaths in African children. The standard clinical case definition for CM misclassifies ~25% of patients, but when malarial retinopathy (MR) is added to the clinical case definition, the specificity improves from 61% to 95%. Ocular fundoscopy requires expensive equipment and technical expertise not often available in malaria endemic settings, so we developed an automated software system to analyze retinal color images for MR lesions: retinal whitening, vessel discoloration, and white-centered hemorrhages. The individual lesion detection algorithms were combined using a partial least square classifier to determine the presence or absence of MR. We used a retrospective retinal image dataset of 86 pediatric patients with clinically defined CM (70 with MR and 16 without) to evaluate the algorithm performance. Our goal was to reduce the false positive rate of CM diagnosis, and so the algorithms were tuned at high specificity. This yielded sensitivity/specificity of 95%/100% for the detection of MR overall, and 65%/94% for retinal whitening, 62%/100% for vessel discoloration, and 73%/96% for hemorrhages. This automated system for detecting MR using retinal color images has the potential to improve the accuracy of CM diagnosis.

  17. Case Report: A Case of Severe Cerebral Malaria Managed with Therapeutic Hypothermia and Other Modalities for Brain Edema.

    Science.gov (United States)

    Gad, AbdAllah; Ali, Sajjad; Zahoor, Talal; Azarov, Nick

    2018-04-01

    Malarial infections are uncommon in the United States and almost all reported cases stem from recent travelers coming from endemic countries. Cerebral malaria (CM) is a severe form of the disease usually affecting children and individuals with limited immunity. Despite proper management, mortality from CM can reach up to 25%, especially when it is associated with brain edema. Inefficient management of the edema may result in brain herniation and death. Uniform guidelines for management of CM-associated brain edema are lacking. In this report, we present a case of CM with associated severe brain edema that was successfully managed using a unique combination of therapeutic hypothermia, hypertonic saline, mannitol, and hyperventilation along with the antimalarial drugs quinidine and doxycycline. Our use of hypothermia was based on its proven benefit for improving neurological outcomes in post-cardiac arrest patients and previous in vitro research, suggesting its potential inhibitory role on malaria growth.

  18. Role of Serum Lactate and Malarial Retinopathy in Prognosis and Outcome of Falciparum and Vivax Cerebral Malaria: A Prospective Cohort Study in Adult Assamese Tribes

    OpenAIRE

    Chaudhari, Kaustubh Suresh; Uttarwar, Sahil Prashant; Tambe, Nikhil Narayan; Sharma, Rohan S; Takalkar, Anant Arunrao

    2016-01-01

    Introduction: There is no comprehensive data or studies relating to clinical presentation and prognosis of cerebral malaria (CM) in the tribal settlements of Assam. High rates of transmission and deaths from complicated malaria guided us to conduct a prospective observational cohort study to evaluate the factors associated with poor outcome and prognosis in patients of CM. Materials and Methods: We admitted 112 patients to the Bandarpara and Damodarpur Tribal Health Centers (THCs) between 201...

  19. Noninvasive measures of brain edema predict outcome in pediatric cerebral malaria.

    Science.gov (United States)

    Kampondeni, Samuel D; Birbeck, Gretchen L; Seydel, Karl B; Beare, Nicholas A; Glover, Simon J; Hammond, Colleen A; Chilingulo, Cowles A; Taylor, Terrie E; Potchen, Michael J

    2018-01-01

    Increased brain volume (BV) and subsequent herniation are strongly associated with death in pediatric cerebral malaria (PCM), a leading killer of children in developing countries. Accurate noninvasive measures of BV are needed for optimal clinical trial design. Our objectives were to examine the performance of six different magnetic resonance imaging (MRI) BV quantification measures for predicting mortality in PCM and to review the advantages and disadvantages of each method. Receiver operator characteristics were generated from BV measures of MRIs of children admitted to an ongoing research project with PCM between 2009 and 2014. Fatal cases were matched to the next available survivor. A total of 78 MRIs of children aged 5 months to 13 years (mean 4.0 years), of which 45% were males, were included. Areas under the curve (AUC) with 95% confidence interval on measures from the initial MRIs were: Radiologist-derived score = 0.69 (0.58-0.79; P = 0.0037); prepontine cistern anteroposterior (AP) dimension = 0.70 (0.56-0.78; P = 0.0133); SamKam ratio [Rt. parietal lobe height/(prepontine AP dimension + fourth ventricle AP dimension)] = 0.74 (0.63-0.83; P = 0.0002); and global cerebrospinal fluid (CSF) space ascertained by ClearCanvas = 0.67 (0.55-0.77; P = 0.0137). For patients with serial MRIs ( n = 37), the day 2 global CSF space AUC was 0.87 (0.71-0.96; P dimension ≤3 mm; cisternal CSF volume ≤7.5 ml; SamKam ratio ≥6.5; and recovery factor ≤0.75. All noninvasive measures of BV performed well in predicting death and providing a proxy measure for brain volume. Initial MRI assessment may inform future clinical trials for subject selection, risk adjustment, or stratification. Measures of temporal change may be used to stage PCM.

  20. Specific Depletion of Ly6Chi Inflammatory Monocytes Prevents Immunopathology in Experimental Cerebral Malaria

    Science.gov (United States)

    Kuepper, Janina M.; Biswas, Aindrila; Djie-Maletz, Andrea; Limmer, Andreas; van Rooijen, Nico; Mack, Matthias; Hoerauf, Achim; Dunay, Ildiko Rita

    2015-01-01

    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 Ly6Chi 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 Ly6Chi 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 Ly6Chi 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. PMID:25884830

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

    Science.gov (United States)

    Schumak, Beatrix; Klocke, Katrin; Kuepper, Janina M; Biswas, Aindrila; Djie-Maletz, Andrea; Limmer, Andreas; van Rooijen, Nico; Mack, Matthias; Hoerauf, Achim; Dunay, Ildiko Rita

    2015-01-01

    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.

  2. 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.

  3. Emergency caesarean delivery in a patient with cerebral malaria-leptospira co infection: Anaesthetic and critical care considerations

    Directory of Open Access Journals (Sweden)

    Sukhen Samanta

    2014-01-01

    Full Text Available Malaria-leptospira co-infection is rarely detected. Emergency surgery in such patients has not been reported. We describe such a case of a 24-year-old primigravida at term pregnancy posted for emergency caesarean delivery who developed pulmonary haemorrhage, acute respiratory distress syndrome, acute kidney injury, and cerebral oedema. Here, we discuss the perioperative management, pain management (with transverse abdominis plane block, intensive care management (special reference to management of pulmonary haemorrhage with intra pulmonary factor VIIa and the role of plasmapheresis in leptospira related jaundice with renal failure.

  4. malaria

    African Journals Online (AJOL)

    children who presented with malaria symptoms at the same clinic and tested positive or ... phagocytes immunity and induce anti-inflammatory immune response ...... treatment gap, Malawi will be ready to submit a validation request for virtual .... Conclusions. Vaccination and quarantine are the important disease preventive.

  5. 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.

  6. Malaria

    Science.gov (United States)

    2011-06-01

    dividing and are far more noticeable than the small amount of clear cyto- plasm surrounding them (Figs 10.6a & 10.6b). Mature schizonts contain 8...edema Same as P. vivax 16 10 • Topics on The paThology of proTozoan and invasive arThropod diseases Figure 10.38 Transmission electron micrograph of...mesangiopathic glo- merulonephropathy caused by quartan malaria, deposition of immune complexes may be demonstrated by electron or immunofluorescence microscopy

  7. STATUS HEMATOLOGI PENDERITA MALARIA SEREBRAL

    Directory of Open Access Journals (Sweden)

    Nurhayati Nurhayati

    2009-05-01

    Full Text Available AbstrakMalaria masih merupakan masalah kesehatan masyarakat dunia. Berdasarkan klasifikasi klinis, malaria dibedakan atas malaria berat dan malaria tanpa komplikasi. Malaria serebral merupakan komplikasi terberat dari malaria falsiparum.Telah dilakukan penelitian seksi silang terhadap penderita malaria falciparum yang dirawat inap di Bangsal Penyakit Dalam RS. Perjan. Dr. M. Djamil Padang dari bulan Juni 2002 sampai Juni 2006. Pada penelitian ini didapatkan jumlah sampel sebanyak 60 orang, terdiri dari 16 orang penderita malaria serebral dan 44 orang penderita malaria tanpa komplikasi.Data penelitian menunjukan terdapat perbedaan bermakna nilai hematokrit (p<0,05 dan jumlah leukosit (p<0,05 antara penderita malaria serebral dengan penderita malaria tanpa komplikasi. Dan terdapat korelasi positif antara nilai hemoglobin dengan hematokrit (r=0,864; p<0,05 pada penderita malaria falsiparum.Kata kunci: malaria serebral, malaria tanpa komplikasi, malaria falsiparumAbstract Malaria is still a problem of health of world society. Based on the clinical classification, are distinguished on severe malaria and uncomplicated malaria. Cerebral malaria is the worst complication of falciparum malaria. Cross section of the research done at the Hospital Dr. M. Djamil Padang againts medical record of malaria patients who are hospitalized in the Internal Medicine from June 2002 until June 2004. In this study, a total sample of 60 people, consisting of 16 cerebral malaria and 44 uncomplicated malaria. Data showed there were significant differences for hematocrit values (p <0.05 and total leukocytes values (p <0.05 between cerebral malaria and uncomplicated malaria patients. There is a positive correlation between hemoglobin with hematocrit values (r = 0.864; p <0.05 of falciparum malaria patients. Keywords: cerebral malaria, uncomplicated malaria, falciparum malaria

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

    Directory of Open Access Journals (Sweden)

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  10. IgE- and IgG mediated severe anaphylactic platelet transfusion reaction in a known case of cerebral malaria

    Directory of Open Access Journals (Sweden)

    B Shanthi

    2013-01-01

    Full Text Available Background: Allergic reactions occur commonly in transfusion practice. However, severe anaphylactic reactions are rare; anti-IgA (IgA: Immunoglobulin A in IgA-deficient patients is one of the well-illustrated and reported causes for such reactions. However, IgE-mediated hypersensitivity reaction through blood component transfusion may be caused in parasitic hyperimmunization for IgG and IgE antibodies. Case Report: We have evaluated here a severe anaphylactic transfusion reaction retrospectively in an 18year-old male, a known case of cerebral malaria, developed after platelet transfusions. The examination and investigations revealed classical signs and symptoms of anaphylaxis along with a significant rise in the serum IgE antibody level and IgG by hemagglutination method. Initial mild allergic reaction was followed by severe anaphylactic reaction after the second transfusion of platelets. Conclusion: Based on these results, screening of patients and donors with mild allergic reactions to IgE antibodies may help in understanding the pathogenesis as well as in planning for preventive desensitization and measures for safe transfusion.

  11. Plasmodium falciparum EPCR-binding PfEMP1 expression increases with malaria disease severity and is elevated in retinopathy negative cerebral malaria

    DEFF Research Database (Denmark)

    Shabani, Estela; Hanisch, Benjamin; Opoka, Robert O.

    2017-01-01

    a completely different disease process or a subgroup within the spectrum of CM remains an important question in malaria. In the current study, we use newly designed primer sets with the best coverage to date in a large cohort of children with SM to determine the role of var genes in malaria disease severity...

  12. Discriminating malaria from dengue fever in endemic areas: clinical and biological criteria, prognostic score and utility of the C-reactive protein: a retrospective matched-pair study in French Guiana.

    Directory of Open Access Journals (Sweden)

    Loïc Epelboin

    Full Text Available BACKGROUND: Dengue and malaria are two major public health concerns in tropical settings. Although the pathogeneses of these two arthropod-borne diseases differ, their clinical and biological presentations are unspecific. During dengue epidemics, several hundred patients with fever and diffuse pain are weekly admitted at the emergency room. It is difficult to discriminate them from patients presenting malaria attacks. Furthermore, it may be impossible to provide a parasitological microscopic examination for all patients. This study aimed to establish a diagnostic algorithm for communities where dengue fever and malaria occur at some frequency in adults. METHODOLOGY/PRINCIPAL FINDINGS: A sub-study using the control groups of a case-control study in French Guiana--originally designed to compare dengue and malaria co-infected cases to single infected cases--was performed between 2004 and 2010. In brief, 208 patients with malaria matched to 208 patients with dengue fever were compared in the present study. A predictive score of malaria versus dengue was established using .632 bootstrap procedures. Multivariate analysis showed that male gender, age, tachycardia, anemia, thrombocytopenia, and CRP>5 mg/l were independently associated with malaria. The predictive score using those variables had an AUC of 0.86 (95%CI: 0.82-0.89, and the CRP was the preponderant predictive factor. The sensitivity and specificity of CRP>5 mg/L to discriminate malaria from dengue were of 0.995 (95%CI: 0.991-1 and 0.35 (95%CI 0.32-0.39, respectively. CONCLUSIONS/SIGNIFICANCE: The clinical and biological score performed relatively well for discriminating cases of dengue versus malaria. Moreover, using only the CRP level turned to be a useful biomarker to discriminate feverish patients at low risk of malaria in an area where both infections exist. It would avoid more than 33% of unnecessary parasitological examinations with a very low risk of missing a malaria attack.

  13. Inhibition of hypoxia-associated response and kynurenine production in response to hyperbaric oxygen as mechanisms involved in protection against experimental cerebral malaria.

    Science.gov (United States)

    Bastos, Marcele F; Kayano, Ana Carolina A V; Silva-Filho, João Luiz; Dos-Santos, João Conrado K; Judice, Carla; Blanco, Yara C; Shryock, Nathaniel; Sercundes, Michelle K; Ortolan, Luana S; Francelin, Carolina; Leite, Juliana A; Oliveira, Rafaella; Elias, Rosa M; Câmara, Niels O S; Lopes, Stefanie C P; Albrecht, Letusa; Farias, Alessandro S; Vicente, Cristina P; Werneck, Claudio C; Giorgio, Selma; Verinaud, Liana; Epiphanio, Sabrina; Marinho, Claudio R F; Lalwani, Pritesh; Amino, Rogerio; Aliberti, Julio; Costa, Fabio T M

    2018-03-20

    Cerebral malaria (CM) is a multifactorial syndrome involving an exacerbated proinflammatory status, endothelial cell activation, coagulopathy, hypoxia, and accumulation of leukocytes and parasites in the brain microvasculature. Despite significant improvements in malaria control, 15% of mortality is still observed in CM cases, and 25% of survivors develop neurologic sequelae for life-even after appropriate antimalarial therapy. A treatment that ameliorates CM clinical signs, resulting in complete healing, is urgently needed. Previously, we showed a hyperbaric oxygen (HBO)-protective effect against experimental CM. Here, we provide molecular evidence that HBO targets brain endothelial cells by decreasing their activation and inhibits parasite and leukocyte accumulation, thus improving cerebral microcirculatory blood flow. HBO treatment increased the expression of aryl hydrocarbon receptor over hypoxia-inducible factor 1-α (HIF-1α), an oxygen-sensitive cytosolic receptor, along with decreased indoleamine 2,3-dioxygenase 1 expression and kynurenine levels. Moreover, ablation of HIF-1α expression in endothelial cells in mice conferred protection against CM and improved survival. We propose that HBO should be pursued as an adjunctive therapy in CM patients to prolong survival and diminish deleterious proinflammatory reaction. Furthermore, our data support the use of HBO in therapeutic strategies to improve outcomes of non-CM disorders affecting the brain.-Bastos, M. F., Kayano, A. C. A. V., Silva-Filho, J. L., Dos-Santos, J. C. K., Judice, C., Blanco, Y. C., Shryock, N., Sercundes, M. K., Ortolan, L. S., Francelin, C., Leite, J. A., Oliveira, R., Elias, R. M., Câmara, N. O. S., Lopes, S. C. P., Albrecht, L., Farias, A. S., Vicente, C. P., Werneck, C. C., Giorgio, S., Verinaud, L., Epiphanio, S., Marinho, C. R. F., Lalwani, P., Amino, R., Aliberti, J., Costa, F. T. M. Inhibition of hypoxia-associated response and kynurenine production in response to hyperbaric oxygen

  14. [Correlation of diffusion tensor imaging between the cerebral cortex and speech discrimination in presbycusis].

    Science.gov (United States)

    Peng, Lu; Yu, Shuilian; Chen, Ruichun; Jing, Yan; Liang, Jianping

    2015-09-01

    To investigate the relationship between pure-tone average (PTA), the fractional anisotropy (FA) of the auditory pathway, cognitive cortex and auditory cortex in presbycusis. Twenty-five elderly subjects with presbycusis were participated in the study. PTA, speech discrimination abilities were evaluated in each subject. Diffusion tensor imaging (DTI) was applied to access the FA of the IC, the superior frontal gyrus and the Heschl's gyrus. Compare the difference between two sides of the values of FA in the three areas. Bivariate correlation analysis was performed to evaluate the effects of PTA and FA of the inferior colliculus (IC), the superior frontal gyrus and the Heschl's gyrus on speech discrimination abilities. There were no significant differences between the left and right side of the inferior colliculus (P > 0.05). Higher FA values were recorded at the left side of the Heschl's gyrus and the superior frontal gyrus (P < 0.05). Both PTA and the FA of the superior frontal gyrus have a negative association with speech discrimination abilities (P < 0.01, P < 0.05), while the FA of the Heschl's gyrus has a positive association with speech discrimination abilities (P < 0.05). Our findings indicated that the speech discrimination abilities of the elderly is not only related to the peripheral auditory function, but also to the central auditory and cognitive function.

  15. Selected Gray Matter Volumes and Gender but Not Basal Ganglia nor Cerebellum Gyri Discriminate Left Versus Right Cerebral Hemispheres: Multivariate Analyses in human Brains at 3T.

    Science.gov (United States)

    Roldan-Valadez, Ernesto; Suarez-May, Marcela A; Favila, Rafael; Aguilar-Castañeda, Erika; Rios, Camilo

    2015-07-01

    Interest in the lateralization of the human brain is evident through a multidisciplinary number of scientific studies. Understanding volumetric brain asymmetries allows the distinction between normal development stages and behavior, as well as brain diseases. We aimed to evaluate volumetric asymmetries in order to select the best gyri able to classify right- versus left cerebral hemispheres. A cross-sectional study performed in 47 right-handed young-adults healthy volunteers. SPM-based software performed brain segmentation, automatic labeling and volumetric analyses for 54 regions involving the cerebral lobes, basal ganglia and cerebellum from each cerebral hemisphere. Multivariate discriminant analysis (DA) allowed the assembling of a predictive model. DA revealed one discriminant function that significantly differentiated left vs. right cerebral hemispheres: Wilks' λ = 0.008, χ(2) (9) = 238.837, P brain gyri are able to accurately classify left vs. right cerebral hemispheres by using a multivariate approach; the selected regions correspond to key brain areas involved in attention, internal thought, vision and language; our findings favored the concept that lateralization has been evolutionary favored by mental processes increasing cognitive efficiency and brain capacity. © 2015 Wiley Periodicals, Inc.

  16. Amide proton transfer imaging to discriminate between low- and high-grade gliomas: added value to apparent diffusion coefficient and relative cerebral blood volume

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Yoon Seong; Ahn, Sung Soo; Lee, Seung-Koo [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, College of Medicine, Seoul (Korea, Republic of); Chang, Jong Hee; Kang, Seok-Gu [Yonsei University College of Medicine, Department of Neurosurgery, Seoul (Korea, Republic of); Kim, Se Hoon [Yonsei University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Zhou, Jinyuan [Johns Hopkins University School of Medicine, Division of MRI Research, Department of Radiology, Baltimore, MD (United States)

    2017-08-15

    To evaluate the added value of amide proton transfer (APT) imaging to the apparent diffusion coefficient (ADC) from diffusion tensor imaging (DTI) and the relative cerebral blood volume (rCBV) from perfusion magnetic resonance imaging (MRI) for discriminating between high- and low-grade gliomas. Forty-six consecutive adult patients with diffuse gliomas who underwent preoperative APT imaging, DTI and perfusion MRI were enrolled. APT signals were compared according to the World Health Organization grade. The diagnostic ability and added value of the APT signal to the ADC and rCBV for discriminating between low- and high-grade gliomas were evaluated using receiver operating characteristic (ROC) analyses and integrated discrimination improvement. The APT signal increased as the glioma grade increased. The discrimination abilities of the APT, ADC and rCBV values were not significantly different. Using both the APT signal and ADC significantly improved discrimination vs. the ADC alone (area under the ROC curve [AUC], 0.888 vs. 0.910; P = 0.007), whereas using both the APT signal and rCBV did not improve discrimination vs. the rCBV alone (AUC, 0.927 vs. 0.923; P = 0.222). APT imaging may be a useful imaging biomarker that adds value to the ADC for discriminating between low- and high-grade gliomas. (orig.)

  17. 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

    and no 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...

  18. Metabolic fingerprints of serum, brain, and liver are distinct for mice with cerebral and noncerebral malaria: a ¹H NMR spectroscopy-based metabonomic study.

    Science.gov (United States)

    Ghosh, Soumita; Sengupta, Arjun; Sharma, Shobhona; Sonawat, Haripalsingh M

    2012-10-05

    Cerebral malaria (CM) is a life-threatening disease in humans caused by Plasmodium falciparum, leading to high mortality. Plasmodium berghei ANKA (PbA) infection in C57Bl/6 mice induces pathologic symptoms similar to that in human CM. However, experimental CM incidence in mice is variable, and there are no known metabolic correlates/fingerprints for the animals that develop CM. Here, we have used (1)H NMR-based metabonomics to investigate the metabolic changes in the mice with CM with respect to the mice that have noncerebral malaria (NCM) of the same batchmates with identical genetic backgrounds and infected simultaneously. The metabolic profile of the infected mice (both CM and NCM) was separately compared with the metabolite profile of uninfected control mice of same genetic background. The objective of this study was to search for metabolic changes/fingerprints of CM and identify the pathways that might be differentially altered in mice that succumbed to CM. The results show that brain, liver, and sera exhibit unique metabolic fingerprints for CM over NCM mice. Some of the major fingerprints are increased level of triglycerides, VLDL-cholesterol in sera of CM mice, and decreased levels of glutamine in the sera concomitant with increased levels of glutamine in the brain of the mice with CM. Moreover, glycerophosphocholine is decreased in both the brain and the liver of animals with CM, and myo-inositol and histamine are increased in the liver of CM mice. The metabolic fingerprints in brain, sera, and liver of mice with CM point toward perturbation in the ammonia detoxification pathway and perturbation in lipid and choline metabolism in CM specifically. The study helps us to understand the severity of CM over NCM and in unrevealing the specific metabolic pathways that are compromised in CM.

  19. Role of Serum Lactate and Malarial Retinopathy in Prognosis and Outcome of Falciparum and Vivax Cerebral Malaria: A Prospective Cohort Study in Adult Assamese Tribes.

    Science.gov (United States)

    Chaudhari, Kaustubh Suresh; Uttarwar, Sahil Prashant; Tambe, Nikhil Narayan; Sharma, Rohan S; Takalkar, Anant Arunrao

    2016-01-01

    There is no comprehensive data or studies relating to clinical presentation and prognosis of cerebral malaria (CM) in the tribal settlements of Assam. High rates of transmission and deaths from complicated malaria guided us to conduct a prospective observational cohort study to evaluate the factors associated with poor outcome and prognosis in patients of CM. We admitted 112 patients to the Bandarpara and Damodarpur Tribal Health Centers (THCs) between 2011 and 2013 with a strict diagnosis of CM. We assessed the role of clinical, fundoscopy and laboratory findings (mainly lactic acid) in the immediate outcome in terms of death and recovery, duration of hospitalization, neurocognitive impairment, cranial nerve palsies and focal neurological deficit. The case fatality rate of CM was 33.03% and the prevalence of residual neurological sequelae at discharge was 16.07%. These are significantly higher than the previous studies. The mortality rate and neurological complications rate in patients with retinal whitening was 38.46% and 23.07%, with vessel changes was 25% and 18.75%, with retinal hemorrhage was 55.55% and 11.11% and with hyperlactatemia was 53.85% and 18.46%, respectively. Three patients of papilledema alone died. Our study suggests a strong correlation between hyperlactatemia, retinal changes (whitening, vessel changes and hemorrhage) and depth and duration of coma with longer duration of hospitalization, increased mortality, neurological sequelae and death. Plasmodium vivax mono-infection as a cause of CM has been confirmed. Prognostic evaluation of CM is useful for judicious allocation of resources in the THC.

  20. Role of serum lactate and malarial retinopathy in prognosis and outcome of falciparum and vivax cerebral Malaria: A prospective cohort study in adult assamese tribes

    Directory of Open Access Journals (Sweden)

    Kaustubh Suresh Chaudhari

    2016-01-01

    Full Text Available Introduction: There is no comprehensive data or studies relating to clinical presentation and prognosis of cerebral malaria (CM in the tribal settlements of Assam. High rates of transmission and deaths from complicated malaria guided us to conduct a prospective observational cohort study to evaluate the factors associated with poor outcome and prognosis in patients of CM. Materials and Methods: We admitted 112 patients to the Bandarpara and Damodarpur Tribal Health Centers (THCs between 2011 and 2013 with a strict diagnosis of CM. We assessed the role of clinical, fundoscopy and laboratory findings (mainly lactic acid in the immediate outcome in terms of death and recovery, duration of hospitalization, neurocognitive impairment, cranial nerve palsies and focal neurological deficit. Results: The case fatality rate of CM was 33.03% and the prevalence of residual neurological sequelae at discharge was 16.07%. These are significantly higher than the previous studies. The mortality rate and neurological complications rate in patients with retinal whitening was 38.46% and 23.07%, with vessel changes was 25% and 18.75%, with retinal hemorrhage was 55.55% and 11.11% and with hyperlactatemia was 53.85% and 18.46%, respectively. Three patients of papilledema alone died. Conclusion: Our study suggests a strong correlation between hyperlactatemia, retinal changes (whitening, vessel changes and hemorrhage and depth and duration of coma with longer duration of hospitalization, increased mortality, neurological sequelae and death. Plasmodium vivax mono-infection as a cause of CM has been confirmed. Prognostic evaluation of CM is useful for judicious allocation of resources in the THC.

  1. Altered regulation of Akt signaling with murine cerebral malaria, effects on long-term neuro-cognitive function, restoration with lithium treatment.

    Directory of Open Access Journals (Sweden)

    Minxian Dai

    Full Text Available Neurological and cognitive impairment persist in more than 20% of cerebral malaria (CM patients long after successful anti-parasitic treatment. We recently reported that long term memory and motor coordination deficits are also present in our experimental cerebral malaria model (ECM. We also documented, in a murine model, a lack of obvious pathology or inflammation after parasite elimination, suggesting that the long-term negative neurological outcomes result from potentially reversible biochemical and physiological changes in brains of ECM mice, subsequent to acute ischemic and inflammatory processes. Here, we demonstrate for the first time that acute ECM results in significantly reduced activation of protein kinase B (PKB or Akt leading to decreased Akt phosphorylation and inhibition of the glycogen kinase synthase (GSK3β in the brains of mice infected with Plasmodium berghei ANKA (PbA compared to uninfected controls and to mice infected with the non-neurotrophic P. berghei NK65 (PbN. Though Akt activation improved to control levels after chloroquine treatment in PbA-infected mice, the addition of lithium chloride, a compound which inhibits GSK3β activity and stimulates Akt activation, induced a modest, but significant activation of Akt in the brains of infected mice when compared to uninfected controls treated with chloroquine with and without lithium. In addition, lithium significantly reversed the long-term spatial and visual memory impairment as well as the motor coordination deficits which persisted after successful anti-parasitic treatment. GSK3β inhibition was significantly increased after chloroquine treatment, both in lithium and non-lithium treated PbA-infected mice. These data indicate that acute ECM is associated with abnormalities in cell survival pathways that result in neuronal damage. Regulation of Akt/GSK3β with lithium reduces neuronal degeneration and may have neuroprotective effects in ECM. Aberrant regulation of Akt

  2. Malaria deaths in a rural hospital

    African Journals Online (AJOL)

    An audit of all malaria deaths that occurred at Manguzi Hospital between 1 October 1998 to 30 September 1999 was performed. There were 41 deaths from malaria in this time period, which was many more than for the previous three years. The most common causes of death were cerebral malaria, pulmonary oedema, ...

  3. Amodiaquine analogues containing NO-donor substructures: synthesis and their preliminary evaluation as potential tools in the treatment of cerebral malaria.

    Science.gov (United States)

    Bertinaria, Massimo; Guglielmo, Stefano; Rolando, Barbara; Giorgis, Marta; Aragno, Cristina; Fruttero, Roberta; Gasco, Alberto; Parapini, Silvia; Taramelli, Donatella; Martins, Yuri C; Carvalho, Leonardo J M

    2011-05-01

    The synthesis and physico-chemical properties of novel compounds obtained by conjugation of amodiaquine with moieties containing either furoxan or nitrooxy NO-donor substructures are described. The synthesised compounds were tested in vitro against both the chloroquine sensitive, D10 and the chloroquine resistant, W-2 strains of Plasmodium falciparum (P. falciparum). Most of the compounds showed an antiplasmodial activity comparable to that of the parent drug. By comparing the activities of simple related structures devoid of the ability to release NO, it appears that the contribution of NO to the antiplasmodial action in vitro is marginal. All the compounds were able to relax rat aorta strips with a NO-dependent mechanism, thus showing their capacity to release NO in the vessels. A preliminary in vivo study using Plasmodium berghei ANKA-infected mice showed a trend for prolonged survival of mice with cerebral malaria treated with compound 40, which is potent and fast amodiaquine-derived NO-donor, when compared with amodiaquine alone or with compound 31, a milder NO-donor. The two compounds showed in vivo antiplasmodial activity similar to that of amodiaquine. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

  4. FTIR Imaging of Brain Tissue Reveals Crystalline Creatine Deposits Are an ex Vivo Marker of Localized Ischemia during Murine Cerebral Malaria: General Implications for Disease Neurochemistry

    Science.gov (United States)

    2012-01-01

    Phosphocreatine is a major cellular source of high energy phosphates, which is crucial to maintain cell viability under conditions of impaired metabolic states, such as decreased oxygen and energy availability (i.e., ischemia). Many methods exist for the bulk analysis of phosphocreatine and its dephosphorylated product creatine; however, no method exists to image the distribution of creatine or phosphocreatine at the cellular level. In this study, Fourier transform infrared (FTIR) spectroscopic imaging has revealed the ex vivo development of creatine microdeposits in situ in the brain region most affected by the disease, the cerebellum of cerebral malaria (CM) diseased mice; however, such deposits were also observed at significantly lower levels in the brains of control mice and mice with severe malaria. In addition, the number of deposits was observed to increase in a time-dependent manner during dehydration post tissue cutting. This challenges the hypotheses in recent reports of FTIR spectroscopic imaging where creatine microdeposits found in situ within thin sections from epileptic, Alzheimer’s (AD), and amlyoid lateral sclerosis (ALS) diseased brains were proposed to be disease specific markers and/or postulated to contribute to the brain pathogenesis. As such, a detailed investigation was undertaken, which has established that the creatine microdeposits exist as the highly soluble HCl salt or zwitterion and are an ex-vivo tissue processing artifact and, hence, have no effect on disease pathogenesis. They occur as a result of creatine crystallization during dehydration (i.e., air-drying) of thin sections of brain tissue. As ischemia and decreased aerobic (oxidative metabolism) are common to many brain disorders, regions of elevated creatine-to-phosphocreatine ratio are likely to promote crystal formation during tissue dehydration (due to the lower water solubility of creatine relative to phosphocreatine). The results of this study have demonstrated that

  5. Cerebrospinal fluid kynurenine and kynurenic acid concentrations are associated with coma duration and long-term neurocognitive impairment in Ugandan children with cerebral malaria.

    Science.gov (United States)

    Holmberg, Dag; Franzén-Röhl, Elisabeth; Idro, Richard; Opoka, Robert O; Bangirana, Paul; Sellgren, Carl M; Wickström, Ronny; Färnert, Anna; Schwieler, Lilly; Engberg, Göran; John, Chandy C

    2017-07-28

    One-fourth of children with cerebral malaria (CM) retain cognitive sequelae up to 2 years after acute disease. The kynurenine pathway of the brain, forming neuroactive metabolites, e.g. the NMDA-receptor antagonist kynurenic acid (KYNA), has been implicated in long-term cognitive dysfunction in other CNS infections. In the present study, the association between the kynurenine pathway and neurologic/cognitive complications in children with CM was investigated. Cerebrospinal fluid (CSF) concentrations of KYNA and its precursor kynurenine in 69 Ugandan children admitted for CM to Mulago Hospital, Kampala, Uganda, between 2008 and 2013 were assessed. CSF kynurenine and KYNA were compared to CSF cytokine levels, acute and long-term neurologic complications, and long-term cognitive impairments. CSF kynurenine and KYNA from eight Swedish children without neurological or infectious disease admitted to Astrid Lindgren's Children's Hospital were quantified and used for comparison. Children with CM had significantly higher CSF concentration of kynurenine and KYNA than Swedish children (P coma duration in children of all ages (P = 0.003 and 0.04, respectively), and CSF kynurenine concentrations were associated with worse overall cognition (P = 0.056) and attention (P = 0.003) at 12-month follow-up in children ≥5 years old. CSF KYNA and kynurenine are elevated in children with CM, indicating an inhibition of glutamatergic and cholinergic signaling. This inhibition may lead acutely to prolonged coma and long-term to impairment of attention and cognition.

  6. Measuring physiological and pathological femoral anteversion using a biplanar low-dose X-ray system: validity, reliability, and discriminative ability in cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Thepaut, Matthias [Laboratoire de Traitement de l' Information Medicale, INSERM U1101, Brest (France); CHRU de Brest, Hopital Morvan, Service de chirurgie pediatrique, Brest (France); Brochard, Sylvain [Laboratoire de Traitement de l' Information Medicale, INSERM U1101, Brest (France); CHRU de Brest, Hopital Morvan, Service de Medecine Physique et de Readaptation, Brest (France); Universite de Bretagne Occidentale, Brest (France); Leboucher, Julien [Laboratoire de Traitement de l' Information Medicale, INSERM U1101, Brest (France); Lempereur, Mathieu [Laboratoire de Traitement de l' Information Medicale, INSERM U1101, Brest (France); CHRU de Brest, Hopital Morvan, Service de Medecine Physique et de Readaptation, Brest (France); Stindel, Eric [Laboratoire de Traitement de l' Information Medicale, INSERM U1101, Brest (France); CHRU de Brest, La Cavale Blanche, Service d' Orthopedie-Traumatologie, Brest (France); Universite de Bretagne Occidentale, Brest (France); Tissot, Valentin [CHRU de Brest, Service de radiologie, Brest (France); Borotikar, Bhushan S. [Laboratoire de Traitement de l' Information Medicale, INSERM U1101, Brest (France); Institut Mines-Telecom, Telecom Bretagne, Brest (France)

    2016-02-15

    The aims of this study were to evaluate the concurrent validity and reliability of a low-dose biplanar X-ray system (Ld-BPR) for the measurement of femoral anteversion (FA) by comparing Ld-BPR-based three-dimensional measures with CT-scan-based measures and to assess the discriminative ability of this method in children with cerebral palsy. Fifty dry femora were scanned using both a CT scan and the Ld-BPR system. Ten femora were artificially modified to mimic a range of anteversion from -30 to +60 and scanned by both modalities. FA was quantified using the images from both modalities and statistically compared for concurrent validity. Intra- and inter-observer reliability of the Ld-BPR system was also determined. Further, Ld-BPR data from 16 hemiplegic and 22 diplegic children were analyzed for its discriminative ability. The concurrent validity between the Ld-BPR and CT-scan measures was excellent (R {sup 2} = 0.83-0.84) and no significant differences were found. The intra- and inter-trial reliability were excellent (ICCs = 0.98 and 0.97) with limits of agreement of (-2.28 ; +2.65 ) and (-2.76 ; +3.38 ) respectively. Further, no significant effects of angle or method were found in the sample of modified femora. Ld-BPR measures for FA were significantly different between healthy and impaired femora. The excellent concurrent validity with the CT scan modality, the excellent reliability, and the ability to discriminate pathological conditions evaluated by this study make this radiological method suitable for a validated use across hospitals and research institutes. (orig.)

  7. 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 mala...

  8. About Malaria

    Science.gov (United States)

    ... Emergency Consultations, and General Public. Contact Us About Malaria Recommend on Facebook Tweet Share Compartir Malaria is ... from sub-Saharan Africa and South Asia. About Malaria Topics FAQs Frequently Asked Question, Incubation period, uncomplicated & ...

  9. Predictors of childhood severe malaria in a densely populated area ...

    African Journals Online (AJOL)

    Coma, convulsions and unconsciousness were more indicative of cerebral malaria. Hemoglobin and blood glucose levels decreased significantly in severe malaria patients compared with uncomplicated malaria patients or controls (P < 0.001). On the contrary, blood transaminases and CRP levels increased significantly in ...

  10. High-Throughput Testing of Antibody-Dependent Binding Inhibition of Placental Malaria Parasites

    DEFF Research Database (Denmark)

    Nielsen, Morten A; Salanti, Ali

    2015-01-01

    The particular virulence of Plasmodium falciparum manifests in diverse severe malaria syndromes as cerebral malaria, severe anemia and placental malaria. The cause of both the severity and the diversity of infection outcome, is the ability of the infected erythrocyte (IE) to bind a range......-throughput assay used in the preclinical and clinical development of a VAR2CSA based vaccine against placental malaria....

  11. 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....

  12. 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...

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

    KAUST Repository

    Ramaprasad, Abhinay

    2012-01-01

    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

  14. Malaria Research

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Malaria Go to Information for Researchers ► Credit: NIAID Colorized ... for the disease. Why Is the Study of Malaria a Priority for NIAID? Roughly 3.2 billion ...

  15. The ¿/d T-cell response to Plasmodium falciparum malaria in a population in which malaria is endemic

    DEFF Research Database (Denmark)

    Hviid, L; Kurtzhals, J A; Dodoo, D

    1996-01-01

    Frequencies and absolute numbers of peripheral gamma/delta T cells have been reported to increase after episodes of Plasmodium falciparum malaria in adults with limited or no previous malaria exposure. In contrast, little is known about the gamma/delta T-cell response to malaria in children from...... areas where malaria is endemic, who bear the burden of malaria-related morbidity and mortality. We investigated the gamma/delta T-cell response in 19 Ghanaian children from an area of hyperendemic, seasonal malaria transmission. The children presented with cerebral malaria (n = 7), severe malarial...... anemia (n = 5), or uncomplicated malaria (n = 7) and were monitored from admission until 4 weeks later. We found no evidence of increased frequencies of gamma/delta T cells in any of the patient groups, whereas one adult expatriate studied in Ghana and three adults admitted to the hospital in Copenhagen...

  16. Insights into deregulated TNF and IL-10 production in malaria

    DEFF Research Database (Denmark)

    Boeuf, Philippe S; Loizon, Séverine; Awandare, Gordon A

    2012-01-01

    the activation status of those cells in SMA patients. METHODS: The IL-10 and TNF production capacity and the activation phenotype of monocytes and T cells were compared in samples collected from 332 Ghanaian children with non-overlapping SMA (n = 108), cerebral malaria (CM) (n = 144) or uncomplicated malaria (UM...

  17. 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.

  18. CT and MR perfusion can discriminate severe cerebral hypoperfusion from perfusion absence: evaluation of different commercial software packages by using digital phantoms

    Energy Technology Data Exchange (ETDEWEB)

    Uwano, Ikuko; Kudo, Kohsuke; Sasaki, Makoto [Iwate Medical University, Advanced Medical Research Center, Morioka (Japan); Christensen, Soren [University of Melbourne, Royal Melbourne Hospital, Departments of Neurology and Radiology, Victoria (Australia); Oestergaard, Leif [Aarhus University Hospital, Department of Neuroradiology, Center for Functionally Integrative Neuroscience, DK, Aarhus C (Denmark); Ogasawara, Kuniaki; Ogawa, Akira [Iwate Medical University, Department of Neurosurgery, Morioka (Japan)

    2012-05-15

    Computed tomography perfusion (CTP) and magnetic resonance perfusion (MRP) are expected to be usable for ancillary tests of brain death by detection of complete absence of cerebral perfusion; however, the detection limit of hypoperfusion has not been determined. Hence, we examined whether commercial software can visualize very low cerebral blood flow (CBF) and cerebral blood volume (CBV) by creating and using digital phantoms. Digital phantoms simulating 0-4% of normal CBF (60 mL/100 g/min) and CBV (4 mL/100 g/min) were analyzed by ten software packages of CT and MRI manufacturers. Region-of-interest measurements were performed to determine whether there was a significant difference between areas of 0% and areas of 1-4% of normal flow. The CTP software detected hypoperfusion down to 2-3% in CBF and 2% in CBV, while the MRP software detected that of 1-3% in CBF and 1-4% in CBV, although the lower limits varied among software packages. CTP and MRP can detect the difference between profound hypoperfusion of <5% from that of 0% in digital phantoms, suggesting their potential efficacy for assessing brain death. (orig.)

  19. Malaria prophylaxis

    African Journals Online (AJOL)

    Malaria D:lay still be contracted despite good cOD:lpliance with ... true that prophylaxis is always better than no prophy- laxis, nor is ... If used during pregnancy, a folic acid supplement ... include folate deficiency, agranulocytosis, illegaloblastic.

  20. Biphasic Clinical Course Among Kenyan Children With Cerebral ...

    African Journals Online (AJOL)

    Background Cerebral malaria is the most severe neurological complication of Falciparum malaria. It is associated with a significant risk of death and neurological sequelae. A biphasic clinical picture is associated with an even greater risk of neurological sequelae. Objective To examine the incidence and clinical ...

  1. 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.

  2. Malaria chemotherapy.

    Science.gov (United States)

    Winstanley, Peter; Ward, Stephen

    2006-01-01

    Most malaria control strategies today depend on safe and effective drugs, as they have done for decades. But sensitivity to chloroquine, hitherto the workhorse of malaria chemotherapy, has rapidly declined throughout the tropics since the 1980s, and this drug is now useless in many high-transmission areas. New options for resource-constrained governments are few, and there is growing evidence that the burden from malaria has been increasing, as has malaria mortality in Africa. In this chapter, we have tried to outline the main pharmacological properties of current drugs, and their therapeutic uses and limitations. We have summarised the ways in which these drugs are employed, both in the formal health sector and in self-medication. We have briefly touched on the limitations of current drug development, but have tried to pick out a few promising drugs that are under development. Given that Plasmodium falciparum is the organism that kills, and that has developed multi-drug resistance, we have tended to focus upon it. Similarly, given that around 90% of global mortality from malaria occurs in Africa, there is the tendency to dwell on this continent. We give no apology for placing our emphasis upon the use of antimalarial drugs in endemic populations rather than their use for prophylaxis in travellers.

  3. Plasmodium vivax hospitalizations in a monoendemic malaria region: severe vivax malaria?

    Science.gov (United States)

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

    2014-07-01

    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 fit the World Health Organization definition for severe malaria. Of these 81 individuals, 28 individuals were critically ill (0.4%, 95% confidence interval = 0.2-0.6%) with severe anemia (57%), shock (25%), lung injury (21%), acute renal failure (14%), or cerebral malaria (11%). Two potentially malaria-related deaths occurred. Compared with uncomplicated cases, individuals critically ill were older (38 versus 26 years old, P < 0.001), but similar in other regards. Severe vivax malaria monoinfection with critical illness is more common than previously thought. © The American Society of Tropical Medicine and Hygiene.

  4. 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

    2006-01-01

    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 s...

  5. 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...

  6. Reduction in serum sphingosine 1-phosphate concentration in malaria.

    Directory of Open Access Journals (Sweden)

    Chuchard Punsawad

    Full Text Available Sphingosine 1-phosphate (S1P is a lipid mediator formed by the metabolism of sphingomyelin which is involved in the endothelial permeability and inflammation. Although the plasma S1P concentration is reportedly decreased in patients with cerebral malaria, the role of S1P in malaria is still unclear. The purpose of this study was to examine the impact of malaria on circulating S1P concentration and its relationship with clinical data in malaria patients. Serum S1P levels were measured in 29 patients with P. vivax, 30 patients with uncomplicated P. falciparum, and 13 patients with complicated P. falciparum malaria on admission and on day 7, compared with healthy subjects (n = 18 as control group. The lowest level of serum S1P concentration was found in the complicated P. falciparum malaria group, compared with P. vivax, uncomplicated P. falciparum patients and healthy controls (all p < 0.001. In addition, serum S1P level was positively correlated with platelet count, hemoglobin and hematocrit levels in malaria patients. In conclusions, low levels of S1P are associated with the severity of malaria, and are correlated with thrombocytopenia and anemia. These findings highlight a role of S1P in the severity of malaria and support the use of S1P and its analogue as a novel adjuvant therapy for malaria complications.

  7. Malaria and Tropical Travel

    Centers for Disease Control (CDC) Podcasts

    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.

  8. 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...

  9. 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 ...

  10. Short communication: Cerebral Malaria Complicated by Blindness ...

    African Journals Online (AJOL)

    grade intermittent fever associated with multiple convulsions and prolonged coma. He regained consciousness after 12 days of treatment with intravenous quinine but was found to have blindness, sensory‑neural deafness and extrapyramidal ...

  11. Evaluation of Students' Conceptual Understanding of Malaria

    Science.gov (United States)

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

    2010-01-01

    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'…

  12. Role of viruses in Kenyan children presenting with acute encephalopathy in a malaria-endemic area

    NARCIS (Netherlands)

    Schubart, Christian D.; Mturi, Neema; Beld, Marcel G. H. M.; Wertheim, Pauline M.; Newton, Charles R. J. C.

    2006-01-01

    In malaria-endemic areas, it is difficult to differentiate between cerebral malaria (CM), bacterial meningitis, and viral encephalitis. We examined the cerebrospinal fluid of 49 children who fulfilled the World Health Organization's (WHO) definition of CM and in 47 encephalopathic children, without

  13. Cerebral microangiopathies

    International Nuclear Information System (INIS)

    Linn, Jennifer

    2011-01-01

    Cerebral microangiopathies are a very heterogenous group of diseases characterized by pathological changes of the small cerebral vessels. They account for 20 - 30 % of all ischemic strokes. Degenerative microangiopathy and sporadic cerebral amyloid angiography represent the typical acquired cerebral microangiopathies, which are found in over 90 % of cases. Besides, a wide variety of rare, hereditary microangiopathy exists, as e.g. CADASIL (Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy), Fabrys disease and MELAS syndrome (Mitochondrial myopathy, Encephalopathy, Lactic Acidosis, and Stroke-like episodes). (orig.)

  14. Structural Discrimination

    DEFF Research Database (Denmark)

    Thorsen, Mira Skadegård

    discrimination as two ways of articulating particular, opaque forms of racial discrimination that occur in everyday Danish (and other) contexts, and have therefore become normalized. I present and discuss discrimination as it surfaces in data from my empirical studies of discrimination in Danish contexts...

  15. DC8 and DC13 var genes associated with severe malaria bind avidly to diverse endothelial cells.

    Directory of Open Access Journals (Sweden)

    Marion Avril

    Full Text Available During blood stage infection, Plasmodium falciparum infected erythrocytes (IE bind to host blood vessels. This virulence determinant enables parasites to evade spleen-dependent killing mechanisms, but paradoxically in some cases may reduce parasite fitness by killing the host. Adhesion of infected erythrocytes is mediated by P. falciparum erythrocyte membrane protein 1 (PfEMP1, a family of polymorphic adhesion proteins encoded by var genes. Whereas cerebral binding and severe malaria are associated with parasites expressing DC8 and DC13 var genes, relatively little is known about the non-brain endothelial selection on severe malaria adhesive types. In this study, we selected P. falciparum-IEs on diverse endothelial cell types and demonstrate that DC8 and DC13 var genes were consistently among the major var transcripts selected on non-brain endothelial cells (lung, heart, bone marrow. To investigate the molecular basis for this avid endothelial binding activity, recombinant proteins were expressed from the predominant upregulated DC8 transcript, IT4var19. In-depth binding comparisons revealed that multiple extracellular domains from this protein bound brain and non-brain endothelial cells, and individual domains largely did not discriminate between different endothelial cell types. Additionally, we found that recombinant DC8 and DC13 CIDR1 domains exhibited a widespread endothelial binding activity and could compete for DC8-IE binding to brain endothelial cells, suggesting they may bind the same host receptor. Our findings provide new insights into the interaction of severe malaria adhesive types and host blood vessels and support the hypothesis that parasites causing severe malaria express PfEMP1 variants with a superior ability to adhere to diverse endothelial cell types, and may therefore endow these parasites with a growth and transmission advantage.

  16. Cerebral vasculitis

    International Nuclear Information System (INIS)

    Greenan, T.J.; Grossman, R.I.

    1990-01-01

    This paper reviews retrospectively MR, CT, and angiographic findings in patients with cerebral vasculitis in order to understand the strengths and weaknesses of the various imaging modalities, as well as the spectrum of imaging abnormalities in this disease entity. Studies were retrospectively reviewed in 12 patients with cerebral vasculitis proved by means of angiography and/or brain biopsy

  17. Clinical Manifestations, Treatment, and Outcome of Hospitalized Patients with Plasmodium vivax Malaria in Two Indian States: A Retrospective Study

    Directory of Open Access Journals (Sweden)

    Jagjit Singh

    2013-01-01

    Full Text Available This was a retrospective study done on 110 patients hospitalized with P. vivax malaria in three medical college hospitals, one in the union territory of Chandigarh and the other two in Gujarat, that is, Ahmedabad and Surat. The clinical presentation, treatment, and outcome were recorded. As per WHO criteria for severity, 19 of 110 patients had severe disease—six patients had clinical jaundice with hepatic dysfunction, three patients had severe anemia, three had spontaneous bleeding, two had acute respiratory distress syndrome, and one had cerebral malaria, hyperparasitemia, renal failure, circulatory collapse, and metabolic acidosis. All patients with severe P. vivax malaria survived, but one child with cerebral malaria had neurological sequelae. There was wide variation in the antimalarial treatment received at the three centres. Plasmodium vivax malaria can no longer be considered a benign condition. WHO guidelines for treatment of P. vivax malaria need to be reinforced.

  18. Malaria Treatment (United States)

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria Treatment (United States) Recommend on Facebook Tweet Share Compartir Treatment of Malaria: Guidelines For Clinicians (United States) Download PDF version ...

  19. Malaria and Travelers

    Science.gov (United States)

    ... Providers, Emergency Consultations, and General Public. Contact Us Malaria and Travelers for U.S. Residents Recommend on Facebook ... may be at risk for infection. Determine if malaria transmission occurs at the destinations Obtain a detailed ...

  20. 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...

  1. Differential discriminator

    International Nuclear Information System (INIS)

    Dukhanov, V.I.; Mazurov, I.B.

    1981-01-01

    A principal flowsheet of a differential discriminator intended for operation in a spectrometric circuit with statistical time distribution of pulses is described. The differential discriminator includes four integrated discriminators and a channel of piled-up signal rejection. The presence of the rejection channel enables the discriminator to operate effectively at loads of 14x10 3 pulse/s. The temperature instability of the discrimination thresholds equals 250 μV/ 0 C. The discrimination level changes within 0.1-5 V, the level shift constitutes 0.5% for the filling ratio of 1:10. The rejection coefficient is not less than 90%. Alpha spectrum of the 228 Th source is presented to evaluate the discriminator operation with the rejector. The rejector provides 50 ns time resolution

  2. Malaria in Children.

    Science.gov (United States)

    Cohee, Lauren M; Laufer, Miriam K

    2017-08-01

    Malaria is a leading cause of morbidity and mortality in endemic areas, leading to an estimated 438,000 deaths in 2015. Malaria is also an important health threat to travelers to endemic countries and should be considered in evaluation of any traveler returning from a malaria-endemic area who develops fever. Considering the diagnosis of malaria in patients with potential exposure is critical. Prompt provision of effective treatment limits the complications of malaria and can be life-saving. Understanding Plasmodium species variation, epidemiology, and drug-resistance patterns in the geographic area where infection was acquired is important for determining treatment choices. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Differentiating between dengue fever and malaria using hematological parameters in endemic areas of Thailand.

    Science.gov (United States)

    Kotepui, Manas; PhunPhuech, Bhukdee; Phiwklam, Nuoil; Uthaisar, Kwuntida

    2017-03-02

    Dengue fever (DF) and malaria are the two major public health concerns in tropical countries such as Thailand. Early differentiation between dengue and malaria could help clinicians to identify patients who should be closely monitored for signs of dengue hemorrhagic fever or severe malaria. This study aims to build knowledge on diagnostic markers that are used to discriminate between the infections, which frequently occur in malaria-endemic areas, such as the ones in Thailand. A retrospective study was conducted in Phop Phra Hospital, a hospital located in the Thailand-Burma border area, a malaria-endemic area, between 2013 and 2015. In brief, data on 336 patients infected with malaria were compared to data on 347 patients infected with DF. White blood cells, neutrophil, monocyte, eosinophil, neutrophil-lymphocyte ratio, and monocyte-lymphocyte ratio were significantly lower in patients with DF compared to patients with malaria (P dengue and malaria infection. This study concluded that several hematological parameters were different for diagnosing DF and malaria. A decision tree model revealed that using neutrophils, lymphocyte, MCHC, and gender was guided to discriminate patients with dengue and malaria infection. In addition, using these markers will thus lead to early detection, diagnosis, and prompt treatment of these tropical diseases.

  4. VEGF Promotes Malaria-Associated Acute Lung Injury in Mice

    Science.gov (United States)

    Carapau, Daniel; Pena, Ana C.; Ataíde, Ricardo; Monteiro, Carla A. A.; Félix, Nuno; Costa-Silva, Artur; Marinho, Claudio R. F.; Dias, Sérgio; Mota, Maria M.

    2010-01-01

    The spectrum of the clinical presentation and severity of malaria infections is broad, ranging from uncomplicated febrile illness to severe forms of disease such as cerebral malaria (CM), acute lung injury (ALI), acute respiratory distress syndrome (ARDS), pregnancy-associated malaria (PAM) or severe anemia (SA). Rodent models that mimic human CM, PAM and SA syndromes have been established. Here, we show that DBA/2 mice infected with P. berghei ANKA constitute a new model for malaria-associated ALI. Up to 60% of the mice showed dyspnea, airway obstruction and hypoxemia and died between days 7 and 12 post-infection. The most common pathological findings were pleural effusion, pulmonary hemorrhage and edema, consistent with increased lung vessel permeability, while the blood-brain barrier was intact. Malaria-associated ALI correlated with high levels of circulating VEGF, produced de novo in the spleen, and its blockage led to protection of mice from this syndrome. In addition, either splenectomization or administration of the anti-inflammatory molecule carbon monoxide led to a significant reduction in the levels of sera VEGF and to protection from ALI. The similarities between the physiopathological lesions described here and the ones occurring in humans, as well as the demonstration that VEGF is a critical host factor in the onset of malaria-associated ALI in mice, not only offers important mechanistic insights into the processes underlying the pathology related with malaria but may also pave the way for interventional studies. PMID:20502682

  5. Malaria og graviditet

    DEFF Research Database (Denmark)

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

    1992-01-01

    In regions where malaria is endemism, the disease is a recognised cause of complications of pregnancy such as spontaneous abortion, premature delivery, intrauterine growth retardation and foetal death. Malaria is seldom seen in pregnant women in Denmark but, during the past two years, the authors...... the patients but also their practitioners were unaware that malaria can occur several years after exposure. Three out of the four patients had employed malaria prophylaxis. As resistance to malarial prophylactics in current use is increasing steadily, chemoprophylaxis should be supplemented by mechanical...... 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...

  6. Severe and uncomplicated falciparum malaria in children from three regions and three ethnic groups in Cameroon: prospective study

    Directory of Open Access Journals (Sweden)

    Achidi Eric A

    2012-06-01

    Full Text Available Abstract Background To identify the factors that account for differences in clinical outcomes of malaria as well as its relationship with ethnicity, transmission intensity and parasite density. Methods A prospective study was conducted in nine health facilities in the Centre, Littoral and South West regions of Cameroon, and in three ethnic groups; the Bantu, Semi-Bantu and Foulbe. Children aged one month to 13 years, with diagnosis suggestive of malaria, were recruited and characterized using the WHO definition for severe and uncomplicated malaria. Malaria parasitaemia was determined by light microscopy, haematological analysis using an automated haematology analyser and glucose level by colorimetric technique. Results Of the febrile children screened, 971 of the febrile children screened fulfilled the inclusion criteria for specific malaria clinical phenotypes. Forty-nine (9.2% children had cerebral malaria, a feature that was similar across age groups, ethnicity and gender but lower (P P P = 0.009 and Foulbe (P = 0.026 counterparts in the Centre region. The overall study case fatality was 4.8 (47/755, with cerebral malaria being the only significant risk factor associated with death. Severe anaemia, though a common and major clinical presentation, was not significantly associated with risk of death. Conclusion About half of the acutely febrile children presented with severe malaria, the majority being cases of severe malaria anaemia, followed by respiratory distress and cerebral malaria. The latter two were less prevalent in the Centre region compared to the other regions. Cerebral malaria and hyperpyrexia were the only significant risk factors associated with death.

  7. Natural infection of Plasmodium brasilianum in humans: Man and monkey share quartan malaria parasites in the Venezuelan Amazon

    Directory of Open Access Journals (Sweden)

    Albert Lalremruata

    2015-09-01

    Interpretation: This study reports, for the first time, naturally acquired infections in humans with parasites termed as P. brasilianum. We conclude that quartan malaria parasites are easily exchanged between humans and monkeys in Latin America. We hypothesize a lack of host specificity in mammalian hosts and consider quartan malaria to be a true anthropozoonosis. Since the name P. brasilianum suggests a malaria species distinct from P. malariae, we propose that P. brasilianum should have a nomenclatorial revision in case further research confirms our findings. The expansive reservoir of mammalian hosts discriminates quartan malaria from other Plasmodium spp. and requires particular research efforts.

  8. Severe falciparum malaria in young children of the Kassena-Nankana district of northern Ghana.

    Science.gov (United States)

    Oduro, Abraham R; Koram, Kwadwo A; Rogers, William; Atuguba, Frank; Ansah, Patrick; Anyorigiya, Thomas; Ansah, Akosua; Anto, Francis; Mensah, Nathan; Hodgson, Abraham; Nkrumah, Francis

    2007-07-27

    Severe falciparum malaria in children was studied as part of the characterization of the Kassena-Nankana District Ghana for future malaria vaccine trials. Children aged 6-59 months with diagnosis suggestive of acute disease were characterized using the standard WHO definition for severe malaria. Of the total children screened, 45.2% (868/1921) satisfied the criteria for severe malaria. Estimated incidence of severe malaria was 3.4% (range: 0.4-8.3%) cases per year. The disease incidence was seasonal: 560 cases per year, of which 70.4% occurred during the wet season (June-October). The main manifestations were severe anaemia (36.5%); prolonged or multiple convulsions (21.6%); respiratory distress (24.4%) and cerebral malaria (5.4%). Others were hyperpyrexia (11.1%); hyperparasitaemia (18.5%); hyperlactaemia (33.4%); and hypoglycaemia (3.2%). The frequency of severe anaemia was 39.8% in children of six to 24 months of age and 25.9% in children of 25-60 months of age. More children (8.7%) in the 25-60 months age group had cerebral malaria compared with 4.4% in the 6-24 months age group. The overall case fatality ratio was 3.5%. Cerebral malaria and hyperlactataemia were the significant risk factors associated with death. Severe anaemia, though a major presentation, was not significantly associated with risk of death. Severe malaria is a frequent and seasonal childhood disease in northern Ghana and maybe an adequate endpoint for future malaria vaccine trials.

  9. Congenital malaria in China.

    Directory of Open Access Journals (Sweden)

    Zhi-Yong Tao

    2014-03-01

    Full Text Available BACKGROUND: Congenital malaria, in which infants are directly infected with malaria parasites from their mother prior to or during birth, is a potentially life-threatening condition that occurs at relatively low rates in malaria-endemic regions. It is recognized as a serious problem in Plasmodium falciparum-endemic sub-Saharan Africa, where recent data suggests that it is more common than previously believed. In such regions where malaria transmission is high, neonates may be protected from disease caused by congenital malaria through the transfer of maternal antibodies against the parasite. However, in low P. vivax-endemic regions, immunity to vivax malaria is low; thus, there is the likelihood that congenital vivax malaria poses a more significant threat to newborn health. Malaria had previously been a major parasitic disease in China, and congenital malaria case reports in Chinese offer valuable information for understanding the risks posed by congenital malaria to neonatal health. As most of the literature documenting congenital malaria cases in China are written in Chinese and therefore are not easily accessible to the global malaria research community, we have undertaken an extensive review of the Chinese literature on this subject. METHODS/PRINCIPAL FINDINGS: Here, we reviewed congenital malaria cases from three major searchable Chinese journal databases, concentrating on data from 1915 through 2011. Following extensive screening, a total of 104 cases of congenital malaria were identified. These cases were distributed mainly in the eastern, central, and southern regions of China, as well as in the low-lying region of southwest China. The dominant species was P. vivax (92.50%, reflecting the malaria parasite species distribution in China. The leading clinical presentation was fever, and other clinical presentations were anaemia, jaundice, paleness, diarrhoea, vomiting, and general weakness. With the exception of two cases, all patients

  10. [Cerebral protection].

    Science.gov (United States)

    Cattaneo, A D

    1993-09-01

    Cerebral protection means prevention of cerebral neuronal damage. Severe brain damage extinguishes the very "human" functions such as speech, consciousness, intellectual capacity, and emotional integrity. Many pathologic conditions may inflict injuries to the brain, therefore the protection and salvage of cerebral neuronal function must be the top priorities in the care of critically ill patients. Brain tissue has unusually high energy requirements, its stores of energy metabolites are small and, as a result, the brain is totally dependent on a continuous supply of substrates and oxygen, via the circulation. In complete global ischemia (cardiac arrest) reperfusion is characterized by an immediate reactive hyperemia followed within 20-30 min by a delayed hypoperfusion state. It has been postulated that the latter contributes to the ultimate neurologic outcome. In focal ischemia (stroke) the primary focus of necrosis is encircled by an area (ischemic penumbra) that is underperfused and contains neurotoxic substances such as free radicals, prostaglandins, calcium, and excitatory neurotransmitters. The variety of therapeutic effort that have addressed the question of protecting the brain reflects their limited success. 1) Barbiturates. After an initial enthusiastic endorsement by many clinicians and years of vigorous controversy, it can now be unequivocally stated that there is no place for barbiturate therapy following resuscitation from cardiac arrest. One presumed explanation for this negative statement is that cerebral metabolic suppression by barbiturates (and other anesthetics) is impossible in the absence of an active EEG. Conversely, in the event of incomplete ischemia EEG activity in usually present (albeit altered) and metabolic suppression and hence possibly protection can be induced with barbiturates. Indeed, most of the animal studies led to a number of recommendations for barbiturate therapy in man for incomplete ischemia. 2) Isoflurane. From a cerebral

  11. 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.

  12. Spatial discrimination and visual discrimination

    DEFF Research Database (Denmark)

    Haagensen, Annika M. J.; Grand, Nanna; Klastrup, Signe

    2013-01-01

    Two methods investigating learning and memory in juvenile Gottingen minipigs were evaluated for potential use in preclinical toxicity testing. Twelve minipigs were tested using a spatial hole-board discrimination test including a learning phase and two memory phases. Five minipigs were tested...... in a visual discrimination test. The juvenile minipigs were able to learn the spatial hole-board discrimination test and showed improved working and reference memory during the learning phase. Performance in the memory phases was affected by the retention intervals, but the minipigs were able to remember...... the concept of the test in both memory phases. Working memory and reference memory were significantly improved in the last trials of the memory phases. In the visual discrimination test, the minipigs learned to discriminate between the three figures presented to them within 9-14 sessions. For the memory test...

  13. Mass discrimination

    Energy Technology Data Exchange (ETDEWEB)

    Broeckman, A. [Rijksuniversiteit Utrecht (Netherlands)

    1978-12-15

    In thermal ionization mass spectrometry the phenomenon of mass discrimination has led to the use of a correction factor for isotope ratio-measurements. The correction factor is defined as the measured ratio divided by the true or accepted value of this ratio. In fact this factor corrects for systematic errors of the whole procedure; however mass discrimination is often associated just with the mass spectrometer.

  14. How discriminating are discriminative instruments?

    Science.gov (United States)

    Hankins, Matthew

    2008-05-27

    The McMaster framework introduced by Kirshner & Guyatt is the dominant paradigm for the development of measures of health status and health-related quality of life (HRQL). The framework defines the functions of such instruments as evaluative, predictive or discriminative. Evaluative instruments are required to be sensitive to change (responsiveness), but there is no corresponding index of the degree to which discriminative instruments are sensitive to cross-sectional differences. This paper argues that indices of validity and reliability are not sufficient to demonstrate that a discriminative instrument performs its function of discriminating between individuals, and that the McMaster framework would be augmented by the addition of a separate index of discrimination. The coefficient proposed by Ferguson (Delta) is easily adapted to HRQL instruments and is a direct, non-parametric index of the degree to which an instrument distinguishes between individuals. While Delta should prove useful in the development and evaluation of discriminative instruments, further research is required to elucidate the relationship between the measurement properties of discrimination, reliability and responsiveness.

  15. How discriminating are discriminative instruments?

    Directory of Open Access Journals (Sweden)

    Hankins Matthew

    2008-05-01

    Full Text Available Abstract The McMaster framework introduced by Kirshner & Guyatt is the dominant paradigm for the development of measures of health status and health-related quality of life (HRQL. The framework defines the functions of such instruments as evaluative, predictive or discriminative. Evaluative instruments are required to be sensitive to change (responsiveness, but there is no corresponding index of the degree to which discriminative instruments are sensitive to cross-sectional differences. This paper argues that indices of validity and reliability are not sufficient to demonstrate that a discriminative instrument performs its function of discriminating between individuals, and that the McMaster framework would be augmented by the addition of a separate index of discrimination. The coefficient proposed by Ferguson (Delta is easily adapted to HRQL instruments and is a direct, non-parametric index of the degree to which an instrument distinguishes between individuals. While Delta should prove useful in the development and evaluation of discriminative instruments, further research is required to elucidate the relationship between the measurement properties of discrimination, reliability and responsiveness.

  16. In vivo effect of chronic nicotine exposure on outcome of Plasmodium berghei ANKA malaria

    Directory of Open Access Journals (Sweden)

    Tsige Ketema

    2017-04-01

    Full Text Available Objective: To assess effect of nicotine, major addictive component of tobacco smoke, on outcomes of the deadly malaria parasite using mice as animal model. Methods: Male Swiss albino mice were treated with 100 and 200 µg/mL of nicotine in drinking water daily for 6 weeks followed by Plasmodium berghei ANKA (PbA infection. On the seventh day of post infection (p.i., physical, clinical, histopathological, biochemical and hematological parameters were assessed. Data were analyzed using SPSS software. Results: Nicotine was significantly (P < 0.05 positively associated with lower levels of hemoglobin (Hb, hematocrit (HCT, red blood cells (RBCs, C-reactive protein (CRP and uric acid (UA, higher risk to incidence of pulmonary edema, elevated level of liver and kidney biomarkers. Also significant increment (P < 0.01 of monocyte-lymphocyte count ratio (MLCR was observed. Risk to high temperature, lower platelet count, high parastemia and cerebral malaria was lesser in mice treated with nicotine (100 and 200 µg/mL followed by PbA infection than the positive control. Lack of neurological symptoms might be accounted to the anti-inflammatory property of nicotine that could inhibit production of pro-inflammatory mediators responsible for occurrence of cerebral malaria. Conclusions: This study showed that despite down regulation of most cerebral malaria symptoms nicotine was strongly associated with increased risk to most clinical symptoms of malaria. Thus, like in respiratory infections, nicotine use might enhance susceptibility to malaria.

  17. A STAT6 Intronic Single-Nucleotide Polymorphism is Associated with Clinical Malaria in Ghanaian Children

    Directory of Open Access Journals (Sweden)

    Daniel Amoako-Sakyi

    2016-01-01

    Full Text Available Malaria pathogenesis may be influenced by IgE responses and cytokine cross-regulation. Several mutations in the IL-4/STAT6 signaling pathway can alter cytokine cross-regulation and IgE responses during a Plasmodium falciparum malarial infection. This study investigated the relationship between a STAT6 intronic single-nucleotide polymorphism (rs3024974, total IgE, cytokines, and malaria severity in 238 Ghanaian children aged between 0.5 and 13 years. Total IgE and cytokine levels were measured by ELISA, while genotyping was done by polymerase chain reaction-restriction fragment length polymorphism (RFLP. Compared with healthy controls, heterozygosity protected against clinical malaria: uncomplicated malaria (odds ratios [OR] = 0.13, P < 0.001, severe malarial anemia (OR = 0.18, P < 0.001, and cerebral malaria (OR = 0.39, P = 0.022. Levels of total IgE significantly differed among malaria phenotypes (P = 0.044 and rs3024974 genotypes (P = 0.037. Neither cytokine levels nor IL-6/IL-10 ratios were associated with malaria phenotypes or rs3024974 genotypes. This study suggests a role for rs3024974 in malaria pathogenesis and offers further insights into an IL-4/STAT6 pathway mutation in malaria pathogenesis.

  18. Septic Shock due to Cytomegalovirus Infection in Acute Respiratory Distress Syndrome after Falciparum Malaria.

    Science.gov (United States)

    Harbarth; Meyer; Grau; Loutan; Ricou

    1997-09-01

    Incidence of falciparum malaria in developed countries has increased in recent years due to tourism to tropical countries and immigration from Asia and Africa. In Switzerland, about 250 cases of malaria were reported in 1994 to the Federal Office of Health, including three cases with fatal outcome.1 The most commonly described complications of plasmodia infection are cerebral malaria, acute renal failure, and severe anemia with disseminated intravascular coagulation. However, pulmonary involvement occurs in 3 to 10% of cases and represents the most serious complication of this infection, with a lethality of 70%.2,3 Furthermore, a pronounced general immunosuppression has been reported in malaria patients, which may predispose them to opportunistic infections.4 We report a case of Plasmodium falciparum infection complicated by severe acute respiratory distress syndrome (ARDS) with development of systemic cytomegalovirus (CMV) infection leading to death. This evolution implies a severe immune deficiency associated with malaria, as previously suggested in the literature.

  19. Testing in mice the hypothesis that melanin is protective in malaria infections.

    Directory of Open Access Journals (Sweden)

    Michael Waisberg

    Full Text Available Malaria has had the largest impact of any infectious disease on shaping the human genome, exerting enormous selective pressure on genes that improve survival in severe malaria infections. Modern humans originated in Africa and lost skin melanization as they migrated to temperate regions of the globe. Although it is well documented that loss of melanization improved cutaneous Vitamin D synthesis, melanin plays an evolutionary ancient role in insect immunity to malaria and in some instances melanin has been implicated to play an immunoregulatory role in vertebrates. Thus, we tested the hypothesis that melanization may be protective in malaria infections using mouse models. Congenic C57BL/6 mice that differed only in the gene encoding tyrosinase, a key enzyme in the synthesis of melanin, showed no difference in the clinical course of infection by Plasmodium yoelii 17XL, that causes severe anemia, Plasmodium berghei ANKA, that causes severe cerebral malaria or Plasmodium chabaudi AS that causes uncomplicated chronic disease. Moreover, neither genetic deficiencies in vitamin D synthesis nor vitamin D supplementation had an effect on survival in cerebral malaria. Taken together, these results indicate that neither melanin nor vitamin D production improve survival in severe malaria.

  20. Malaria, malnutrition, and birthweight

    DEFF Research Database (Denmark)

    Cates, Jordan E.; Unger, Holger W.; Briand, Valerie

    2017-01-01

    were identified by the Maternal Malaria and Malnutrition (M3) initiative using a convenience sampling approach and were eligible for pooling given adequate ethical approval and availability of essential variables. Study-specific adjusted effect estimates were calculated using inverse probability...... be multiplicative interaction between malaria infection at enrollment and low MUAC within studies conducted in Africa; however, this finding was not consistent on the additive scale, when accounting for multiple comparisons, or when using other definitions of malaria and malnutrition. The major limitations...... of the study included availability of only 2 cross-sectional measurements of malaria and the limited availability of ultrasound-based pregnancy dating to assess impacts on preterm birth and fetal growth in all studies.  Conclusions : Pregnant women with malnutrition and malaria infection are at increased risk...

  1. Severe malaria in Europe

    DEFF Research Database (Denmark)

    Kurth, Florian; Develoux, Michel; Mechain, Matthieu

    2017-01-01

    BACKGROUND: Malaria remains one of the most serious infections for travellers to tropical countries. Due to the lack of harmonized guidelines a large variety of treatment regimens is used in Europe to treat severe malaria. METHODS: The European Network for Tropical Medicine and Travel Health (Trop......Net) conducted an 8-year, multicentre, observational study to analyse epidemiology, treatment practices and outcomes of severe malaria in its member sites across Europe. Physicians at participating TropNet centres were asked to report pseudonymized retrospective data from all patients treated at their centre...... for microscopically confirmed severe Plasmodium falciparum malaria according to the 2006 WHO criteria. RESULTS: From 2006 to 2014 a total of 185 patients with severe malaria treated in 12 European countries were included. Three patients died, resulting in a 28-day survival rate of 98.4%. The majority of infections...

  2. 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...

  3. United Cerebral Palsy

    Science.gov (United States)

    ... your local affiliate Find your local affiliate United Cerebral Palsy United Cerebral Palsy (UCP) is a trusted resource for individuals with Cerebral Palsy and other disabilities and their networks. Individuals with ...

  4. 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 ...

  5. Birth Defects: Cerebral Palsy

    Science.gov (United States)

    ... Loss > Birth defects & other health conditions > Cerebral palsy Cerebral palsy E-mail to a friend Please fill in ... this page It's been added to your dashboard . Cerebral palsy (also called CP) is a group of conditions ...

  6. Frequently Asked Questions (FAQs) about Malaria

    Science.gov (United States)

    ... Facebook Tweet Share Compartir The Disease What is Malaria? Malaria is a serious and sometimes fatal disease ... cycle of disease and poverty. How People Get Malaria (Transmission) How is malaria transmitted? Usually, people get ...

  7. 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.

  8. Malaria and Vascular Endothelium

    International Nuclear Information System (INIS)

    Alencar, Aristóteles Comte Filho de; Lacerda, Marcus Vinícius Guimarães de; Okoshi, Katashi; Okoshi, Marina Politi

    2014-01-01

    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

  9. Antibodies to ICAM1-binding PfEMP1-DBLβ are biomarkers of protective immunity to malaria in a cohort of young children from Papua New Guinea

    DEFF Research Database (Denmark)

    Tessema, Sofonias K; Utama, Digjaya; Chesnokov, Olga

    2018-01-01

    Plasmodium falciparum Erythrocyte Membrane Protein 1 (PfEMP1) mediates parasite sequestration to the cerebral microvasculature via binding of DBLβ domains to Intercellular Adhesion Molecule 1 (ICAM1) and is associated with severe cerebral malaria. In a cohort of 187 young children from Papua New ...

  10. Cerebral palsy

    International Nuclear Information System (INIS)

    Truwit, C.L.; Barkovich, A.J.; Koch, T.; Ferreiro, D.

    1990-01-01

    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)

  11. 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.......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....

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

    International Nuclear Information System (INIS)

    KV Kanodia; AV Vanikar

    2010-01-01

    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).

  13. Changing the Malaria Environment

    African Journals Online (AJOL)

    tega

    Malaria in the 21st Century” was held at ... seconds, and more than one million deaths occur annually from this disease. ... Biological control, for example the use of predatory fish against mosquito larvae and the use of other predatory insects.

  14. 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...

  15. 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...... 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...... of 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...

  16. Artemisinin derivatives for treating severe malaria.

    Science.gov (United States)

    McIntosh, H M; Olliaro, P

    2000-01-01

    Artemisinin derivatives may have advantages over quinoline drugs for treating severe malaria since they are fast acting and effective against quinine resistant malaria parasites. The objective of this review was to assess the effects of artemisinin drugs for severe and complicated falciparum malaria in adults and children. We searched the Cochrane Infectious Diseases Group trials register, Cochrane Controlled Trials Register, Medline, Embase, Science Citation Index, Lilacs, African Index Medicus, conference abstracts and reference lists of articles. We contacted organisations, researchers in the field and drug companies. Randomised and pseudo-randomised trials comparing artemisinin drugs (rectal, intramuscular or intravenous) with standard treatment, or comparisons between artemisinin derivatives in adults or children with severe or complicated falciparum malaria. Eligibility, trial quality assessment and data extraction were done independently by two reviewers. Study authors were contacted for additional information. Twenty three trials are included, allocation concealment was adequate in nine. Sixteen trials compared artemisinin drugs with quinine in 2653 patients. Artemisinin drugs were associated with better survival (mortality odds ratio 0.61, 95% confidence interval 0.46 to 0.82, random effects model). In trials where concealment of allocation was adequate (2261 patients), this was barely statistically significant (odds ratio 0.72, 95% CI 0.54 to 0.96, random effects model). In 1939 patients with cerebral malaria, mortality was also lower with artemisinin drugs overall (odds ratio 0.63, 95% CI 0.44 to 0.88, random effects model). The difference was not significant however when only trials reporting adequate concealment of allocation were analysed (odds ratio 0.78, 95% CI 0.55 to 1.10, random effects model) based on 1607 patients. No difference in neurological sequelae was shown. Compared with quinine, artemisinin drugs showed faster parasite clearance from

  17. 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.

  18. Renewed mobilization against malaria.

    Science.gov (United States)

    1991-01-01

    1 million people die in the world from malaria annually, 800,000 of whom are 5 year old children in Sub-Sahara Africa. Further it affects 270 million people. In fact, 110 million develop malaria, 90 million of whom are from Sub-Saharan Africa. Thus WHO has introduced a new world initiative for malaria control to reverse the worsening trend that began in the mid 1970s. In October 1991, 150 officials from 50 African, Asian, and Latin American countries and participants from UN cooperation and development agencies and bilateral agencies attended an interregional conference at the WHO Regional office for Africa in Brazzaville, Congo. It strove to evaluate malaria situations specific to Africa, to update the malaria control plan in Africa, and to contribute to the development of an implementable world strategy. This world strategy needs to consider the local situation and encourage participation of the government and people of affected countries. Further individuals, communities, and various sectors of the national economy including those involved in health, education, development, and agriculture need to participate in malaria control. In addition, for this strategy to work, most countries must strengthen the management and financing of health services to meet their needs. For example, local populations must share local operating costs such as those for essential drugs and mosquito control operations. Community participation must also include personal protection such as impregnated bed nets and environmental measures. Besides malaria control must be integrated into the existing health system at country, provincial, and peripheral levels. In sum, improved case management, control of malaria transmission, and prevention and control of epidemics form the basis for the new strategy.

  19. 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.

  20. Severe and complicated malaria in KwaZulu-Natal | Soni | South ...

    African Journals Online (AJOL)

    regression model showed a high parasite load and cerebral malaria (relative risks of 11.9 and 51.8 respectively) and high urea levels to be the significant predictors of poor outcome (95% confidence ... replacement and early referral to a tertiary hospital with facilities for intensive monitoring and supportive treatment.

  1. Laboratory diagnostics of malaria

    Science.gov (United States)

    Siahaan, L.

    2018-03-01

    Even now, malaria treatment should only be administered after laboratory confirmation. There are several principal methods for diagnosing malaria. All these methods have their disadvantages.Presumptive treatment of malaria is widely practiced where laboratory tests are not readily available. Microscopy of Giemsa-stained thick and thin blood films remains the gold standard for the diagnosis of malaria infection. The technique of slide preparation, staining and reading are well known and standardized, and so is the estimate of the parasite density and parasite stages. Microscopy is not always available or feasible at primary health services in limited resource settings due to cost, lack of skilled manpower, accessories and reagents required. Rapid diagnostic tests (RDTs) are potential tools for parasite-based diagnosis since the tests are accurate in detecting malaria infections and are easy to use. The test is based on the capture of parasite antigen that released from parasitized red blood cells using monoclonal antibodies prepared against malaria antigen target. Polymerase Chain Reaction (PCR), depend on DNA amplification approaches and have higher sensitivity than microscopy. PCR it is not widely used due to the lack of a standardized methodology, high costs, and the need for highly-trained staff.

  2. Hari Malaria Sedunia 2013 Investasi Di Masa Depan. Taklukkan Malaria

    Directory of Open Access Journals (Sweden)

    Hotnida Sitorus

    2017-02-01

    Full Text Available Abstract Malaria is still the global health problems, World Health Organization estimates that malaria causes death of approximately 660.000 in 2010, most of the age of the children in the region of sub-Saharan Africa. World Malaria Day 2013 assigned the theme “Invest in the future. Defeat malaria”. It takes political will and collective action to jointly combat malaria through malaria elimination. Needed more new donors to be involved in global partnerships against malaria. These partnerships exist, one of which is support of funding or facility for malaria endemic countries which do not have sufficient resources to control malaria. A lot of effort has been done or is still in the development stage. The use of long-lasting insecticidal nets appropriately can reduce malaria cases. The use of rapid diagnostic test, especially in remote areas and health facility with no microscopy, is very beneficial for patients to get prompt treatment. The control of malaria through integrated vector management is a rational decision making process to optimize the use of resources in the control of vector. Sterile insect technique has a promising prospect and expected to replace the role of chemical insecticides that have negative impact both on the environment and target vector (resistance. Keywords: Malaria, long-lasting insecticidal nets, rapid diagnostic test Abstrak Malaria masih menjadi masalah kesehatan dunia, Organisasi Kesehatan Dunia (WHO memperkirakan malaria menyebabkan kurang lebih 660.000 kematian pada tahun 2010, kebanyakan usia anak-anak di wilayah Sub-Sahara Afrika. Pada peringatan hari malaria dunia tahun 2013 ditetapkan tema “Investasi di masa depan. Taklukkan malaria”. Dibutuhkan kemauan politik dan tindakan kolektif untuk bersama-sama memerangi malaria melalui gerakan eliminasi malaria. Diperlukan lebih banyak donor baru untuk turut terlibat dalam kemitraan global melawan malaria. Wujud kemitraan tersebut salah satunya adalah

  3. Cerebral Palsy (For Teens)

    Science.gov (United States)

    ... Staying Safe Videos for Educators Search English Español Cerebral Palsy KidsHealth / For Teens / Cerebral Palsy What's in this ... do just what everyone else does. What Is Cerebral Palsy? Cerebral palsy (CP) is a disorder of the ...

  4. Knowledge of malaria and practice of home management of malaria ...

    African Journals Online (AJOL)

    Background: Malaria is a preventable and treatable disease associated with high morbidity and mortality. It is the 3rd leading cause of death for children under five years worldwide. Home-based management of malaria may go a long way in reducing the attending morbidity and mortality associated with malaria in this group ...

  5. Case management of malaria: Diagnosis

    African Journals Online (AJOL)

    triggering control programme action, and detecting gametocyte carriers, who may ... clinical malaria does not generally apply to local-born populations, although it ... deficiencies in the quality of malaria diagnosis in routine laboratories. Quality ...

  6. MALARIA VACCINE: MYTH OR REALITY?

    African Journals Online (AJOL)

    Femi Olaleye

    Malaria currently remains the highest killer disease nationwide despite existing control measures. Malaria vaccine ... that malaria could be eliminated or at least controlled. However, because of changes in vector behaviour, drug resistance, manpower constraints for public ..... Although animal host models are different from ...

  7. Malaria and Agriculture in Kenya

    International Development Research Centre (IDRC) Digital Library (Canada)

    Nancy Minogue

    die every day from malaria, conventional efforts to control the disease have not worked. Malaria parasites are .... and other animals. Mosquito nets. Provide insecticide-treated bednets to groups at high risk for malaria, namely young children and pregnant women, through partnerships with nongovernmental organizations ...

  8. Towards A Malaria Vaccine?

    Directory of Open Access Journals (Sweden)

    B S GARG

    1990-12-01

    Full Text Available The last few years have seen a marked change in the understanding of malaria mmunology.We have very little knowledge on immunity of Malaria based on experiments in humanbeings due to ethical reasons. Whatsoever our knowledge exists at present is based onexperimentas in mice and monkey. However it is clear that it is sporzoite or merozoitewhich is directly exposed to our immune system in the life cycle of Malaria parasite. On thebasis of human experiments we can draw inference that immunity to malaria is species.specific (on cross immunity, stage specific and strain specific as well acquired in the response to surface antigen and relapsed antigen although the parasite also demonstrates escape machanism to immune system.So the host system kills or elimi nate the parasite by means of (a Antbody to extracell~ular form of parasite with the help of mechanism of Block invasion, Agglutination or opsonization and/or (b Cellular machanism-either by phago-cytosis of parasite or by antibody dependent cellular cytotoxicity ABCC (? or by effects of mediators like tumor necrosis fJ.ctor (TNF in cerebaral malaria or crisis forming factor as found in sudan or by possible role of lysis mechanism.However, inspite of all these theories the parasite has been able to invade the immunesystem by virtue of its intracellular development stage specificity, sequestration in capillaries and also by its unusual characteristics of antigenic diversity and antigenic variation.

  9. Roll back malaria update.

    Science.gov (United States)

    1999-10-01

    This article presents the activities under WHO's Roll Back Malaria (RBM) program in Asia, particularly in Nepal, Indonesia, India, Bangladesh, Sri Lanka and the Philippines. In India, the RBM program will start in 5 districts with a major malaria problem. A national committee has been formed by researchers, which will be able to provide operational and strategic support and research expertise in relation to malaria. In Bangladesh, the RBM program was initiated in the sparsely populated hill tract areas of Banderban and Chittagong where access to health care is very poor. At the district level, effective partnerships with private practitioners, politicians, community leaders, school teachers, the press and district Ministry of Health officials are operating to plan for rolling back malaria. In Myanmar, Cambodia, Lao People's Democratic Republic, Yunnan province of China, Vietnam, and Thailand, the focus of the RBM program was to move health care closer to the malaria-infected communities. WHO¿s Global Health Leadership Fellowship Programme, supported by the UN Foundation and Rockefeller Foundation, enables potential leaders to experience the work of UN agencies and contribute to the work of the organization for 2 years. Three out of four persons appointed to the RBM program received prestigious awards: Dr. Paola Marchesini of Brazil; Dr. Tieman Diarra of Mali; and Dr. Bob Taylor of the UK.

  10. Cerebral edema in drug addicts

    Directory of Open Access Journals (Sweden)

    Daruši Dragana J.

    2014-01-01

    Full Text Available Background/Aim. The effect of drugs leaves permanent consequences on the brain, organic in type, followed by numerous manifestations, and it significantly affects the development of mental dysfunctions. The clinicians are often given a task to estimate a patient’s personality during treatment or during experts estimate of a drug addict. The aim of this research was to determine the differences, if any, in characteristics of addicts experience and personality traits in drug addicts with or without cerebral edema. Methods. The research was conducted on a sample of 252 male drug addicts, the average age of 23.3 (SD = 4.3 years. Cerebral edema was confirmed on magnetic resonance (MR images of the brain performed during the treatment of the addicts. The participants were tested by the psychologists using Minnesota Multiphasic Personality Inventory (MMPI-201 test, and the data were processed using canonical discriminate analysis within the SPSS program. The dependent variable in the study was cerebral edema. A block of independent variables, designed for the requirements of this study, consisted of two subgroups. The first one consisted of 12 variables describing the relevant characteristics of drug abuse. The second subgroup consisted of 8 psychopathological tendencies in the personality defined by the mentioned test. Results. Cerebral edema was confirmed in 52 (20.63% of the drug addicts. The differences between the groups of drug addicts with and without cerebral edema were determined in the following: the time span of taking drugs (0.301, use of alcohol parallel with drugs (0.466, and treatment for addiction (0.603. In the drug addicts with a cerebral edema, MMPI-201 confirmed the increase in the scales for hypochondria, psychopathic deviations and psychastenia, and the decrease in the scales for schizophrenia and depression. Conclusion. Our study confirmed a possible connection between cerebral edema and personality traits in a number of the

  11. The economic burden of malaria.

    Science.gov (United States)

    Gallup, J L; Sachs, J D

    2001-01-01

    Malaria and poverty are intimately connected. Controlling for factors such as tropical location, colonial history, and geographical isolation, countries with intensive malaria had income levels in 1995 of only 33% that of countries without malaria, whether or not the countries were in Africa. The high levels of malaria in poor countries are not mainly a consequence of poverty. Malaria is geographically specific. The ecological conditions that support the more efficient malaria mosquito vectors primarily determine the distribution and intensity of the disease. Intensive efforts to eliminate malaria in the most severely affected tropical countries have been largely ineffective. Countries that have eliminated malaria in the past half century have all been either subtropical or islands. These countries' economic growth in the 5 years after eliminating malaria has usually been substantially higher than growth in the neighboring countries. Cross-country regressions for the 1965-1990 period confirm the relationship between malaria and economic growth. Taking into account initial poverty, economic policy, tropical location, and life expectancy, among other factors, countries with intensive malaria grew 1.3% less per person per year, and a 10% reduction in malaria was associated with 0.3% higher growth. Controlling for many other tropical diseases does not change the correlation of malaria with economic growth, and these diseases are not themselves significantly negatively correlated with economic growth. A second independent measure of malaria has a slightly higher correlation with economic growth in the 1980-1996 period. We speculate about the mechanisms that could cause malaria to have such a large impact on the economy, such as foreign investment and economic networks within the country.

  12. Cerebral Vasculitis

    Directory of Open Access Journals (Sweden)

    Fariborz Khorvash

    2017-02-01

    Full Text Available Introduction: Vasculitis is an inflammation systems may be involved of blood vessels due to various origins. Vessels of the peripheral and/or central nervous. Vasculitis of the CNS is rare and occurs in the context of systemic diseases or as primary angiitis of the CNS. Epidemiology: The overall incidence of primary vasculitis is about 40/1,000,000 persons [excluding giant cell (temporal arteritis, GCA]. Its incidence increases with age. The incidence of GCA is much higher (around 200/1,000,000 persons in the age group[50 years. Clinical Presentation: Clinical and pathological presentation in CNS vasculitis represents a wide spectrum. Among others, headache, cranial nerve affections, encephalopathy, seizures, psychosis, myelitis, stroke, intracranial haemorrhage and aseptic meningoencephalitis are described. Primary and secondary vasculitides leading more frequently to CNS manifestations are discussed. Primary and secondary Vasculitides: Including Giant Cell (Temporal Arteritis , Takayasu arteritis, Polyarteritis nodosa, Primary angiitis of the CNS, Wegener’s granulomatosis, and Connective tissue diseases, such as systemic lupus erythematosus (SLE, scleroderma, rheumatoid arthritis, mixed connective disease and Sjögren syndrome, are systemic immune-mediated diseases that lead to multiple organ affections. Cerebral Vasculitis: Imaging and Differential Diagnosis: Vasculitides represent a heterogeneous group of inflammatory diseases that affect blood vessel walls of varying calibers (inflammatory vasculopathy. Since the devastating symptoms of CNS vasculitis are at least partially reversible, early diagnosis and appropriate treatment are important. In order to establish a differential diagnosis clinical features, disease progression, age of onset, blood results, as well as CSF examinations have to be taken into consideration. Neuroimaging techniques, such as MRI and DSA, play a central role in the diagnosis and disease monitoring .The diagnostic

  13. Erythropoietin and its receptors in the brainstem of adults with fatal falciparum malaria

    Directory of Open Access Journals (Sweden)

    White Nicholas J

    2009-11-01

    Full Text Available Abstract Background Facilitation of endogenous neuroprotective pathways, such as the erythropoietin (Epo pathway, has been proposed as adjuvant treatment strategies in cerebral malaria. Whether different endogenous protein expression levels of Epo or differences in the abundance of its receptor components could account for the extent of structural neuropathological changes or neurological complications in adults with severe malaria was investigated. Methods High sensitivity immunohistochemistry was used to assess the frequency, distribution and concordance of Epo and components of its homodimeric and heteromeric receptors, Epo receptor and CD131, within the brainstem of adults who died of severe malaria. The following relationships with Epo and its receptor components were also defined: (i sequestration and indicators of hypoxia; (ii vascular damage in the form of plasma protein leakage and haemorrhage; (iii clinical complications and neuropathological features of severe malaria disease. Brainstems of patients dying in the UK from unrelated non-infectious causes were examined for comparison. Results The incidence of endogenous Epo in parenchymal brain cells did not greatly differ between severe malaria and non-neurological UK controls at the time of death. However, EpoR and CD131 labelling of neurons was greater in severe malaria compared with non-neurological controls (P = .009. EpoR labelling of vessels was positively correlated with admission peripheral parasite count (P = .01 and cerebral sequestration (P P = .001. There were no significant correlations with indicators of vascular damage, neuronal chromatolysis, axonal swelling or vital organ failure. Conclusion Cells within the brainstem of severe malaria patients showed protein expression of Epo and its receptor components. However, the incidence of endogeneous expression did not reflect protection from vascular or neuronal injury, and/or clinical manifestations, such as coma. These

  14. Malaria-induced changes in host odors enhance mosquito attraction.

    Science.gov (United States)

    De Moraes, Consuelo M; Stanczyk, Nina M; Betz, Heike S; Pulido, Hannier; Sim, Derek G; Read, Andrew F; Mescher, Mark C

    2014-07-29

    Vector-borne pathogens may alter traits of their primary hosts in ways that influence the frequency and nature of interactions between hosts and vectors. Previous work has reported enhanced mosquito attraction to host organisms infected with malaria parasites but did not address the mechanisms underlying such effects. Here we document malaria-induced changes in the odor profiles of infected mice (relative to healthy individuals) over the course of infection, as well as effects on the attractiveness of infected hosts to mosquito vectors. We observed enhanced mosquito attraction to infected mice during a key period after the subsidence of acute malaria symptoms, but during which mice remained highly infectious. This attraction corresponded to an overall elevation in the volatile emissions of infected mice observed during this period. Furthermore, data analyses--using discriminant analysis of principal components and random forest approaches--revealed clear differences in the composition of the volatile blends of infected and healthy individuals. Experimental manipulation of individual compounds that exhibited altered emission levels during the period when differential vector attraction was observed also elicited enhanced mosquito attraction, indicating that compounds being influenced by malaria infection status also mediate vector host-seeking behavior. These findings provide important insights into the cues that mediate vector attraction to hosts infected with transmissible stages of malaria parasites, as well as documenting characteristic changes in the odors of infected individuals that may have potential value as diagnostic biomarkers of infection.

  15. 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

  16. Plasmodium falciparum-induced severe malaria with acute kidney injury and jaundice: a case report

    Science.gov (United States)

    Baswin, A.; Siregar, M. L.; Jamil, K. F.

    2018-03-01

    P. falciparum-induced severe malaria with life-threatening complications like acute kidney injury (AKI), jaundice, cerebral malaria, severe anemia, acidosis, and acute respiratory distress syndrome (ARDS). A 31-year-old soldier man who works in Aceh Singkil, Indonesia which is an endemic malaria area presented with a paroxysm of fever, shaking chills and sweats over four days, headache, arthralgia, abdominal pain, pale, jaundice, and oliguria. Urinalysis showed hemoglobinuria. Blood examination showed hemolytic anemia, thrombocytopenia, and hyperbilirubinemia. Falciparum malaria was then confirmed by peripheral blood smear, antimalarial medications were initiated, and hemodialysis was performed for eight times. The patient’s condition and laboratory results were quickly normalized. We report a case of P. falciparum-induced severe malaria with AKI and jaundice. The present case suggests that P. falciparum may induce severe malaria with life-threatening complications, early diagnosis and treatment is important to improve the quality of life of patients. Physicians must be alert for correct diagnosis and proper management of imported tropical malaria when patients have travel history in endemic areas.

  17. 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.

  18. Vacuna contra la malaria

    OpenAIRE

    Patarroyo, Manuel Elkin

    2017-01-01

    La malaria es una enfermedad parasitaria producida por la picadura de un mosquito; una afección que en el año 2015 registró 212 millones de casos y 429.000 muertes. Cada dos minutos, la malaria provocó la muerte de un niño menor de cinco años en todo el mundo. Diferentes científicos a lo largo de todo el mundo han hecho múltiples intentos para combatir esta enfermedad con una vacuna efectiva que pueda erradicarla de raíz.

  19. Malaria resistance | Iyabo | Nigerian Medical Practitioner

    African Journals Online (AJOL)

    Age and puberty have been found to contribute to malaria resistance. It is expected that knowledge of natural resistance to malaria may aid in developing Vaccines against this deadly disease. Keywords: malaria resistance, puberty, malaria economy, malaria vaccine. Nigerian Medical Practitioner Vol. 49(5) 2006: 133-142 ...

  20. [Cerebral aspergillosis].

    Science.gov (United States)

    Tattevin, P; Jauréguiberry, S; Gangneux, J-P

    2004-05-01

    The brain is almost always a localization of invasive aspergillosis, after hematogenous spread from pulmonary aspergillosis. Brain aspergilosis is not rare and is one of the worst prognosis factors of invasive aspergillosis. The incidence of this severe mycosis is currently on the rise due to the development of major immunosuppressive treatments. Brain aspergillosis is noteworthy for its vascular tropism, leading to infectious cerebral vasculitis, mainly involving thalamoperforating and lenticulostriate arteries, with a high frequency of thalamic or basal nuclei lesions. Extra-neurologic features that suggest this diagnosis are: i) risk factors for invasive aspergillosis (major or prolonged neutropenia, hematologic malignancies, prolonged corticosteroid treatment, bone marrow or solid organ transplant, AIDS); ii) persistent fever not responding to presumptive antibacterial treatment; iii) respiratory signs (brain aspergillosis is associated with pulmonary aspergillosis in 80 to 95 p. 100 of cases). Perspectives. Two recent major improvements in brain aspergillosis management must be outlined: i) for diagnostic purposes, the development of testing for Aspergillus antigenemia (a non-invasive procedure with good diagnostic value for invasive aspergillosis); ii) for therapeutic purposes, the demonstration that voriconazole is better than amphotericin B in terms of clinical response, tolerance and survival, for all types of invasive aspergillosis, the benefit being probably even greater in case of brain aspergillosis because of the good diffusion of voriconazole into the central nervous system. Brain aspergillosis is a severe emerging opportunistic infection for which diagnostic and therapeutic tools have recently improved. Thus, this diagnostic must be suspected early, especially in the immunocompromised patient, in the event of respiratory symptoms and when the brain lesions are localized in the central nuclei and the thalamus.

  1. Quantification of extra-cerebral and cerebral hemoglobin concentrations during physical exercise using time-domain near infrared spectroscopy

    OpenAIRE

    Auger, Héloïse; Bherer, Louis; Boucher, Étienne; Hoge, Richard; Lesage, Frédéric; Dehaes, Mathieu

    2016-01-01

    Fitness is known to have beneficial effects on brain anatomy and function. However, the understanding of mechanisms underlying immediate and long-term neurophysiological changes due to exercise is currently incomplete due to the lack of tools to investigate brain function during physical activity. In this study, we used time-domain near infrared spectroscopy (TD-NIRS) to quantify and discriminate extra-cerebral and cerebral hemoglobin concentrations and oxygen saturation (SO2) in young adults...

  2. Fighting discrimination.

    Science.gov (United States)

    Wientjens, Wim; Cairns, Douglas

    2012-10-01

    In the fight against discrimination, the IDF launched the first ever International Charter of Rights and Responsibilities of People with Diabetes in 2011: a balance between rights and duties to optimize health and quality of life, to enable as normal a life as possible and to reduce/eliminate the barriers which deny realization of full potential as members of society. It is extremely frustrating to suffer blanket bans and many examples exist, including insurance, driving licenses, getting a job, keeping a job and family affairs. In this article, an example is given of how pilots with insulin treated diabetes are allowed to fly by taking the responsibility of using special blood glucose monitoring protocols. At this time the systems in the countries allowing flying for pilots with insulin treated diabetes are applauded, particularly the USA for private flying, and Canada for commercial flying. Encouraging developments may be underway in the UK for commercial flying and, if this materializes, could be used as an example for other aviation authorities to help adopt similar protocols. However, new restrictions implemented by the new European Aviation Authority take existing privileges away for National Private Pilot Licence holders with insulin treated diabetes in the UK. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  3. Pulmonary manifestations of malaria

    International Nuclear Information System (INIS)

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

    1987-01-01

    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. (orig.) [de

  4. Chemotherapy of Malaria

    Science.gov (United States)

    1974-05-31

    malaria in Vietnam was resisent to drugs such as chloroquine , generally recognized since World War ii as satisfactory antimalarial agents. The urgent...known to have antimalarial activity; (3) structural analogues of compounds found active in our test system and representing several novel chemical

  5. Plasmodium falciparum malaria

    African Journals Online (AJOL)

    Durrheim, Karen Barnes. Objectives. To assess the therapeutic efficacy of sulfadoxine- pyrimethamine (SP) after 5 years of use as first-line treatment of uncomplicated Plasmodium falciparum malaria, and thus guide the selection of artemisinin-based combination therapy in Mpumalanga, South Africa. Design. An open-label ...

  6. Malaria and gold fever.

    Science.gov (United States)

    Veeken, H

    1993-08-14

    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.

  7. Malaria prevention and treatment

    African Journals Online (AJOL)

    to allow prompt and accurate treatment of malaria in areas out .... It is essential to seek medical advice promptly if ... Not ideal for machine operators, drivers or those that work at heights .... with food that contains oil e.g. chips, bread and butter.

  8. Extrastriate cortical areas activated during visual discrimination in man

    DEFF Research Database (Denmark)

    Roland, PE

    1981-01-01

    The regional cerebral blood flow (rCBF) was measured in 254 different regions of the human extrastriate cerebral cortex during rest and during visual shape discrimination. Visual shape discrimination increased the rCBF markedly in the frontal eye fields, the upper part of the prefrontal cortex, t......, the lateral occipital cortex and the superior parietal cortex. Moderate increases of rCBF appeared in the inferotemporal cortex, the parietotemporo-occipital region and scattered in the lateral part of the prefrontal cortex....

  9. Dynamic digitized cerebral parenchymography

    International Nuclear Information System (INIS)

    Theron, J.; Alachkar, F.; Nelson, M.; Mazia, D.

    1992-01-01

    Aortic arch injections centred on the head have been performed routinely in patients with cerebral ischaemia. Digital angiograms with modified windowing (low and narrow) have been used. This 'cerebral' arch injection allows much improved analysis of the cerebral parenchymal vascularization, giving better understanding of hemispheric ischaemia and making the decision about revascularization more rational. (orig.)

  10. Childhood malaria: mothers' perception and treatment- seeking ...

    African Journals Online (AJOL)

    major strategies for reducing the burden of malaria, therefore ... children. The incidence of history of fever, indicative of malaria in children of the respondents within one ... interventions for the control of childhood malaria. ..... Yellow eyes. 20.

  11. Choosing a Drug to Prevent Malaria

    Science.gov (United States)

    ... Malaria About Malaria FAQs Fast Facts Disease Biology Ecology Human Factors Sickle Cell Mosquitoes Parasites Where Malaria ... medicines, also consider the possibility of drug-drug interactions with other medicines that the person might be ...

  12. Discrimination and Anti-discrimination in Denmark

    DEFF Research Database (Denmark)

    Olsen, Tore Vincents

    The purpose of this report is to describe and analyse Danish anti-discrimination legislation and the debate about discrimination in Denmark in order to identify present and future legal challenges. The main focus is the implementation of the EU anti-discrimination directives in Danish law...

  13. Malaria and protective behaviours: is there a malaria trap?

    Science.gov (United States)

    Berthélemy, Jean-Claude; Thuilliez, Josselin; Doumbo, Ogobara; Gaudart, Jean

    2013-06-13

    In spite of massive efforts to generalize efficient prevention, such as insecticide-treated mosquito nets (ITN) or long-lasting insecticidal nets (LLINs), malaria remains prevalent in many countries and ITN/LLINs are still only used to a limited extent. This study proposes a new model for malaria economic analysis by combining economic epidemiology tools with the literature on poverty traps. A theoretical model of rational protective behaviour in response to malaria is designed, which includes endogenous externalities and disease characteristics. Survey data available for Uganda provide empirical support to the theory of prevalence-elastic protection behaviours, once endogeneity issues related to epidemiology and poverty are solved. Two important conclusions emerge from the model. First, agents increase their protective behaviour when malaria is more prevalent in a society. This is consistent with the literature on "prevalence-elastic behaviour". Second, a 'malaria trap' defined as the result of malaria reinforcing poverty while poverty reduces the ability to deal with malaria can theoretically exist and the conditions of existence of the malaria trap are identified. These results suggest the possible existence of malaria traps, which provides policy implications. Notably, providing ITN/LLINs at subsidized prices is not sufficient. To be efficient an ITN/LLINs dissemination campaigns should include incentive of the very poor for using ITN/LLINs.

  14. Effects of Milrinone continuous intravenous infusion on global cerebral oxygenation and cerebral vasospasm after cerebral aneurysm surgical clipping

    Directory of Open Access Journals (Sweden)

    Mohamed A. Ghanem

    2014-01-01

    Conclusions: Milrinone improved significantly the global cerebral oxygenation and reduced the incidence of cerebral vasospasm during the dangerous period of cerebral spasm after cerebral aneurysm clipping.

  15. Early home treatment of childhood fevers with ineffective antimalarials is deleterious in the outcome of severe malaria

    Directory of Open Access Journals (Sweden)

    Olumese Peter E

    2008-07-01

    Full Text Available Abstract Background Early diagnosis and prompt treatment including appropriate home-based treatment of malaria is a major strategy for malaria control. A major determinant of clinical outcome in case management is compliance and adherence to effective antimalarial regimen. Home-based malaria treatment with inappropriate medicines is ineffective and there is insufficient evidence on how this contributes to the outcome of severe malaria. This study evaluated the effects of pre-hospital antimalarial drugs use on the presentation and outcome of severe malaria in children in Ibadan, Nigeria. Methods Two hundred and sixty-eight children with a median age of 30 months comprising 114 children with cerebral malaria and 154 with severe malarial anaemia (as defined by WHO were prospectively enrolled. Data on socio-demographic data, treatments given at home, clinical course and outcome of admission were collected and analysed. Results A total of 168 children had treatment with an antimalarial treatment at home before presenting at the hospital when there was no improvement. There were no significant differences in the haematocrit levels, parasite counts and nutritional status of the pre-hospital treated and untreated groups. The most commonly used antimalarial medicine was chloroquine. Treatment policy was revised to Artemesinin-based Combination Therapy (ACT in 2005 as a response to unacceptable levels of therapeutic failures with chloroquine, however chloroquine use remains high. The risk of presenting as cerebral malaria was 1.63 times higher with pre-hospital use of chloroquine for treatment of malaria, with a four-fold increase in the risk of mortality. Controlling for other confounding factors including age and clinical severity, pre-hospital treatment with chloroquine was an independent predictor of mortality. Conclusion This study showed that, home treatment with chloroquine significantly impacts on the outcome of severe malaria. This finding

  16. Plasmodium vivax Malaria in Cambodia

    Science.gov (United States)

    Siv, Sovannaroth; Roca-Feltrer, Arantxa; Vinjamuri, Seshu Babu; Bouth, Denis Mey; Lek, Dysoley; Rashid, Mohammad Abdur; By, Ngau Peng; Popovici, Jean; Huy, Rekol; Menard, Didier

    2016-01-01

    The Cambodian National Strategic Plan for Elimination of Malaria aims to move step by step toward elimination of malaria across Cambodia with an initial focus on Plasmodium falciparum malaria before achieving elimination of all forms of malaria, including Plasmodium vivax in 2025. The emergence of artemisinin-resistant P. falciparum in western Cambodia over the last decade has drawn global attention to support the ultimate goal of P. falciparum elimination, whereas the control of P. vivax lags much behind, making the 2025 target gradually less achievable unless greater attention is given to P. vivax elimination in the country. The following review presents in detail the past and current situation regarding P. vivax malaria, activities of the National Malaria Control Program, and interventional measures applied. Constraints and obstacles that can jeopardize our efforts to eliminate this parasite species are discussed. PMID:27708187

  17. Microembolism after cerebral angiography

    International Nuclear Information System (INIS)

    Manaka, Hiroshi; Sakai, Hideki; Nagata, Izumi

    2000-01-01

    Acute microemboli are detected more precisely with the recently developed diffusion-weighted MR imaging (DWI). We happened to obtain 24 DWIs after 350 diagnostic cerebral angiographies in 1999. DWIs after cerebral angiographies showed bright lesions in 7 patients (28%), of whom 6 had no neurological symptoms after cerebral angiography. Seven of the 24 patients had risk factors for arteriosclerosis. Only one patient had embolic events due to angiography. Microemboli related to cerebral angiographies are inevitable in some patients. Most are silent, however, we should investigate the cause of microemboli and should make cerebral angiography safer. (author)

  18. Natural infection of Plasmodium brasilianum in humans: Man and monkey share quartan malaria parasites in the Venezuelan Amazon.

    Science.gov (United States)

    Lalremruata, Albert; Magris, Magda; Vivas-Martínez, Sarai; Koehler, Maike; Esen, Meral; Kempaiah, Prakasha; Jeyaraj, Sankarganesh; Perkins, Douglas Jay; Mordmüller, Benjamin; Metzger, Wolfram G

    2015-09-01

    The quartan malaria parasite Plasmodium malariae is the widest spread and best adapted human malaria parasite. The simian Plasmodium brasilianum causes quartan fever in New World monkeys and resembles P. malariae morphologically. Since the genetics of the two parasites are nearly identical, differing only in a range of mutations expected within a species, it has long been speculated that the two are the same. However, no naturally acquired infection with parasites termed as P. brasilianum has been found in humans until now. We investigated malaria cases from remote Yanomami indigenous communities of the Venezuelan Amazon and analyzed the genes coding for the circumsporozoite protein (CSP) and the small subunit of ribosomes (18S) by species-specific PCR and capillary based-DNA sequencing. Based on 18S rRNA gene sequencing, we identified 12 patients harboring malaria parasites which were 100% identical with P. brasilianum isolated from the monkey, Alouatta seniculus. Translated amino acid sequences of the CS protein gene showed identical immunodominant repeat units between quartan malaria parasites isolated from both humans and monkeys. This study reports, for the first time, naturally acquired infections in humans with parasites termed as P. brasilianum. We conclude that quartan malaria parasites are easily exchanged between humans and monkeys in Latin America. We hypothesize a lack of host specificity in mammalian hosts and consider quartan malaria to be a true anthropozoonosis. Since the name P. brasilianum suggests a malaria species distinct from P. malariae, we propose that P. brasilianum should have a nomenclatorial revision in case further research confirms our findings. The expansive reservoir of mammalian hosts discriminates quartan malaria from other Plasmodium spp. and requires particular research efforts.

  19. Characterization of malaria mortality in Valle del Cauca, 2005-2006 Caracterización de la mortalidad por malaria en el Valle del Cauca, 2005-2006

    Directory of Open Access Journals (Sweden)

    Gloria Castro

    2009-12-01

    Full Text Available Introduction. Valle del Cauca is one of the states in Colombia that reports a high number of deaths due to malaria. Understanding the basis of malarial deaths is useful for assessing the efficacy of the health system and to identify areas where improvements are necessary to decrease malaria mortality.
    Objective. Potential determinants of mortality in malaria cases are characterized in a demographic study centered in Valle del Cauca.
    Materials and methods. A descriptive analysis was directed to 25 cases of malaria death occurring in Valle del Cauca during 2005 and 2006.
    Results. The mean age was 31.3 years (range, 2 to 71 yr, 11 were women (1 pregnant, 11 were from the malaria-endemic port of Buenaventura, and 5 from other Pacific coastal states. After entering the health system facility, the standard malaria diagnostic, the thick smear, was not ordered for 7 cases at any time during the treatment period. In cases where a thick smear was taken at first contact, 11 had a positive and 5 had a negative initial report. Cerebral malaria (7/18 cases and renal failure (6/18 cases were the most frequent complications. During hospitalization, 13/18 cases developed other complications, mainly acute lung edema (8/18 cases and shock (5/18 cases.
    Conclusions. Failures in primary health care of patients with malaria were recognized. This information has been used to implement actions aimed at improving initial care of malaria subjects in the health services of Valle del Cauca. The study recommends that other states in Colombia increase their efforts to decrease malaria mortality.Introducción. El Valle del Cauca es uno de los departamentos que mayor número de muertes por paludismo reporta en Colombia. El análisis de estas muertes permite una aproximación diagnóstica al funcionamiento del sistema de salud y contribuye a generar propuestas tendientes a disminuir la mortalidad por esta enfermedad.
    Objetivo. Caracterizar demogr

  20. Use of Poisson spatiotemporal regression models for the Brazilian Amazon Forest: malaria count data

    Directory of Open Access Journals (Sweden)

    Jorge Alberto Achcar

    2011-12-01

    Full Text Available INTRODUCTION: Malaria is a serious problem in the Brazilian Amazon region, and the detection of possible risk factors could be of great interest for public health authorities. The objective of this article was to investigate the association between environmental variables and the yearly registers of malaria in the Amazon region using Bayesian spatiotemporal methods. METHODS: We used Poisson spatiotemporal regression models to analyze the Brazilian Amazon forest malaria count for the period from 1999 to 2008. In this study, we included some covariates that could be important in the yearly prediction of malaria, such as deforestation rate. We obtained the inferences using a Bayesian approach and Markov Chain Monte Carlo (MCMC methods to simulate samples for the joint posterior distribution of interest. The discrimination of different models was also discussed. RESULTS: The model proposed here suggests that deforestation rate, the number of inhabitants per km², and the human development index (HDI are important in the prediction of malaria cases. CONCLUSIONS: It is possible to conclude that human development, population growth, deforestation, and their associated ecological alterations are conducive to increasing malaria risk. We conclude that the use of Poisson regression models that capture the spatial and temporal effects under the Bayesian paradigm is a good strategy for modeling malaria counts.

  1. Use of Poisson spatiotemporal regression models for the Brazilian Amazon Forest: malaria count data.

    Science.gov (United States)

    Achcar, Jorge Alberto; Martinez, Edson Zangiacomi; Souza, Aparecida Doniseti Pires de; Tachibana, Vilma Mayumi; Flores, Edilson Ferreira

    2011-01-01

    Malaria is a serious problem in the Brazilian Amazon region, and the detection of possible risk factors could be of great interest for public health authorities. The objective of this article was to investigate the association between environmental variables and the yearly registers of malaria in the Amazon region using bayesian spatiotemporal methods. We used Poisson spatiotemporal regression models to analyze the Brazilian Amazon forest malaria count for the period from 1999 to 2008. In this study, we included some covariates that could be important in the yearly prediction of malaria, such as deforestation rate. We obtained the inferences using a bayesian approach and Markov Chain Monte Carlo (MCMC) methods to simulate samples for the joint posterior distribution of interest. The discrimination of different models was also discussed. The model proposed here suggests that deforestation rate, the number of inhabitants per km², and the human development index (HDI) are important in the prediction of malaria cases. It is possible to conclude that human development, population growth, deforestation, and their associated ecological alterations are conducive to increasing malaria risk. We conclude that the use of Poisson regression models that capture the spatial and temporal effects under the bayesian paradigm is a good strategy for modeling malaria counts.

  2. PENELITIAN OBAT ANTI MALARIA

    Directory of Open Access Journals (Sweden)

    Emiliana Tjitra

    2012-09-01

    Full Text Available Some sensitivity tests of antimalarial drugs had been done by National Institute of Health Research and Development in collaboration with Directorate General of Communicable Disease Control and Environment Health, Naval Medical Research Unit No.2 and Faculty of Medicine University of Indonesia. In-vivo and or in-vitro Plasmodium falciparum multidrug resistance was reported from 11 provinces : Aceh, North Sumatera, Riau, Lampung, West Java, Jakarta (imported case, Central Java, East Kalimantan, South Sulawesi, East Nusa Tenggara and Irian Jaya. Only quinine had a good response for treatment of falciparum malaria resistant to multidrug. R falciparum resistant to mefloquine or halofantrine was found although it was not available in Indonesia yet. Chloroquine prophylaxis using standard dose was still effective in Tanjung Pinang and Central Java. To support the successfulness of treatment in malaria control programme, further studies on alternative antimalaria drugs is needed.

  3. Households' incidence on malaria and expenditures to treat malaria ...

    African Journals Online (AJOL)

    CONCLUSION: The relationship between expenditure and use of different vector control depends on the geographic location of respondents. People living in the rural areas spend more to have access to malaria control tools. Location of respondent has a positive effect on expenditures and use of malaria control tools.

  4. Malaria parasitemia among asymptomatic infants seen in a malaria ...

    African Journals Online (AJOL)

    In clinical settings, management of malaria cases has primarily been centred on case definition, giving minimal consideration to the asymptomatic individuals who remain a major reservoir since they do not seek care. In malaria endemic areas, infants are likely to remain asymptomatic since they have partial immunity ...

  5. Pulse duration discriminator

    International Nuclear Information System (INIS)

    Kosakovskij, L.F.

    1980-01-01

    Basic circuits of a discriminator for discrimination of pulses with the duration greater than the preset one, and of a multifunctional discriminator allowing to discriminate pulses with the duration greater (tsub(p)>tsub(s)) and lesser (tsub(p) tsub(s) and with the duration tsub(p) [ru

  6. Mannose-binding lectin is a disease modifier in clinical malaria and may function as opsonin for Plasmodium falciparum-infected erythrocytes

    DEFF Research Database (Denmark)

    Garred, Peter; Nielsen, Morten A; Kurtzhals, Jørgen

    2003-01-01

    Variant alleles in the mannose-binding lectin (MBL) gene (mbl2) causing low levels of functional MBL are associated with susceptibility to different infections and are common in areas where malaria is endemic. Therefore, we investigated whether MBL variant alleles in 551 children from Ghana were...... associated with the occurrence and outcome parameters of Plasmodium falciparum malaria and asked whether MBL may function as an opsonin for P. falciparum. No difference in MBL genotype frequency was observed between infected and noninfected children or between children with cerebral malaria and/or severe...... malarial anemia and children with uncomplicated malaria. However, patients with complicated malaria who were homozygous for MBL variant alleles had significantly higher parasite counts and lower blood glucose levels than their MBL-competent counterparts. Distinct calcium-dependent binding of MBL...

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

    Directory of Open Access Journals (Sweden)

    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.

  8. Quantification of extra-cerebral and cerebral hemoglobin concentrations during physical exercise using time-domain near infrared spectroscopy.

    Science.gov (United States)

    Auger, Héloïse; Bherer, Louis; Boucher, Étienne; Hoge, Richard; Lesage, Frédéric; Dehaes, Mathieu

    2016-10-01

    Fitness is known to have beneficial effects on brain anatomy and function. However, the understanding of mechanisms underlying immediate and long-term neurophysiological changes due to exercise is currently incomplete due to the lack of tools to investigate brain function during physical activity. In this study, we used time-domain near infrared spectroscopy (TD-NIRS) to quantify and discriminate extra-cerebral and cerebral hemoglobin concentrations and oxygen saturation ( SO 2 ) in young adults at rest and during incremental intensity exercise. In extra-cerebral tissue, an increase in deoxy-hemoglobin ( HbR ) and a decrease in SO 2 were observed while only cerebral HbR increased at high intensity exercise. Results in extra-cerebral tissue are consistent with thermoregulatory mechanisms to dissipate excess heat through skin blood flow, while cerebral changes are in agreement with cerebral blood flow ( CBF ) redistribution mechanisms to meet oxygen demand in activated regions during exercise. No significant difference was observed in oxy- ( HbO 2 ) and total hemoglobin ( HbT ). In addition HbO 2 , HbR and HbT increased with subject's peak power output (equivalent to the maximum oxygen volume consumption; VO 2 peak) supporting previous observations of increased total mass of red blood cells in trained individuals. Our results also revealed known gender differences with higher hemoglobin in men. Our approach in quantifying both extra-cerebral and cerebral absolute hemoglobin during exercise may help to better interpret past and future continuous-wave NIRS studies that are prone to extra-cerebral contamination and allow a better understanding of acute cerebral changes due to physical exercise.

  9. Malaria in pregnancy | Okpere | Nigerian Medical Journal

    African Journals Online (AJOL)

    Malaria remains one of the highest contributors to the precarious maternal mortality figures in sub-Saharan Africa. At least 6 million women worldwide are at risk of malaria infection in pregnancy. Malaria contributes to at least 10,000 maternal deaths and to at least 200,000 newborn deaths annually. Malaria is a contributor ...

  10. Cerebral cortex modulation of pain

    Institute of Scientific and Technical Information of China (English)

    Yu-feng XIE; Fu-quan HUO; Jing-shi TANG

    2009-01-01

    Pain is a complex experience encompassing sensory-discriminative, affective-motivational and cognitiv e-emotional com-ponents mediated by different mechanisms. Contrary to the traditional view that the cerebral cortex is not involved in pain perception, an extensive cortical network associated with pain processing has been revealed using multiple methods over the past decades. This network consistently includes, at least, the anterior cingulate cortex, the agranular insular cortex, the primary (SⅠ) and secondary somatosensory (SⅡ) cortices, the ventrolateral orbital cortex and the motor cortex. These corti-cal structures constitute the medial and lateral pain systems, the nucleus submedius-ventrolateral orbital cortex-periaque-ductal gray system and motor cortex system, respectively. Multiple neurotransmitters, including opioid, glutamate, GABA and dopamine, are involved in the modulation of pain by these cortical structures. In addition, glial cells may also be in-volved in cortical modulation of pain and serve as one target for pain management research. This review discusses recent studies of pain modulation by these cerebral cortical structures in animals and human.

  11. Working without a blindfold: the critical role of diagnostics in malaria control

    Directory of Open Access Journals (Sweden)

    Bell David R

    2008-12-01

    Full Text Available Abstract Diagnostic testing for malaria has for many years been eschewed, lest it be an obstacle to the delivery of rapid, life-saving treatment. The approach of treating malaria without confirmatory testing has been reinforced by the availability of inexpensive treatment with few side effects, by the great difficulty of establishing quality-assured microscopy in rural and resource-poor settings, and by the preeminence of malaria as a cause of important fever in endemic regions. Within the last decade, all three of these factors have changed. More expensive artemisinin combination therapy (ACT has been widely introduced, simple immunochromatographic tests for malaria have been developed that can be used as an alternative to microscopy by village health workers, and recognition of the health cost of mismanaging non-malarial fever is growing. In most of the world a small fraction of fever is due to malaria, and reflex treatment with ACT does not make medical or economic sense. Global malaria control efforts have been energized by the availability of new sources of funding, and by the rapid reduction in malaria prevalence in a number of settings where bed nets, indoor residual spraying with insecticides, and ACT have been systematically deployed. This momentum has been captured by a new call for malaria elimination. Without wide implementation of accurate and discriminating diagnostic testing, and reporting of results, most fever will be inappropriately managed, millions of doses of ACT will be wasted, and malaria control programmes will be blindfolded to the impact of their efforts.

  12. Molecular Factors and Biological Pathways Associated with Malaria Fever and the Pathogenesis of Cerebral Malaria

    Science.gov (United States)

    2007-04-09

    environmental degradation , policies against the use of residual insecticides in house, human migration and probably most importantly the rapid...8. Brandts, C. H., M. Ndjave, W. Graninger, and P. G. Kremsner. 1997. Effect of paracetamol on parasite clearance time in Plasmodium falciparum...label, RNA was degraded by the addition of NaOH, and labeled cDNA was purified and concentrated by ultrafiltration through a vivaspin 500 column

  13. Malaria Surveillance - United States, 2015.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M; Tan, Kathrine R

    2018-05-04

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles species mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to provide information on its occurrence (e.g., temporal, geographic, and demographic), guide prevention and treatment recommendations for travelers and patients, and facilitate transmission control measures if locally acquired cases are identified. This report summarizes confirmed malaria cases in persons with onset of illness in 2015 and summarizes trends in previous years. Malaria cases diagnosed by blood film microscopy, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff members. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System (NMSS), the National Notifiable Diseases Surveillance System (NNDSS), or direct CDC consultations. CDC reference laboratories provide diagnostic assistance and conduct antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. This report summarizes data from the integration of all NMSS and NNDSS cases, CDC reference laboratory reports, and CDC clinical consultations. CDC received reports of 1,517 confirmed malaria cases, including one congenital case, with an onset of symptoms in 2015 among persons who received their diagnoses in the United States. Although the number of

  14. [Fake malaria drugs].

    Science.gov (United States)

    Bygbjerg, Ib Christian

    2009-03-02

    The literature on fake medicaments is sparse, even if approximately 15% of all medicaments are fake, a figure that for antimalarials in particular reaches 50% in parts of Africa and Asia. Sub-standard and fake medicines deplete the public's confidence in health systems, health professionals and in the pharmaceutical industry - and increase the risk that resistance develops. For a traveller coming from a rich Western country, choosing to buy e.g. preventive antimalarials over the internet or in poor malaria-endemic areas, the consequences may be fatal. International trade-, control- and police-collaboration is needed to manage the problem, as is the fight against poverty and poor governance.

  15. Bioorganometallic Chemistry and Malaria

    Science.gov (United States)

    Biot, Christophe; Dive, Daniel

    This chapter summarizes recent developments in the design, synthesis, and structure-activity relationship studies of organometallic antimalarials. It begins with a general introduction to malaria and the biology of the parasite Plasmodium falciparum, with a focus on the heme detoxification system. Then, a number of metal complexes from the literature are reported for their antiplasmodial activity. The second half of the chapter deals with the serendipitous discovery of ferroquine, its mechanism(s) of action, and the failure to induce a resistance. Last, but not least, we suggest that the bioorganometallic approach offers the potential for the design of novel therapeutic agents.

  16. Fight malaria at home: Therapeutic and prophylaxis clinical data

    Directory of Open Access Journals (Sweden)

    Deepak Bhattacharya

    2011-06-01

    Full Text Available Objective: To identify a new, safe and effective source to combat and prevent drug resistant malaria therapeutically and to make it as a home-made bio-medicine which is called as OMARIA (Orissa malaria research indigenous attempt and use it on long term basis (decade in mono clinical station and in field. Methods: The rind of a lesser known Indian indigenous fruit dalimba/ Punica granatum (P. granatum is taken. Manual process to make a hand-made or home-made bio-medicine is done. Hand-filled into gelatin capsules and administered as an internal medicine. Therapy to 532 clinical cases is given at the Govt Red Cross Clinic, and Prophylaxis at site is administered to 401 cases by adopting 3 villages. Results: Hydrophyllic, ellagitannins viz., punicalagin (C 48H28O 30; mw 1 1 00~1 1 25, punicalin (C 34H22O 22; mw 780~785, ellagic acid (C14H6O8; mw 302 and K+ co-exists as the only drug moieties. OMARIA has no other confounding or confabulating compounds. There is non alkaloid. Conclusions: OMARIA delivers therapeutics and prophylaxis to drug resistant Plasmodium falciparum (P. falciparum cases. There are no side effects and no contradictions. Non-toxic at bolus/loading doses. No case progressed to cerebral malaria. OMARIA is a first time work. Original report on pan global basis.

  17. Cerebral venous angioma

    International Nuclear Information System (INIS)

    Inagawa, Tetsuji; Taguchi, Haruyoshi; Kamiya, Kazuko; Yano, Takashi; Nakajima, Reiko

    1984-01-01

    This report presents a 27-year-old male patient who was diagnosed as having cerebral venous angioma in the postero-temporal area by CT scan and cerebral angiography. The patient improved by removing angioma with electrocoagulation of medullary veins. (Namekawa, K.)

  18. Association between serum transferrin receptor levels and malaria ...

    African Journals Online (AJOL)

    user

    ... and malaria is common in sub-Saharan Africa, and is a complex phenomenon. ... iron status and malaria incidence among children in a high malaria ... seasonally as cash crops. ... Children were followed for presence of malaria parasites by.

  19. 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

  20. Handling conditional discrimination

    NARCIS (Netherlands)

    Zliobaite, I.; Kamiran, F.; Calders, T.G.K.

    2011-01-01

    Historical data used for supervised learning may contain discrimination. We study how to train classifiers on such data, so that they are discrimination free with respect to a given sensitive attribute, e.g., gender. Existing techniques that deal with this problem aim at removing all discrimination

  1. The Badness of Discrimination

    DEFF Research Database (Denmark)

    Lippert-Rasmussen, Kasper

    2006-01-01

    . In this paper I address these issues. First, I offer a taxonomy of discrimination. I then argue that discrimination is bad, when it is, because it harms people. Finally, I criticize a rival, disrespect-based account according to which discrimination is bad regardless of whether it causes harm....

  2. [Congenital malaria due to Plasmodium falciparum and Plasmodium malariae].

    Science.gov (United States)

    Zenz, W; Trop, M; Kollaritsch, H; Reinthaler, F

    2000-05-19

    Increasing tourism and growing numbers of immigrants from malaria-endemic countries are leading to a higher importation rate of rare tropical disorders in European countries. We describe, to the best of our knowledge, the first case of connatal malaria in Austria. The patient is the first child of a 24 year old mother who was born in Ghana and immigrated to Austria one and a half years before delivery. She did not stay in an endemic region during this period and did not show fever or any other signs of malaria. The boy was healthy for the first six weeks of his life. In the 8th week of life he was admitted to our hospital due to persistent fever of unknown origin. On physical examination he showed only mild splenomegaly. Routine laboratory testing revealed mild hemolytic anemia with a hemoglobin value of 8.3 g/l. In the blood smear Plasmodium falciparum and Plasmodium malariae were detected. Oral therapy with quinine hydrochloride was successful and blood smears became negative for Plasmodia within 6 days. This case shows that congenital malaria can occur in children of clinically healthy women who were born in malaria-endemic areas even one and a half year after they have immigrated to non-endemic regions.

  3. Clinical discriminators between acute brain hemorrhage and infarction: a practical score for early patient identification Características clínicas diferenciais entre hemorragia e infarto cerebral: uma escala prática para identificação precoce do paciente

    Directory of Open Access Journals (Sweden)

    Ayrton R. Massaro

    2002-06-01

    Full Text Available New treatments for acute stroke require a rapid triage system, which minimizes treatment delays and maximizes selection of eligible patients. Our aim was to create a score for assessing the probability of brain hemorrhage among patients with acute stroke based upon clinical information. Of 1805 patients in the Stroke Data Bank, 1273 had infarction (INF and 237 had parenchymatous hemorrhage (HEM verified by CT. INF and HEM discriminators were determined by logistic regression and used to create a score. ROC curve was used to choose the cut-point for predicting HEM (score Novas perspectivas no tratamento do acidente vascular cerebral (AVC requerem um método de triagem rápido para seleção dos pacientes. Nosso objetivo foi criar uma escala com informações clínicas simples para diferenciar hematoma intra-parenquimatoso (HEM entre os pacientes com AVC. Estudamos 1.273 pacientes com AVC isquêmico (INF e 237 com HEM do Stroke Data Bank. Variáveis independentes para o diagnóstico de INF e HEM foram determinadas pela análise de regressão logística e utilizadas para criar uma escala. Através da curva ROC foi escolhido o nível de corte para discriminar HEM (<= 2 , com sensibilidade de 76%, especificidade de 83%. Foi realizada validação externa utilizando os pacientes do estudo NOMASS. Embora o uso de uma escala de fácil aplicação pelas equipes de emergência não possa substituir os métodos de imagem na diferenciação entre INF e HEM para a indicação de trombolítico, a escala proposta pode ser útil para selecionar pacientes para estudos clínicos e tratamento pré-hospitalar, alertar técnicos de tomografia e as equipes médicas sobre a chegada de pacientes, contribuindo para reduzir atrasos cruciais no tratamento.

  4. Plants used traditionally to treat malaria in Brazil: the archives of Flora Medicinal

    Directory of Open Access Journals (Sweden)

    Botsaris Alexandros S

    2007-05-01

    Full Text Available Abstract The archives of Flora Medicinal, an ancient pharmaceutical laboratory that supported ethnomedical research in Brazil for more than 30 years, were searched for plants with antimalarial use. Forty plant species indicated to treat malaria were described by Dr. J. Monteiro da Silva (Flora Medicinal leader and his co-workers. Eight species, Bathysa cuspidata, Cosmos sulphureus, Cecropia hololeuca, Erisma calcaratum, Gomphrena arborescens, Musa paradisiaca, Ocotea odorifera, and Pradosia lactescens, are related as antimalarial for the first time in ethnobotanical studies. Some species, including Mikania glomerata, Melampodium divaricatum, Galipea multiflora, Aspidosperma polyneuron, and Coutarea hexandra, were reported to have activity in malaria patients under clinical observation. In the information obtained, also, there were many details about the appropriate indication of each plant. For example, some plants are indicated to increase others' potency. There are also plants that are traditionally employed for specific symptoms or conditions that often accompany malaria, such as weakness, renal failure or cerebral malaria. Many plants that have been considered to lack activity against malaria due to absence of in vitro activity against Plasmodium can have other mechanisms of action. Thus researchers should observe ethnomedical information before deciding which kind of screening should be used in the search of antimalarial drugs.

  5. An Anthropologist Looks at Malaria

    African Journals Online (AJOL)

    prevalence of malaria is a major selective agent in- ... century before Darwin put forward the Theory of Natural ... A. C. Allison, a former research student of the Anatomy ... A review of all available ... However, they both draw attention to the.

  6. Premunition in Plasmodium falciparum malaria

    African Journals Online (AJOL)

    STORAGESEVER

    2010-03-08

    Mar 8, 2010 ... antigenic polymorphism, shedding of parts of parasite proteins, cross-reactive epitopes of antigens of ... Due to the lack of HLA molecules on the surface of the .... Susceptibility and death rates in P. falciparum malaria are.

  7. [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

  8. 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.)

  9. Unilateral cerebral polymicrogyria with ipsilateral cerebral hemiatrophy

    International Nuclear Information System (INIS)

    Hayakawa, Katsumi; Kanda, Toyoko; Yamori, Yuriko

    2002-01-01

    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.)

  10. Pulse-width discriminators

    International Nuclear Information System (INIS)

    Budyashov, Yu.G.; Grebenyuk, V.M.; Zinov, V.G.

    1978-01-01

    A pulse duration discriminator is described which is intended for processing signals from multilayer scintillators. The basic elements of the scintillator are: an input gate, a current generator, an integrating capacitor, a Schmidt trigger and an anticoincidence circuit. The basic circuit of the discriminator and its time diagrams explaining its operating are given. The discriminator is based on microcircuits. Pulse duration discrimination threshold changes continuously from 20 to 100 ns, while its amplitude threshold changes within 20 to 100 mV. The temperature instability of discrimination thresholds (both in pulse width and in amplitude) is better than 0.1 per cent/deg C

  11. 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 sensitivity......, 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....

  12. Heritability of malaria in Africa.

    Directory of Open Access Journals (Sweden)

    Margaret J Mackinnon

    2005-12-01

    Full Text Available While many individual genes have been identified that confer protection against malaria, the overall impact of host genetics on malarial risk remains unknown.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.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 of disease in malaria-endemic areas.

  13. 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

  14. LABOR DISCRIMINATION IN BULGARIA

    Directory of Open Access Journals (Sweden)

    Vyara Slavyanska

    2017-03-01

    Full Text Available Labor discrimination is a phenomenon with very serious social and economic consequences, which has increased actuality and importance in Bulgaria nowadays. Because of the high price of discrimination, building effective anti-discrimination legislation occupies a special place in the policy of the European Union. Despite the European directives, the presence of anti-discrimination legislation and the broadly declared anti-discrimination inclinations in our country, these are absolutely not enough for providing environment of equality, with a climate of respect and tolerance to the differences. It turns out that certain groups are definitely victims of labor discrimination. In this connection the present article consecutively identifies these groups, as well as the reasons for their discrimination, underlining the necessity and benefits of the integration of the different.

  15. Association of haptoglobin phenotypes with susceptibility to Falciparum Malaria in Sudan

    International Nuclear Information System (INIS)

    Elagib, Atif Abdel Rahman

    1999-09-01

    haptoglobin phenotype (1-1) is associated with susceptibility to falciparum malaria in infection and development of severe complications. Further more, the distribution of the hyptogolobin phenotypes (1-1), (2-1) and (2-2) among 60 individuals homozuyus for sickle cell heamoglobin (SS) was found to be 80 %, 20% and 0.0 % respectively, whereas the distribution among 30 individuals with sickle cell trait (AS) was 40.0 % and 0.0 % respectively. Therefore, it is reasonable to suggest that the known susceptibility of sickle cell anaemia patients to malaria complications may be associated with the high frequency of the haptoglobin phenotype (1-1), whereas the reported resistance among sickle cell traits to malaria may be due to high frequency of the haptoglobin phenotype (2-1). The plasma levels of haptoglobin in187 individuals with uncomplicated falciparm malaria and 23 patients with cerebral malaria and 24 healthy controls was determined by nephelmetry. The mean haptoglobin levels in the three groups were found to be, 0.8071 g/l, 0.726 g/l respectively. There is a significant decrease in the haptoglobin level in malaria patients as compared to controls. The data presented in this study demonstrate a direct interaction of haptoglobin with malaria antigen preparations with molecular weight of 200 kDa as shown by Western blotting technique. The decrease in haptoglobin level in plasma of malaria patients may be (partially?) due to an interaction with malaria parasites, in addition to transport of free haemoglobin of the haemolysed red cells to the liver. From the data presented, it is highly tentative to speculate that the malaria parasite interacts with haptoglobin phenotypes differently, as a mean of immune invasion mechanism or use haptoglobin as ligand for homing to the liver and/or the red blood cells.(Author)

  16. Genome wide analysis of inbred mouse lines identifies a locus containing Ppar-gamma as contributing to enhanced malaria survival.

    Directory of Open Access Journals (Sweden)

    Selina E R Bopp

    2010-05-01

    Full Text Available The genetic background of a patient determines in part if a person develops a mild form of malaria and recovers, or develops a severe form and dies. We have used a mouse model to detect genes involved in the resistance or susceptibility to Plasmodium berghei malaria infection. To this end we first characterized 32 different mouse strains infected with P. berghei and identified survival as the best trait to discriminate between the strains. We found a locus on chromosome 6 by linking the survival phenotypes of the mouse strains to their genetic variations using genome wide analyses such as haplotype associated mapping and the efficient mixed-model for association. This new locus involved in malaria resistance contains only two genes and confirms the importance of Ppar-gamma in malaria infection.

  17. Malaria in Brazil: an overview.

    Science.gov (United States)

    Oliveira-Ferreira, Joseli; Lacerda, Marcus V G; Brasil, Patrícia; Ladislau, José L B; Tauil, Pedro L; Daniel-Ribeiro, Cláudio Tadeu

    2010-04-30

    Malaria is still a major public health problem in Brazil, with approximately 306,000 registered cases in 2009, but it is estimated that in the early 1940s, around six million cases of malaria occurred each year. As a result of the fight against the disease, the number of malaria cases decreased over the years and the smallest numbers of cases to-date were recorded in the 1960s. From the mid-1960s onwards, Brazil underwent a rapid and disorganized settlement process in the Amazon and this migratory movement led to a progressive increase in the number of reported cases. Although the main mosquito vector (Anopheles darlingi) is present in about 80% of the country, currently the incidence of malaria in Brazil is almost exclusively (99,8% of the cases) restricted to the region of the Amazon Basin, where a number of combined factors favors disease transmission and impair the use of standard control procedures. Plasmodium vivax accounts for 83,7% of registered cases, while Plasmodium falciparum is responsible for 16,3% and Plasmodium malariae is seldom observed. Although vivax malaria is thought to cause little mortality, compared to falciparum malaria, it accounts for much of the morbidity and for huge burdens on the prosperity of endemic communities. However, in the last few years a pattern of unusual clinical complications with fatal cases associated with P. vivax have been reported in Brazil and this is a matter of concern for Brazilian malariologists. In addition, the emergence of P. vivax strains resistant to chloroquine in some reports needs to be further investigated. In contrast, asymptomatic infection by P. falciparum and P. vivax has been detected in epidemiological studies in the states of Rondonia and Amazonas, indicating probably a pattern of clinical immunity in both autochthonous and migrant populations. Seropidemiological studies investigating the type of immune responses elicited in naturally-exposed populations to several malaria vaccine candidates in

  18. Malaria in Brazil: an overview

    Directory of Open Access Journals (Sweden)

    Brasil Patrícia

    2010-04-01

    Full Text Available Abstract Malaria is still a major public health problem in Brazil, with approximately 306 000 registered cases in 2009, but it is estimated that in the early 1940s, around six million cases of malaria occurred each year. As a result of the fight against the disease, the number of malaria cases decreased over the years and the smallest numbers of cases to-date were recorded in the 1960s. From the mid-1960s onwards, Brazil underwent a rapid and disorganized settlement process in the Amazon and this migratory movement led to a progressive increase in the number of reported cases. Although the main mosquito vector (Anopheles darlingi is present in about 80% of the country, currently the incidence of malaria in Brazil is almost exclusively (99,8% of the cases restricted to the region of the Amazon Basin, where a number of combined factors favors disease transmission and impair the use of standard control procedures. Plasmodium vivax accounts for 83,7% of registered cases, while Plasmodium falciparum is responsible for 16,3% and Plasmodium malariae is seldom observed. Although vivax malaria is thought to cause little mortality, compared to falciparum malaria, it accounts for much of the morbidity and for huge burdens on the prosperity of endemic communities. However, in the last few years a pattern of unusual clinical complications with fatal cases associated with P. vivax have been reported in Brazil and this is a matter of concern for Brazilian malariologists. In addition, the emergence of P. vivax strains resistant to chloroquine in some reports needs to be further investigated. In contrast, asymptomatic infection by P. falciparum and P. vivax has been detected in epidemiological studies in the states of Rondonia and Amazonas, indicating probably a pattern of clinical immunity in both autochthonous and migrant populations. Seropidemiological studies investigating the type of immune responses elicited in naturally-exposed populations to several

  19. [Malaria in Poland in 2010].

    Science.gov (United States)

    Stepień, Małgorzata

    2012-01-01

    The objective of this study was to describe the epidemiology of imported malaria in Poland in 2010 in comparison to previous years. The study included malaria cases that were collected and registered by the State Sanitary Inspection in 2010 in Poland. Data reported was verified, processed and published by National Institute of Public Health - National Institute of Hygiene. All cases were laboratory confirmed by blood film, polymerase chain reaction or rapid diagnostic tests outlined by the EU case definition. Differences in the distribution of demographic, parasitological and clinical characteristics, and incidence were analyzed. In 2010, a total of 35 confirmed malaria cases were notified in Poland, 13 more than 2009. All cases were imported, 49% from Africa, including 1 case with relapsing malaria caused by P. vivax and 2 cases of recrudescence falciparum malaria following failure of treatment. The number of cases acquired in Asia (37% of the total), mainly from India and Indonesia, was significantly higher than observed in previous years. Among cases with species-specific diagnosis 19 (63%) were caused by P. falciparum, 9 (30%) by P. vivax, one by P. ovale and one by P. malariae. The median age of all cases was 42 years (range 9 months to 71 years), males comprised 69% of patients, females 31%, three patients were Indian citizens temporarily in Poland. Common reasons for travel to endemic countries were tourism (57%), work-related visits (37%), one person visited family and in one case the reason for travel was unknown. Sixteen travelers took chemoprophylaxis, but only three of them appropriately (adherence to the recommended drug regimen, continuation upon return and use of appropriate medicines). In 2010, there were no deaths due to malaria and clinical course of disease was severe in 7 cases. When compared with 2009, there was a marked increase in the number of imported malaria cases in Poland, however the total number of notified cases remained low. Serious

  20. Cerebral Palsy (For Parents)

    Science.gov (United States)

    ... Going to an Occupational Therapist Scoliosis In the Band: Jens' Story Cerebral ... KidsHealth® is for educational purposes only. For specific medical advice, diagnoses, and treatment, consult your doctor. © 1995- ...

  1. Cerebral Contusions and Lacerations

    Science.gov (United States)

    ... Contusions and Lacerations Concussion Diffuse Axonal Injury Intracranial Hematomas Skull Fracture Sports-Related Concussion Cerebral contusions are ... Contusions and Lacerations Concussion Diffuse Axonal Injury Intracranial Hematomas Skull Fracture Sports-Related Concussion NOTE: This is ...

  2. Cerebral venous angiomas

    International Nuclear Information System (INIS)

    Agnoli, A.L.; Hildebrandt, G.

    1985-01-01

    Clinical symptoms and radiological signs in 15 patients with cerebral venous malformations are presented and the diagnostic problems discussed. The circulation time in combination with cerebral malformations and angiomas of the scalp are described. CT findings in cases of venous malformations of the brain stem are evaluated. Spot-like enhancement, as well as sharply demarcated round shaped enhancement are characteristic for venous angiomas. Cavernous angiomas usually present as homogenous or inhomogenous round shaped enhanced areas. (Author)

  3. Cerebral cartography and connectomics

    OpenAIRE

    Sporns, Olaf

    2015-01-01

    Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamic...

  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

    , and 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 recognizing...... elicited by natural malaria infection in previously primed donors....

  5. A research agenda for malaria eradication: vaccines.

    NARCIS (Netherlands)

    Abdulla, S.; Agre, P.; Alonso, P.L.; 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.; Guinovart, C.; Hall, B.F.; Herrera, S.; Hoffman, S.; Lanzavecchia, A.; Leroy, O.; Levine, M.M.; Loucq, C.; Mendis, K.; Milman, J.; Moorthy, V.S.; Pleuschke, G.; Plowe, C.V.; Reed, S.; Sauerwein, R.W.; Saul, A.; Schofield, L.; Sinden, R.R.; Stubbs, J.; Villafana, T.; Wirth, D.; Yadav, P.; Ballou, R.; Brown, G.; Birkett, A.; Brandt, W.; Brooks, A.; Carter, T.; Golden, A.; Lee, C.; Nunes, J.; Puijalon, O.; Raphael, T.; Richards, H.; Warren, C.; Woods, C.

    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

  6. Malaria in Sokoto, North Western Nigeria

    African Journals Online (AJOL)

    STORAGESEVER

    2009-12-15

    Dec 15, 2009 ... 6Department of Parasitology, School of Medical Laboratory ... Malaria prevalence studies had been undertaken in many parts of Nigeria but there is probably no data ..... within the limits of the malaria prevalence rate reports in.

  7. 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)

  8. Insecticide Resistance Reducing Effectiveness of Malaria Control

    Centers for Disease Control (CDC) Podcasts

    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.

  9. Successfully controlling malaria in South Africa

    African Journals Online (AJOL)

    regard to tourism, within an area of ~100 000 km2. ... Unfortunately, international funding for .... carriers, whether symptomatic or asymptomatic, to interrupt malaria ... education of healthcare workers on malaria diagnosis and treatment.

  10. randomised trial of alternative malaria chemoprophylaxis strategies

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... randomisation produced comparable intervention and comparison groups with balanced characteristics. Specific results of the baseline studies are presented in the companion paper. ... strategies for protecting pregnant women against malaria. ..... from malaria vaccine trial conducted among Tanzanian.

  11. 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.

  12. A small molecule inhibitor of signal peptide peptidase inhibits Plasmodium development in the liver and decreases malaria severity.

    Directory of Open Access Journals (Sweden)

    Iana Parvanova

    Full Text Available The liver stage of Plasmodium's life cycle is the first, obligatory step in malaria infection. Decreasing the hepatic burden of Plasmodium infection decreases the severity of disease and constitutes a promising strategy for malaria prophylaxis. The efficacy of the gamma-secretase and signal peptide peptidase inhibitor LY411,575 in targeting Plasmodium liver stages was evaluated both in human hepatoma cell lines and in mouse primary hepatocytes. LY411,575 was found to prevent Plasmodium's normal development in the liver, with an IC(50 of approximately 80 nM, without affecting hepatocyte invasion by the parasite. In vivo results with a rodent model of malaria showed that LY411,575 decreases the parasite load in the liver and increases by 55% the resistance of mice to cerebral malaria, one of the most severe malaria-associated syndromes. Our data show that LY411,575 does not exert its effect via the Notch signaling pathway suggesting that it may interfere with Plasmodium development through an inhibition of the parasite's signal peptide peptidase. We therefore propose that selective signal peptide peptidase inhibitors could be potentially used for preventive treatment of malaria in humans.

  13. Nanomedicine in cerebral palsy

    Science.gov (United States)

    Balakrishnan, Bindu; Nance, Elizabeth; Johnston, Michael V; Kannan, Rangaramanujam; Kannan, Sujatha

    2013-01-01

    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. PMID:24204146

  14. A comparative study of cerebral atrophy in various alcoholic groups, based on CT findings

    International Nuclear Information System (INIS)

    Ishii, Tomoyuki

    1983-01-01

    The alcoholics were diagnosed and classified based on the criteria, offered at the Alcoholism Diagnostic Conference (1977) which was held under the auspices of the Ministry of Welfare, Japan. Grade of cerebral atrophy was estimated. Measurement items on the Computed Tomography (CT Scan) which contributed to discrimination among these groups were investigated simultaneously. The study consisted of seventy-five alcoholic patients and control group of ninety-four who were devoid of any evidence for alcoholism. Influential factors which were involved in cerebral atrophy of the alcoholic groups were investigated and factorial analysis was completed. There was a definite increase in cerebral atrophy during the aging process in patients with long term durations of drinking alcohol. There was a close correlation between age and duration of drinking alcohol. After the results of canonical discriminant analysis against 9 CT items, the Ventricle index definitely contributed both in the discrimination between the alcoholics and the controls and in the discrimination between alcoholic dementia and other alcoholic psychoses. Furthermore, the horizontal diameter of the third ventricle contributed to the latter discrimination, while the Evans' index contributed to the former discrimination. Therefore, the Ventricle index and the Evans' index turn out as the most valuable diagnostic criteria, as well as the CT index against cerebral atrophy in the alcoholics; however, the horizontal diameter of the third ventricle is useful in comparing among alcoholic psychoses. (J.P.N.)

  15. Comparative study of cerebral atrophy in various alcoholic groups, based on CT findings

    Energy Technology Data Exchange (ETDEWEB)

    Ishii, Tomoyuki (Nippon Medical School, Tokyo)

    1983-02-01

    The alcoholics were diagnosed and classified based on the criteria, offered at the Alcoholism Diagnostic Conference (1977) which was held under the auspices of the Ministry of Welfare, Japan. Grade of cerebral atrophy was estimated. Measurement items on the Computed Tomography (CT Scan) which contributed to discrimination among these groups were investigated simultaneously. The study consisted of seventy-five alcoholic patients and control group of ninety-four who were devoid of any evidence for alcoholism. Influential factors which were involved in cerebral atrophy of the alcoholic groups were investigated and factorial analysis was completed. There was a definite increase in cerebral atrophy during the aging process in patients with long term durations of drinking alcohol. There was a close correlation between age and duration of drinking alcohol. After the results of canonical discriminant analysis against 9 CT items, the Ventricle index definitely contributed both in the discrimination between the alcoholics and the controls and in the discrimination between alcoholic dementia and other alcoholic psychoses. Furthermore, the horizontal diameter of the third ventricle contributed to the latter discrimination, while the Evans' index contributed to the former discrimination. Therefore, the Ventricle index and the Evans' index turn out as the most valuable diagnostic criteria, as well as the CT index against cerebral atrophy in the alcoholics; however, the horizontal diameter of the third ventricle is useful in comparing among alcoholic psychoses.

  16. Quantum-state discrimination

    International Nuclear Information System (INIS)

    Roa, Luis; Retamal, Juan Carlos; Saavedra, Carlos

    2002-01-01

    A proposal for a physical implementation of a quantum-state discrimination protocol using an ion in a linear trap is studied, where two nonorthogonal quantum states are codified using two electronic states of the ion. In addition, a protocol is given for discriminating superpositions of nonorthogonal entangled states between ions inside widely separated optical cavities. The discrimination protocol is extended to the case of N linearly independent nonorthogonal quantum states lying in a space of 2N-1 dimensions

  17. Socially-Tolerable Discrimination

    OpenAIRE

    Amegashie, J. Atsu

    2008-01-01

    History is replete with overt discrimination on the basis of race, gender, age, citizenship, ethnicity, marital status, academic performance, health status, volume of market transactions, religion, sexual orientation, etc. However, these forms of discrimination are not equally tolerable. For example, discrimination based on immutable or prohibitively unalterable characteristics such as race, gender, or ethnicity is much less acceptable. Why? I develop a simple rent-seeking model of conflict w...

  18. Cerebral palsy and congenital malformations

    DEFF Research Database (Denmark)

    Garne, Ester; Dolk, Helen; Krägeloh-Mann, Inge

    2007-01-01

    AIM: To determine the proportion of children with cerebral palsy (CP) who have cerebral and non-cerebral congenital malformations. METHODS: Data from 11 CP registries contributing to the European Cerebral Palsy Database (SCPE), for children born in the period 1976-1996. The malformations were...... classified as recognized syndromes, chromosomal anomalies, cerebral malformations or non-cerebral malformations. Prevalence of malformations was compared to published data on livebirths from a European database of congenital malformations (EUROCAT). RESULTS: Overall 547 out of 4584 children (11.9%) with CP...... 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...

  19. 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

  20. morphological identification of malaria vectors within anopheles

    African Journals Online (AJOL)

    DR. AMIN

    Africa among the human population. Determination of risk of malaria transmission requires quick and accurate methods of identification of Anopheles mosquitoes especially when targeting vector control. (Maxwell, et al., 2003). Anopheles mosquito transmits malaria. The most important vectors of malaria are members of.

  1. Malaria in Pregnancy: Morbidities and Management | Yakasai ...

    African Journals Online (AJOL)

    control of malaria in the African Subregion during pregnancy has been recommended by the World Health Organization (WHO). These include intermittent preventive treatment (IPT), use of insecticide treated nets (ITNs) and access to effective case management for malaria illness and anemia. Keywords: malaria in ...

  2. Malaria - sick air on the march

    International Nuclear Information System (INIS)

    Aunan, Kristin

    1999-01-01

    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

  3. Malaria parasite positivity among febrile neonates | Enyuma ...

    African Journals Online (AJOL)

    Background: Malaria, earlier considered rare in neonates, has been reported with increasing frequency in the last decade. Neonatal malaria diagnosis is challenging because the clinical features are non-specific, variable and also overlap with bacterial infection. Aim: To determine the prevalence of neonatal malaria and ...

  4. Comparative effectiveness of malaria preventive measures on ...

    African Journals Online (AJOL)

    The burden of malaria and its associated problems in pregnancy can be reduced by the use of different malaria preventive measures. This study was conducted to determine the comparative effectiveness of three different malaria preventive measures on populations of parturient in Abeokuta, Ogun State, Nigeria.

  5. HUBUNGAN ANOPHELES BARBIROSTRIS DENGAN MALARIA

    Directory of Open Access Journals (Sweden)

    Krisna Iryani

    2013-03-01

    Full Text Available Malaria is a disease caused by intercellular obligate protozoa genus of Plasmodium which is a parasite carried by female Anopheles mosquito. One of them is Anopheles barbirostris. Research in several places already proved that Anopheles barbirostris acts as a vector of malaria. One case that occurred in Cineam district, Tasikmalaya regency showed that Anopheles barbirostris is suspected as vector of malaria. This is proven through a research on the relationship between Anopheles barbirostris with malaria. Data was taken from the larvae and adult mosquitoes captured around Cineam village, Tasikmalaya. The observation was done in the open field and laboratory. Data and identification by pictorial key for female Anopheles showed that the population of Anopheles barbirostris was always a dominant population compared to another Anopheles species. Because of the breeding ponds and the resting places were around the village, it is suspected that they mainly bit humans. The result of the observation in laboratory showed the life cycle of Anopheles barbirostris are around 20-27 days, and the longevity of 20 days. Morphological identification of Anopheles barbirostris by pictorial key for female Anopheles showed that there is no any significant difference. This research showed that Anopheles barbirostris was suspected as vector of malaria in Cineam village, Tasikmalaya.

  6. [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.

  7. Management of malaria in pregnancy

    Directory of Open Access Journals (Sweden)

    Stephen J Rogerson

    2017-01-01

    Full Text Available Pregnant women are especially susceptible to malaria infection. Without existing immunity, severe malaria can develop requiring emergency treatment, and pregnancy loss is common. In semi-immune women, consequences of malaria for the mother include anaemia while stillbirth, premature delivery and foetal growth restriction affect the developing foetus. Preventive measures include insecticide-treated nets and (in some African settings intermittent preventive treatment. Prompt management of maternal infection is key, using parenteral artemisinins for severe malaria, and artemisinin combination treatments (ACTs in the second and third trimesters of pregnancy. ACTs may soon also be recommended as an alternative to quinine as a treatment in the first trimester of pregnancy. Monitoring the safety of antimalarials and understanding their pharmacokinetics is particularly important in pregnancy with the altered maternal physiology and the risks to the developing foetus. As increasing numbers of countries embrace malaria elimination as a goal, the special needs of the vulnerable group of pregnant women and their infants should not be overlooked.

  8. 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

  9. Monitoring of cerebral haemodynamics in newborn infants

    DEFF Research Database (Denmark)

    Liem, K Djien; Greisen, Gorm

    2010-01-01

    The most important cerebrovascular injuries in newborn infants, particularly in preterm infants, are cerebral haemorrhage and ischemic injury. The typical cerebral vascular anatomy and the disturbance of cerebral haemodynamics play important roles in the pathophysiology. The term 'cerebral haemod...

  10. 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

  11. [Malaria and intestinal protozoa].

    Science.gov (United States)

    Rojo-Marcos, Gerardo; Cuadros-González, Juan

    2016-03-01

    Malaria is life threatening and requires urgent diagnosis and treatment. Incidence and mortality are being reduced in endemic areas. Clinical features are unspecific so in imported cases it is vital the history of staying in a malarious area. The first line treatments for Plasmodium falciparum are artemisinin combination therapies, chloroquine in most non-falciparum and intravenous artesunate if any severity criteria. Human infections with intestinal protozoa are distributed worldwide with a high global morbid-mortality. They cause diarrhea and sometimes invasive disease, although most are asymptomatic. In our environment populations at higher risk are children, including adopted abroad, immune-suppressed, travelers, immigrants, people in contact with animals or who engage in oral-anal sex. Diagnostic microscopic examination has low sensitivity improving with antigen detection or molecular methods. Antiparasitic resistances are emerging lately. Copyright © 2016 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. 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

  13. Malaria Surveillance - United States, 2014.

    Science.gov (United States)

    Mace, Kimberly E; Arguin, Paul M

    2017-05-26

    Malaria in humans is caused by intraerythrocytic protozoa of the genus Plasmodium. These parasites are transmitted by the bite of an infective female Anopheles mosquito. The majority of malaria infections in the United States occur among persons who have traveled to regions with ongoing malaria transmission. However, malaria is occasionally acquired by persons who have not traveled out of the country through exposure to infected blood products, congenital transmission, laboratory exposure, or local mosquitoborne transmission. Malaria surveillance in the United States is conducted to identify episodes of local transmission and to guide prevention recommendations for travelers. This report summarizes cases in persons with onset of illness in 2014 and trends during previous years. Malaria cases diagnosed by blood film, polymerase chain reaction, or rapid diagnostic tests are reported to local and state health departments by health care providers or laboratory staff. Case investigations are conducted by local and state health departments, and reports are transmitted to CDC through the National Malaria Surveillance System, National Notifiable Diseases Surveillance System, or direct CDC consultations. CDC conducts antimalarial drug resistance marker testing on blood samples submitted by health care providers or local or state health departments. Data from these reporting systems serve as the basis for this report. CDC received reports of 1,724 confirmed malaria cases, including one congenital case and two cryptic cases, with onset of symptoms in 2014 among persons in the United States. The number of confirmed cases in 2014 is consistent with the number of confirmed cases reported in 2013 (n = 1,741; this number has been updated from a previous publication to account for delayed reporting for persons with symptom onset occurring in late 2013). Plasmodium falciparum, P. vivax, P. ovale, and P. malariae were identified in 66.1%, 13.3%, 5.2%, and 2.7% of cases, respectively

  14. Malaria in inter-war British India.

    Science.gov (United States)

    Bynum, W F

    2000-06-01

    British India was an important site of much important malaria research. Although Ronald Ross left India in 1899, a number of malariologists continued the task of evaluating the incidence and distribution of malaria in the country. Implementing practical solutions was hampered by formidable social and economic problems. This paper examines the Indian situation in the late 1920s, through a retrospective selection of writings chosen by J.A. Sinton for reproduction in an early issue of 'The records of the malaria survey of India', and the analysis of the Indian malaria situation through a visit of the League of Nations Malaria Commission in 1929.

  15. Severe falciparum malaria: A case report

    Science.gov (United States)

    Arcelia, F.; Asymida, F.; Lubis, N. F. M.; Pasaribu, A. P.

    2018-03-01

    Plasmodium parasites caused Malaria. Indonesia is one of the countries in Southeast Asia that endemic to malaria. The burden of malaria is more in the eastern part of Indonesia than the Western part as well as the endemicity. Some cases of malaria will develop to severe form. Usually, the manifestation of children and adult are different. We reported a severe case of malaria in a 14-year-old boy who develops several manifestations such as anemia, hypoglycemia, sepsis and black water fever. We successfully treated the patient with Artesunate intravenous and continued with Dihydroartemisinin-piperaquine.

  16. 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...... and development in the field of placental malaria vaccine development....

  17. 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.

  18. INTERSECTIONAL DISCRIMINATION AGAINST CHILDREN

    DEFF Research Database (Denmark)

    Ravnbøl, Camilla Ida

    This paper adds a perspective to existing research on child protection by engaging in a debate on intersectional discrimination and its relationship to child protection. The paper has a twofold objective, (1) to further establish intersectionality as a concept to address discrimination against...... children, and (2) to illustrate the importance of addressing intersectionality within rights-based programmes of child protection....

  19. Discrimination and delusional ideation.

    Science.gov (United States)

    Janssen, I; Hanssen, M; Bak, M; Bijl, R V; de Graaf, R; Vollebergh, W; McKenzie, K; van Os, J

    2003-01-01

    In the UK and The Netherlands, people with high rates of psychosis are chronically exposed to discrimination. To test whether perceived discrimination is associated longitudinally with onset of psychosis. A 3-year prospective study of cohorts with no history of psychosis and differential rates of reported discrimination on the basis of age, gender, disability, appearance, skin colour or ethnicity and sexual orientation was conducted in the Dutch general population (n=4076). The main outcome was onset of psychotic symptoms (delusions and hallucinations). The rate of delusional ideation was 0.5% (n=19) in those who did not report discrimination, 0.9% (n=4) in those who reported discrimination in one domain, and 2.7% (n=3) in those who reported discrimination in more than one domain (exact P=0.027). This association remained after adjustment for possible confounders. No association was found between baseline discrimination and onset of hallucinatory experiences. Perceived discrimination may induce delusional ideation and thus contribute to the high observed rates of psychotic disorder in exposed minority populations.

  20. Discrimination and delusional ideation

    NARCIS (Netherlands)

    Janssen, I.C.M.; Hanssen, M.S.S.; Bak, M.L.F.J.; Bijl, R.V.; Graaf, R. de; Vollebergh, W.A.M.; McKenzie, K.; Os, J. van

    2003-01-01

    Background In the UK and The Netherlands, people with high rates of psychosis are chronically exposed to discrimination. Aims To test whether perceived discrimination is associated longitudinally with onset of psychosis. Method A 3-year prospective study of cohorts with no history of psychosis and

  1. Flash-Type Discrimination

    Science.gov (United States)

    Koshak, William J.

    2010-01-01

    This viewgraph presentation describes the significant progress made in the flash-type discrimination algorithm development. The contents include: 1) Highlights of Progress for GLM-R3 Flash-Type discrimination Algorithm Development; 2) Maximum Group Area (MGA) Data; 3) Retrieval Errors from Simulations; and 4) Preliminary Global-scale Retrieval.

  2. Discrimination against Black Students

    Science.gov (United States)

    Aloud, Ashwaq; Alsulayyim, Maryam

    2016-01-01

    Discrimination is a structured way of abusing people based on racial differences, hence barring them from accessing wealth, political participation and engagement in many spheres of human life. Racism and discrimination are inherently rooted in institutions in the society, the problem has spread across many social segments of the society including…

  3. Digital voltage discriminator

    International Nuclear Information System (INIS)

    Zhou Zhicheng

    1992-01-01

    A digital voltage discriminator is described, which is synthesized by digital comparator and ADC. The threshold is program controllable with high stability. Digital region of confusion is approximately equal to 1.5 LSB. This discriminator has a single channel analyzer function model with channel width of 1.5 LSB

  4. Proteomic Investigation of Falciparum and Vivax Malaria for Identification of Surrogate Protein Markers

    Science.gov (United States)

    Ray, Sandipan; Renu, Durairaj; Srivastava, Rajneesh; Gollapalli, Kishore; Taur, Santosh; Jhaveri, Tulip; Dhali, Snigdha; Chennareddy, Srinivasarao; Potla, Ankit; Dikshit, Jyoti Bajpai; Srikanth, Rapole; Gogtay, Nithya; Thatte, Urmila; Patankar, Swati; Srivastava, Sanjeeva

    2012-01-01

    This study was conducted to analyze alterations in the human serum proteome as a consequence of infection by malaria parasites Plasmodium falciparum and P. vivax to obtain mechanistic insights about disease pathogenesis, host immune response, and identification of potential protein markers. Serum samples from patients diagnosed with falciparum malaria (FM) (n = 20), vivax malaria (VM) (n = 17) and healthy controls (HC) (n = 20) were investigated using multiple proteomic techniques and results were validated by employing immunoassay-based approaches. Specificity of the identified malaria related serum markers was evaluated by means of analysis of leptospirosis as a febrile control (FC). Compared to HC, 30 and 31 differentially expressed and statistically significant (p<0.05) serum proteins were identified in FM and VM respectively, and almost half (46.2%) of these proteins were commonly modulated due to both of the plasmodial infections. 13 proteins were found to be differentially expressed in FM compared to VM. Functional pathway analysis involving the identified proteins revealed the modulation of different vital physiological pathways, including acute phase response signaling, chemokine and cytokine signaling, complement cascades and blood coagulation in malaria. A panel of identified proteins consists of six candidates; serum amyloid A, hemopexin, apolipoprotein E, haptoglobin, retinol-binding protein and apolipoprotein A-I was used to build statistical sample class prediction models. By employing PLS-DA and other classification methods the clinical phenotypic classes (FM, VM, FC and HC) were predicted with over 95% prediction accuracy. Individual performance of three classifier proteins; haptoglobin, apolipoprotein A-I and retinol-binding protein in diagnosis of malaria was analyzed using receiver operating characteristic (ROC) curves. The discrimination of FM, VM, FC and HC groups on the basis of differentially expressed serum proteins demonstrates

  5. Plasmodium species differentiation by non-expert on-line volunteers for remote malaria field diagnosis.

    Science.gov (United States)

    Ortiz-Ruiz, Alejandra; Postigo, María; Gil-Casanova, Sara; Cuadrado, Daniel; Bautista, José M; Rubio, José Miguel; Luengo-Oroz, Miguel; Linares, María

    2018-01-30

    Routine field diagnosis of malaria is a considerable challenge in rural and low resources endemic areas mainly due to lack of personnel, training and sample processing capacity. In addition, differential diagnosis of Plasmodium species has a high level of misdiagnosis. Real time remote microscopical diagnosis through on-line crowdsourcing platforms could be converted into an agile network to support diagnosis-based treatment and malaria control in low resources areas. This study explores whether accurate Plasmodium species identification-a critical step during the diagnosis protocol in order to choose the appropriate medication-is possible through the information provided by non-trained on-line volunteers. 88 volunteers have performed a series of questionnaires over 110 images to differentiate species (Plasmodium falciparum, Plasmodium ovale, Plasmodium vivax, Plasmodium malariae, Plasmodium knowlesi) and parasite staging from thin blood smear images digitalized with a smartphone camera adapted to the ocular of a conventional light microscope. Visual cues evaluated in the surveys include texture and colour, parasite shape and red blood size. On-line volunteers are able to discriminate Plasmodium species (P. falciparum, P. malariae, P. vivax, P. ovale, P. knowlesi) and stages in thin-blood smears according to visual cues observed on digitalized images of parasitized red blood cells. Friendly textual descriptions of the visual cues and specialized malaria terminology is key for volunteers learning and efficiency. On-line volunteers with short-training are able to differentiate malaria parasite species and parasite stages from digitalized thin smears based on simple visual cues (shape, size, texture and colour). While the accuracy of a single on-line expert is far from perfect, a single parasite classification obtained by combining the opinions of multiple on-line volunteers over the same smear, could improve accuracy and reliability of Plasmodium species

  6. Proteomic investigation of falciparum and vivax malaria for identification of surrogate protein markers.

    Directory of Open Access Journals (Sweden)

    Sandipan Ray

    Full Text Available This study was conducted to analyze alterations in the human serum proteome as a consequence of infection by malaria parasites Plasmodium falciparum and P. vivax to obtain mechanistic insights about disease pathogenesis, host immune response, and identification of potential protein markers. Serum samples from patients diagnosed with falciparum malaria (FM (n = 20, vivax malaria (VM (n = 17 and healthy controls (HC (n = 20 were investigated using multiple proteomic techniques and results were validated by employing immunoassay-based approaches. Specificity of the identified malaria related serum markers was evaluated by means of analysis of leptospirosis as a febrile control (FC. Compared to HC, 30 and 31 differentially expressed and statistically significant (p<0.05 serum proteins were identified in FM and VM respectively, and almost half (46.2% of these proteins were commonly modulated due to both of the plasmodial infections. 13 proteins were found to be differentially expressed in FM compared to VM. Functional pathway analysis involving the identified proteins revealed the modulation of different vital physiological pathways, including acute phase response signaling, chemokine and cytokine signaling, complement cascades and blood coagulation in malaria. A panel of identified proteins consists of six candidates; serum amyloid A, hemopexin, apolipoprotein E, haptoglobin, retinol-binding protein and apolipoprotein A-I was used to build statistical sample class prediction models. By employing PLS-DA and other classification methods the clinical phenotypic classes (FM, VM, FC and HC were predicted with over 95% prediction accuracy. Individual performance of three classifier proteins; haptoglobin, apolipoprotein A-I and retinol-binding protein in diagnosis of malaria was analyzed using receiver operating characteristic (ROC curves. The discrimination of FM, VM, FC and HC groups on the basis of differentially expressed serum proteins demonstrates

  7. Socio-economic-political-cultural aspects in malaria control programme implementation in southern India.

    Science.gov (United States)

    Ghosh, S K; Patil, Rajan R; Tiwari, S N

    2012-01-01

    Objective. A Socio-economic-political-cultural (SEPC) study was undertaken under the Roll Back Malaria (RBM) initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU) Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

  8. Introduction to integral discriminants

    International Nuclear Information System (INIS)

    Morozov, A.; Shakirov, Sh.

    2009-01-01

    The simplest partition function, associated with homogeneous symmetric forms S of degree r in n variables, is integral discriminant J n|r (S) = ∫e -S(x 1 ,...,x n ) dx 1 ...dx n . Actually, S-dependence remains the same if e -S in the integrand is substituted by arbitrary function f(S), i.e. integral discriminant is a characteristic of the form S itself, and not of the averaging procedure. The aim of the present paper is to calculate J n|r in a number of non-Gaussian cases. Using Ward identities - linear differential equations, satisfied by integral discriminants - we calculate J 2|3 ,J 2|4 ,J 2|5 and J 3|3 . In all these examples, integral discriminant appears to be a generalized hypergeometric function. It depends on several SL(n) invariants of S, with essential singularities controlled by the ordinary algebraic discriminant of S.

  9. Epidemiologia de la malaria falciparum complicada: estudio de casos y controles en Tumaco y Turbo, Colombia, 2003 The epidemiology of complicated falciparum malaria: case and controls study in Tumaco and Turbo, Colombia, 2003

    Directory of Open Access Journals (Sweden)

    Alberto Tobón C.

    2006-09-01

    Full Text Available OBJETIVOS: Identificar aspectos del hospedero, del parásito y del ambiente asociados con ocurrencia de malaria por Plasmodium falciparum complicada. MÉTODOS: Estudio de casos y controles en pacientes de Tumaco y Turbo (Colombia aplicando los criterios de complicación de la Organización Mundial de la Salud. RESULTADOS: Entre noviembre 2002 y julio 2003 se captaron 64 casos (malaria complicada y 135 controles (malaria no complicada. Las complicaciones fueron: hiperparasitemia (40%, falla hepática (36%, síndrome dificultad respiratoria aguda (7%, falla renal (4%, trombocitopenia grave (3%, anemia grave (2%, malaria cerebral (2% e hipoglicemia grave (1%. Se encontraron como factores de riesgo para malaria falciparum complicada: a Los antecedentes de malaria falciparum durante el último año fueron menores en los casos (OR= 7.0 (1.2-43.6 P=0.019; b Mayor uso previo de antimaláricos en los casos (OR=2.2 (1.1-4.4 P=0.031 y c mayor uso de cloroquina en los casos (OR=7.4 (1.1-7.8 P=0.017. Se hallaron los alelos MAD-20 y K1 del gen msp1 y FC-27 e IC-1 del gen msp2, cuya distribución de frecuencias fue similar entre casos y controles, aunque el alelo K1 mostró una variación importante entre grupos (casos: 9.4%, controles: 3.5%. La frecuencia de "signos de peligro" fue significativamente mayor en los casos (OR= 3.3, (1.5-7.4 P=0.001. Los criterios de complicación malárica de la Organización Mundial de la Salud se comparan con otros y se discuten algunas implicaciones. CONCLUSIÓN: Se identificaron como factores de riesgo para malaria falciparum complicada, la ausencia de antecedentes de malaria falciparum en el último año y el uso de antimaláricos antes de llegar al hospital.OBJECTIVES: Aimed at identifying host and parasite aspects associated to the presence of Plasmodium falciparum complicated malaria. METHODS: Case and controls study in patients from Tumaco and Turbo (Colombia. We used the World Health Organization criteria to assess the

  10. 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.

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

    International Nuclear Information System (INIS)

    Yasinzai, M. I.; Kakarsulemankhel, J. K.

    2013-01-01

    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)

  12. Advances and challenges in malaria vaccine development.

    Science.gov (United States)

    Crompton, Peter D; Pierce, Susan K; Miller, Louis H

    2010-12-01

    Malaria caused by Plasmodium falciparum remains a major public health threat, especially among children and pregnant women in Africa. An effective malaria vaccine would be a valuable tool to reduce the disease burden and could contribute to elimination of malaria in some regions of the world. Current malaria vaccine candidates are directed against human and mosquito stages of the parasite life cycle, but thus far, relatively few proteins have been studied for potential vaccine development. The most advanced vaccine candidate, RTS,S, conferred partial protection against malaria in phase II clinical trials and is currently being evaluated in a phase III trial in Africa. New vaccine targets need to be identified to improve the chances of developing a highly effective malaria vaccine. A better understanding of the mechanisms of naturally acquired immunity to malaria may lead to insights for vaccine development.

  13. Malaria in Brazil, Colombia, Peru and Venezuela: current challenges in malaria control and elimination.

    Science.gov (United States)

    Recht, Judith; Siqueira, André M; Monteiro, Wuelton M; Herrera, Sonia M; Herrera, Sócrates; Lacerda, Marcus V G

    2017-07-04

    In spite of significant progress towards malaria control and elimination achieved in South America in the 2000s, this mosquito-transmitted tropical disease remains an important public health concern in the region. Most malaria cases in South America come from Amazon rain forest areas in northern countries, where more than half of malaria is caused by Plasmodium vivax, while Plasmodium falciparum malaria incidence has decreased in recent years. This review discusses current malaria data, policies and challenges in four South American Amazon countries: Brazil, Colombia, Peru and the Bolivarian Republic of Venezuela. Challenges to continuing efforts to further decrease malaria incidence in this region include: a significant increase in malaria cases in recent years in Venezuela, evidence of submicroscopic and asymptomatic infections, peri-urban malaria, gold mining-related malaria, malaria in pregnancy, glucose-6-phosphate dehydrogenase (G6PD) deficiency and primaquine use, and possible under-detection of Plasmodium malariae. Some of these challenges underscore the need to implement appropriate tools and procedures in specific regions, such as a field-compatible molecular malaria test, a P. malariae-specific test, malaria diagnosis and appropriate treatment as part of regular antenatal care visits, G6PD test before primaquine administration for P. vivax cases (with weekly primaquine regimen for G6PD deficient individuals), single low dose of primaquine for P. falciparum malaria in Colombia, and national and regional efforts to contain malaria spread in Venezuela urgently needed especially in mining areas. Joint efforts and commitment towards malaria control and elimination should be strategized based on examples of successful regional malaria fighting initiatives, such as PAMAFRO and RAVREDA/AMI.

  14. Effect of schistosoma infection on malaria immune response: A systematic review.

    Science.gov (United States)

    Yesuf, Elias Ali; Dejene, Tariku

    2011-01-01

    increase in mean blood serum levels of IgG3 and IFN-γ directed against MSP of malaria were found in schistosoma positive individuals than in schistosoma negative individuals with a SMD (95% CI) of 0.31 (-0.66, 1.29), p=0.52 and 0.16 (-0.27, 0.59), p=0.46, respectively. Implications for Practice Concurrent schistosoma infection increases humoral immune response measures to malaria. This could confound an increase in humoral immune response measures after the administration of malaria vaccine. In addition, it might increase the incidence of malaria complication such as cerebral malaria by increasing IFN-γ levels.Implications for Research Further longitudinal studies aimed at determining the difference in long term response (cellular immunity) to malaria vaccine in individuals with and without schistosoma infection need to be undertaken.

  15. Defibrotide interferes with several steps of the coagulation-inflammation cycle and exhibits therapeutic potential to treat severe malaria.

    Science.gov (United States)

    Francischetti, Ivo M B; Oliveira, Carlo J; Ostera, Graciela R; Yager, Stephanie B; Debierre-Grockiego, Françoise; Carregaro, Vanessa; Jaramillo-Gutierrez, Giovanna; Hume, Jen C C; Jiang, Lubin; Moretz, Samuel E; Lin, Christina K; Ribeiro, José M C; Long, Carole A; Vickers, Brandi K; Schwarz, Ralph T; Seydel, Karl B; Iacobelli, Massimo; Ackerman, Hans C; Srinivasan, Prakash; Gomes, Regis B; Wang, Xunde; Monteiro, Robson Q; Kotsyfakis, Michail; Sá-Nunes, Anderson; Waisberg, Michael

    2012-03-01

    The coagulation-inflammation cycle has been implicated as a critical component in malaria pathogenesis. Defibrotide (DF), a mixture of DNA aptamers, displays anticoagulant, anti-inflammatory, and endothelial cell (EC)-protective activities and has been successfully used to treat comatose children with veno-occlusive disease. DF was investigated here as a drug to treat cerebral malaria. DF blocks tissue factor expression by ECs incubated with parasitized red blood cells and attenuates prothrombinase activity, platelet aggregation, and complement activation. In contrast, it does not affect nitric oxide bioavailability. We also demonstrated that Plasmodium falciparum glycosylphosphatidylinositol (Pf-GPI) induces tissue factor expression in ECs and cytokine production by dendritic cells. Notably, dendritic cells, known to modulate coagulation and inflammation systemically, were identified as a novel target for DF. Accordingly, DF inhibits Toll-like receptor ligand-dependent dendritic cells activation by a mechanism that is blocked by adenosine receptor antagonist (8-p-sulfophenyltheophylline) but not reproduced by synthetic poly-A, -C, -T, and -G. These results imply that aptameric sequences and adenosine receptor mediate dendritic cells responses to the drug. DF also prevents rosetting formation, red blood cells invasion by P. falciparum and abolishes oocysts development in Anopheles gambiae. In a murine model of cerebral malaria, DF affected parasitemia, decreased IFN-γ levels, and ameliorated clinical score (day 5) with a trend for increased survival. Therapeutic use of DF in malaria is proposed.

  16. Neuroimaging of cerebral vasculitis

    International Nuclear Information System (INIS)

    Wengenroth, M.; Saam, T.; Haehnel, S.

    2016-01-01

    Cerebral vasculitis can have a variety of origins. Furthermore, there are no vasculitis-specific symptoms or imaging signs and vasculitis of the CNS can mimic many other neurological diseases, which require different treatment approaches. Thus, the clinical and radiological diagnosis of cerebral vasculitis is challenging. Magnetic resonance imaging (MRI) and MR angiography (MRA) should be the radiological imaging methods of choice to assess the degree of parenchymal damage and to detect vessel wall changes. If the results are unclear digital subtraction angiography (DSA) should be pursued in order to also detect changes in medium sized vessels. Vasculitis of small vessels cannot be detected by vascular imaging and requires brain or leptomeningeal biopsy. In this review we present the current diagnostic approach and a variety of imaging findings in cerebral vasculitis and discuss the main radiological differential diagnoses. (orig.) [de

  17. Duplicated middle cerebral artery

    Science.gov (United States)

    Perez, Jesus; Machado, Calixto; Scherle, Claudio; Hierro, Daniel

    2009-01-01

    Duplicated middle cerebral artery (DMCA) is an anomalous vessel arising from the internal carotid artery. The incidence DMCA is relatively law, and an association between this anomaly and cerebral aneurysms has been documented. There is a controversy whether DMCA may have perforating arteries. This is an important fact to consider in aneurysm surgery. We report the case of a 34-year-old black woman who suffered a subarachnoid hemorrhage and the angiography a left DMCA, and an aneurysm in an inferior branch of the main MCA. The DMCA and the MCA had perforating arteries. The aneurysm was clipped without complications. The observation of perforating arteries in our patient confirms that the DMCA may have perforating arteries. This is very important to be considered in cerebral aneurysms surgery. Moreover, the DMCA may potentially serve as a collateral blood supply to the MCA territory in cases of MCA occlusion. PMID:22140405

  18. Diaschisis with cerebral infarction

    Energy Technology Data Exchange (ETDEWEB)

    Slater, R.; Reivich, M.; Goldberg, H.; Banka, R.; Greenberg, J.

    1977-01-01

    Fifteen patients admitted to Philadelphia General Hospital with acute strokes had repeated measurements of cerebral blood flow measured by the /sup 133/X inhalation method. A progressive decline in cerebral blood flow in both hemispheres was observed during the first week after infarction in twelve of these patients. This decline could be partially explained by loss of autoregulation, but could not be correlated with level of consciousness, clinical status of PCO2. This progressive decline in flow in the non-ischemic hemisphere indicates a process more complex than a simple destruction of axonal afferants to neurons as implied by the term diaschisis. The flow changes in the non-ischemic hemisphere are likely caused by a combination of the immediate effects of decreased neuronal stimulation modified by loss of autoregulation, release of vasoactive substances, cerebral edema, and other factors.

  19. 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...

  20. Optimal price subsidies for appropriate malaria testing and treatment behaviour

    DEFF Research Database (Denmark)

    Hansen, K. S.; Lesner, T. H.; Østerdal, L. P.

    2016-01-01

    Background: Malaria continues to be a serious public health problem particularly in Africa. Many people infected with malaria do not access effective treatment due to high price. At the same time many individuals receiving malaria drugs do not suffer from malaria because of the common practice of...... seeking care for malaria in the private sector. © 2016 The Author(s)....

  1. An open source business model for malaria.

    Science.gov (United States)

    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 among malaria researchers. Our results demonstrate that the public and philanthropic sectors are financing and performing the majority of malaria drug/vaccine discovery and development, but are then restricting access through patents, 'closed' publications and hidden away physical specimens. This makes little sense since it is also the public and philanthropic sector that purchases the drugs and vaccines. We recommend that a more "open source" approach is taken by making the entire value chain more efficient through greater transparency which may lead to more extensive collaborations. This can, for example, be achieved by empowering an existing organization like the Medicines for Malaria Venture (MMV) to act as a clearing house for malaria-related data. The malaria researchers that we surveyed indicated that they would utilize such registry data to increase collaboration. Finally, we question the utility of publicly or philanthropically funded patents for malaria medicines, where little to no profits are available. Malaria R&D benefits from a publicly and philanthropically funded architecture, which starts with academic research institutions, product development partnerships, commercialization assistance through UNITAID and finally procurement through mechanisms like The Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S.' President's Malaria Initiative. We believe that a fresh look should be taken at the cost/benefit of patents particularly related to new malaria

  2. Elimination of Plasmodium falciparum malaria in Tajikistan.

    Science.gov (United States)

    Kondrashin, Anatoly V; Sharipov, Azizullo S; Kadamov, Dilshod S; Karimov, Saifuddin S; Gasimov, Elkhan; Baranova, Alla M; Morozova, Lola F; Stepanova, Ekaterina V; Turbabina, Natalia A; Maksimova, Maria S; Morozov, Evgeny N

    2017-05-30

    Malaria was eliminated in Tajikistan by the beginning of the 1960s. However, sporadic introduced cases of malaria occurred subsequently probably as a result of transmission from infected mosquito Anopheles flying over river the Punj from the border areas of Afghanistan. During the 1970s and 1980s local outbreaks of malaria were reported in the southern districts bordering Afghanistan. The malaria situation dramatically changed during the 1990s following armed conflict and civil unrest in the newly independent Tajikistan, which paralyzed health services including the malaria control activities and a large-scale malaria epidemic occurred with more than 400,000 malaria cases. The malaria epidemic was contained by 1999 as a result of considerable financial input from the Government and the international community. Although Plasmodium falciparum constituted only about 5% of total malaria cases, reduction of its incidence was slower than that of Plasmodium vivax. To prevent increase in P. falciparum malaria both in terms of incidence and territory, a P. falciparum elimination programme in the Republic was launched in 200, jointly supported by the Government and the Global Fund for control of AIDS, tuberculosis and malaria. The main activities included the use of pyrethroids for the IRS with determined periodicity, deployment of mosquito nets, impregnated with insecticides, use of larvivorous fishes as a biological larvicide, implementation of small-scale environmental management, and use of personal protection methods by population under malaria risk. The malaria surveillance system was strengthened by the use of ACD, PCD, RCD and selective use of mass blood surveys. All detected cases were timely epidemiologically investigated and treated based on the results of laboratory diagnosis. As a result, by 2009, P. falciparum malaria was eliminated from all of Tajikistan, one year ahead of the originally targeted date. Elimination of P. falciparum also contributed towards

  3. An open source business model for malaria.

    Directory of Open Access Journals (Sweden)

    Christine Årdal

    Full Text Available 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 among malaria researchers. Our results demonstrate that the public and philanthropic sectors are financing and performing the majority of malaria drug/vaccine discovery and development, but are then restricting access through patents, 'closed' publications and hidden away physical specimens. This makes little sense since it is also the public and philanthropic sector that purchases the drugs and vaccines. We recommend that a more "open source" approach is taken by making the entire value chain more efficient through greater transparency which may lead to more extensive collaborations. This can, for example, be achieved by empowering an existing organization like the Medicines for Malaria Venture (MMV to act as a clearing house for malaria-related data. The malaria researchers that we surveyed indicated that they would utilize such registry data to increase collaboration. Finally, we question the utility of publicly or philanthropically funded patents for malaria medicines, where little to no profits are available. Malaria R&D benefits from a publicly and philanthropically funded architecture, which starts with academic research institutions, product development partnerships, commercialization assistance through UNITAID and finally procurement through mechanisms like The Global Fund to Fight AIDS, Tuberculosis and Malaria and the U.S.' President's Malaria Initiative. We believe that a fresh look should be taken at the cost/benefit of patents particularly related

  4. Malaria successes and challenges in Asia.

    Science.gov (United States)

    Bhatia, Rajesh; Rastogi, Rakesh Mani; Ortega, Leonard

    2013-12-01

    Asia ranks second to Africa in terms of malaria burden. In 19 countries of Asia, malaria is endemic and 2.31 billion people or 62% of the total population in these countries are at risk of malaria. In 2010, WHO estimated around 34.8 million cases and 45,600 deaths due to malaria in Asia. In 2011, 2.7 million cases and > 2000 deaths were reported. India, Indonesia, Myanmar and Pakistan are responsible for >85% of the reported cases (confirmed) and deaths in Asia. In last 10 yr, due to availability of donor's fund specially from Global fund, significant progress has been made by the countries in Asia in scaling-up malaria control interventions which were instrumental in reducing malaria morbidity and mortality significantly. There is a large heterogeneity in malaria epidemiology in Asia. As a result, the success in malaria control/elimination is also diverse. As compared to the data of the year 2000, out of 19 malaria endemic countries, 12 countries were able to reduce malaria incidence (microscopically confirmed cases only) by 75%. Two countries, namely Bangladesh and Malaysia are projected to reach 75% reduction by 2015 while India is projected to reach 50-75% only by 2015. The trend could not be assessed in four countries, namely Indonesia, Myanmar, Pakistan and Timor-Leste due to insufficient consistent data. Numerous key challenges need to be addressed to sustain the gains and eliminate malaria in most parts of Asia. Some of these are to control the spread of resistance in Plasmodium falciparum to artemisinin, control of outdoor transmission, control of vivax malaria and ensuring universal coverage of key interventions. Asia has the potential to influence the malaria epidemiology all over the world as well as to support the global efforts in controlling and eliminating malaria through production of quality-assured ACTs, RDTs and long-lasting insecticidal nets.

  5. Cerebral fat embolism

    International Nuclear Information System (INIS)

    Sakamoto, Toshihisa; Sawada, Yusuke; Yukioka, Tetsuo; Nishide, Kazuyuki; Yoshioka, Toshiharu

    1982-01-01

    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)

  6. Malaria: prevention in travellers.

    Science.gov (United States)

    Croft, Ashley M

    2010-07-12

    Malaria transmission occurs most frequently in environments with humidity greater than 60% and ambient temperature of 25 °C to 30 °C. Risks increase with longer visits and depend on activity. Infection can follow a single mosquito bite. Incubation is usually 10 to 14 days but can be up to 18 months depending on the strain of parasite. We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of non-drug preventive interventions in non-pregnant adult travellers? What are the effects of drug prophylaxis in non-pregnant adult travellers? What are the effects of antimalaria vaccines in adult and child travellers? What are the effects of antimalaria interventions in child travellers, pregnant travellers, and in airline pilots? We searched: Medline, Embase, The Cochrane Library, and other important databases up to November 2009 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 79 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: aerosol insecticides, amodiaquine, air conditioning and electric fans, atovaquone-proguanil, biological control measures, chloroquine (alone or with proguanil), diethyltoluamide (DEET), dietary supplementation, doxycycline, electronic mosquito repellents, full-length and light-coloured clothing, insecticide-treated clothing/nets, mefloquine, mosquito coils and vapourising mats, primaquine, pyrimethamine-dapsone, pyrimethamine-sulfadoxine, smoke, topical (skin-applied) insect repellents, and vaccines.

  7. Gammagraphy of cerebral perfusion

    International Nuclear Information System (INIS)

    Vazquez, Silvia

    2003-01-01

    Important aspects of the gammagraphy of cerebral perfusion and the diverse clinical applications in the neurological diseases are comment in this article. We focus in the usefulness of the photon emission cerebral tomography (SPECT) and its capacity to cross the hemato encephalic barrier through the use of radiopharmacons like 99 mTc-H M-PAO and 99mTc-EDC, thus managing to offer functional data on the captantes neurons of the radiopharmacon. The clinical applications of SPECT are studied; cerebrovascular disease, transient ischemic attacks, dementias, Alzheimer disease, as well as other neurological diseases are referred. (The author)

  8. 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...... in the penumbra is recruited in the infarction process leading to a progressive growth of the infarct. The penumbra hence constitutes an important target for pharmacological treatment because of the existence of a therapeutic time window during which treatment with neuroprotective compounds may prevent...

  9. The pathogenesis of Plasmodium falciparum malaria in humans: insights from splenic physiology

    Science.gov (United States)

    Safeukui, Innocent; Deplaine, Guillaume; Brousse, Valentine; Prendki, Virginie; Thellier, Marc; Turner, Gareth D.; Mercereau-Puijalon, Odile

    2011-01-01

    Clinical manifestations of Plasmodium falciparum infection are induced by the asexual stages of the parasite that develop inside red blood cells (RBCs). Because splenic microcirculatory beds filter out altered RBCs, the spleen can innately clear subpopulations of infected or uninfected RBC modified during falciparum malaria. The spleen appears more protective against severe manifestations of malaria in naïve than in immune subjects. The spleen-specific pitting function accounts for a large fraction of parasite clearance in artemisinin-treated patients. RBC loss contributes to malarial anemia, a clinical form associated with subacute progression, frequent splenomegaly, and relatively low parasitemia. Stringent splenic clearance of ring-infected RBCs and uninfected, but parasite-altered, RBCs, may altogether exacerbate anemia and reduce the risks of severe complications associated with high parasite loads, such as cerebral malaria. The age of the patient directly influences the risk of severe manifestations. We hypothesize that coevolution resulting in increased splenic clearance of P. falciparum–altered RBCs in children favors the survival of the host and, ultimately, sustained parasite transmission. This analysis of the RBC–spleen dynamic interactions during P falciparum infection reflects both data and hypotheses, and provides a framework on which a more complete immunologic understanding of malaria pathogenesis may be elaborated. PMID:20852127

  10. Study on association between genetic polymorphisms of haem oxygenase-1, tumour necrosis factor, cadmium exposure and malaria pathogenicity and severity

    Directory of Open Access Journals (Sweden)

    Ruangweerayut Ronnatrai

    2010-09-01

    Full Text Available Abstract Background Malaria is the most important public health problems in tropical and sub-tropical countries. Haem oxygenase (HO enzyme and the pro-inflammatory cytokine tumour necrosis factor (TNF have been proposed as one of the factors that may play significant role in pathogenicity/severity of malaria infection. HO is the enzyme of the microsomal haem degradation pathway that yields biliverdin, carbon monoxide, and iron. In this study, the association between malaria disease pathogenicity/severity and (GTn repeat polymorphism in the promoter region of the inducible HO-1 including the effect of cadmium exposure (potent inducer of HO-1 transcription as well as polymorphism of TNF were investigated. Methods Blood samples were collected from 329 cases non-severe malaria with acute uncomplicated Plasmodium falciparum malaria (UM and 80 cases with Plasmodium vivax malaria (VM, and 77 cases with severe or cerebral malaria (SM for analysis of genetic polymorphisms of HO-1 and TNF and cadmium levels. These patients consisted of 123 (25.3% Thai, 243 (50.0% Burmese and 120 (24.7% Karen who were present at Mae Sot General Hospital, Mae Sot, Tak Province, Thailand. Results The number of (GTn repeats of the HO-1 gene in all patients varied between 16 and 39 and categorized to short (S, medium (M and long (L GTn repeats. The genotype of (GTn repeat of HO-1 was found to be significantly different among the three ethnic groups of patients. Significantly higher frequency of S/L genotype was found in Burmese compared with Thai patients, while significantly lower frequencies of S/S and M/L but higher frequency of M/M genotype was observed in Burmese compared with Karen patients. No significant association between HO-1 and TNF polymorphisms including the inducing effect of cadmium and malaria pathogenicity/severity was observed. Conclusions Difference in the expression of HO-1 genotype in different ethnic groups may contribute to different severity of malaria

  11. Polymorphisms in the Haem Oxygenase-1 promoter are not associated with severity of Plasmodium falciparum malaria in Ghanaian children.

    Science.gov (United States)

    Hansson, Helle H; Maretty, Lasse; Balle, Christina; Goka, Bamenla Q; Luzon, Elisa; Nkrumah, Francis N; Schousboe, Mette L; Rodrigues, Onike P; Bygbjerg, Ib Christian; Kurtzhals, Jørgen A L; Alifrangis, Michael; Hempel, Casper

    2015-04-11

    Haem oxygenase-1 (HO-1) catabolizes haem and has both cytotoxic and cytoprotective effects. Polymorphisms in the promoter of the Haem oxygenase-1 (HMOX1) gene encoding HO-1 have been associated with several diseases including severe malaria. The objective of this study was to determine the allele and genotype frequencies of two single nucleotide polymorphisms; A(-413)T and G(-1135)A, and a (GT)n repeat length polymorphism in the HMOX1 promoter in paediatric malaria patients and controls to determine possible associations with malaria disease severity. Study participants were Ghanaian children (n=296) admitted to the emergency room at the Department of Child Health, Korle-Bu Teaching Hospital, Accra, Ghana during the malaria season from June to August in 1995, 1996 and 1997, classified as having uncomplicated malaria (n=101) or severe malaria (n=195; defined as severe anaemia (n=63) or cerebral malaria (n=132)). Furthermore, 287 individuals without a detectable Plasmodium infection or asymptomatic carriers of the parasite were enrolled as controls. Blood samples from participants were extracted for DNA and allele and genotype frequencies were determined with allele-specific PCR, restriction fragment length analysis and microsatellite analysis. The number of (GT)n repeats in the study participants varied between 21 and 46 with the majority of alleles having lengths of 26 (8.1%), 29/30 (13.2/17.9%) and 39/40 (8.0/13.8%) repeats, and was categorized into short, medium and long repeats. The (-413)T allele was very common (69.8%), while the (-1135)A allele was present in only 17.4% of the Ghanaian population. The G(-1135)A locus was excluded from further analysis after failing the Hardy-Weinberg equilibrium test. No significant differences in allele or genotype distribution of the A(-413)T and (GT)n repeat polymorphisms were found between the controls and the malaria patients, or between the disease groups, for any of the analysed polymorphisms and no associations with

  12. Cerebral atrophic and degenerative changes following various cerebral diseases, (1)

    International Nuclear Information System (INIS)

    Kino, Masao; Anno, Izumi; Yano, Yuhiko; Anno, Yasuro.

    1980-01-01

    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.)

  13. Utility of health facility-based malaria data for malaria surveillance.

    Directory of Open Access Journals (Sweden)

    Yaw A Afrane

    Full Text Available Currently, intensive malaria control programs are being implemented in Africa to reduce the malaria burden. Clinical malaria data from hospitals are valuable for monitoring trends in malaria morbidity and for evaluating the impacts of these interventions. However, the reliability of hospital-based data for true malaria incidence is often questioned because of diagnosis accuracy issues and variation in access to healthcare facilities among sub-groups of the population. This study investigated how diagnosis and treatment practices of malaria cases in hospitals affect reliability of hospital malaria data.The study was undertaken in health facilities in western Kenya. A total of 3,569 blood smears were analyzed after being collected from patients who were requested by clinicians to go to the hospital's laboratory for malaria testing. We applied several quality control measures for clinical malaria diagnosis. We compared our slide reading results with those from the hospital technicians. Among the 3,390 patients whose diagnoses were analyzed, only 36% had clinical malaria defined as presence of any level of parasitaemia and fever. Sensitivity and specificity of clinicians' diagnoses were 60.1% (95% CI: 61.1-67.5 and 75.0% (95% CI: 30.8-35.7, respectively. Among the 980 patients presumptively treated with an anti-malarial by the clinicians without laboratory diagnosis, only 47% had clinical malaria.These findings revealed substantial over-prescription of anti-malarials and misdiagnosis of clinical malaria. More than half of the febrile cases were not truly clinical malaria, but were wrongly diagnosed and treated as such. Deficiency in malaria diagnosis makes health facility data unreliable for monitoring trends in malaria morbidity and for evaluating impacts of malaria interventions. Improving malaria diagnosis should be a top priority in rural African health centers.

  14. 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...

  15. [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.

  16. Challenges for malaria elimination in Brazil.

    Science.gov (United States)

    Ferreira, Marcelo U; Castro, Marcia C

    2016-05-20

    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.

  17. High Altitude Cerebral Edema

    Science.gov (United States)

    1986-03-01

    described neuropathological findings of cerebral edema and wi4espread petechial hemorrhages in two HAPE fatalities and later reported (52...lethargy, thirst, indigestion, hysterical outburst o: other behavior disturbances, decreased concentration, fever , couhh and peripheral edema (52...autopsy results from the two fatalities in their series. In both cases multiple, widespread petechial hemorrhages were noted throughout the brain. One

  18. Set discrimination of quantum states

    International Nuclear Information System (INIS)

    Zhang Shengyu; Ying Mingsheng

    2002-01-01

    We introduce a notion of set discrimination, which is an interesting extension of quantum state discrimination. A state is secretly chosen from a number of quantum states, which are partitioned into some disjoint sets. A set discrimination is required to identify which set the given state belongs to. Several essential problems are addressed in this paper, including the condition of perfect set discrimination, unambiguous set discrimination, and in the latter case, the efficiency of the discrimination. This generalizes some important results on quantum state discrimination in the literature. A combination of state and set discrimination and the efficiency are also studied

  19. Neuronal discrimination capacity

    International Nuclear Information System (INIS)

    Deng Yingchun; Williams, Peter; Feng Jianfeng; Liu Feng

    2003-01-01

    We explore neuronal mechanisms of discriminating between masked signals. It is found that when the correlation between input signals is zero, the output signals are separable if and only if input signals are separable. With positively (negatively) correlated signals, the output signals are separable (mixed) even when input signals are mixed (separable). Exact values of discrimination capacity are obtained for two most interesting cases: the exactly balanced inhibitory and excitatory input case and the uncorrelated input case. Interestingly, the discrimination capacity obtained in these cases is independent of model parameters, input distribution and is universal. Our results also suggest a functional role of inhibitory inputs and correlated inputs or, more generally, the large variability of efferent spike trains observed in in vivo experiments: the larger the variability of efferent spike trains, the easier it is to discriminate between masked input signals

  20. Neuronal discrimination capacity

    Energy Technology Data Exchange (ETDEWEB)

    Deng Yingchun [Department of Mathematics, Hunan Normal University 410081, Changsha (China); COGS, University of Sussex at Brighton, BN1 9QH (United Kingdom); Williams, Peter; Feng Jianfeng [COGS, University of Sussex at Brighton, BN1 9QH (United Kingdom); Liu Feng [COGS, University of Sussex at Brighton, BN1 9QH (United Kingdom); Physics Department, Nanjing University (China)

    2003-12-19

    We explore neuronal mechanisms of discriminating between masked signals. It is found that when the correlation between input signals is zero, the output signals are separable if and only if input signals are separable. With positively (negatively) correlated signals, the output signals are separable (mixed) even when input signals are mixed (separable). Exact values of discrimination capacity are obtained for two most interesting cases: the exactly balanced inhibitory and excitatory input case and the uncorrelated input case. Interestingly, the discrimination capacity obtained in these cases is independent of model parameters, input distribution and is universal. Our results also suggest a functional role of inhibitory inputs and correlated inputs or, more generally, the large variability of efferent spike trains observed in in vivo experiments: the larger the variability of efferent spike trains, the easier it is to discriminate between masked input signals.

  1. Methods employed in the prevention and treatment of malaria ...

    African Journals Online (AJOL)

    onasoga olayinka

    of malaria among pregnant women in riverine community in Bayelsa State, ... at high risk of the effects of malaria infection and need special protective .... mentioned maintenance of clean environment, as other methods of preventing malaria.

  2. 1 Scepticism towards insecticide treated mosquito nets for malaria ...

    African Journals Online (AJOL)

    Abstract: Despite existence of effective tools for malaria control, malaria ... breaks from traditional approach that tend to study low uptake of health ... Key words: scepticism, low uptake, mosquito nets, malaria, social marketing, Tanzania.

  3. Malaria has no effect on birth weight in Rwanda

    NARCIS (Netherlands)

    Rulisa, S.; Mens, P.F.; Karema, C.; Schallig, H.D.F.H.; Kaligirwa, N.; Vyankandondera, J.; de Vries, P.J.

    2009-01-01

    Background: Malaria has a negative effect on pregnancy outcome, causing low birth weight, premature birth and stillbirths, particularly in areas with high malaria transmission. In Rwanda, malaria transmission intensity ranges from high to nil, probably associated with variable altitudes. Overall,

  4. Factors Influencing Prevention and Control of Malaria among ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    investigate factors that influence malaria prevention and control practices among pregnant ... treatment of clinical cases and the promotion of ... influence their decision regarding malaria ..... have the ability to purchase anti-malaria drugs that.

  5. Discrimination in Textbooks

    OpenAIRE

    大津, 尚志

    1996-01-01

    In this paper, I deal with the issues which concern discriminations in textbooks.In America, they have paid special attentions to these problems since 1960's. They made guidelines for textbooks to check various kinds of discriminative descriptions and tried to make textbooks to meet these standards. In this respects I would examine the present states about textbooks in America and would compare them to the Japanese ones. That would be useful, I believe, when we consider these issues in Japan.

  6. 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

  7. Knowledge, attitude, and practice about malaria: Socio-demographic implications for malaria control in rural Ghana.

    Science.gov (United States)

    Assan, Abraham; Takian, Amirhossein; Hanafi-Bojd, Ahmad Ali; Rahimiforoushani, Abbas; Nematolahi, Shahrzad

    2017-11-01

    Despite continuing international attention to malaria prevention, the disease remains a global public health problem. We investigated socio-demographic factors influencing knowledge, attitudes, and practices about malaria in rural Ghana. Our survey looked at 354 households. Mean knowledge score was higher among individuals with a history of volunteers having visited their households to educate them about malaria; families with 4-6 members; and males. Households with at least one under-five-aged child also had significantly higher knowledge scores. Households with at least one pregnant woman evinced a positive attitude towards malaria prevention. National malaria control strategies have achieved positive results in the fight against malaria. Nonetheless, multipronged community-based health strategies that integrate malaria programs and population growth control initiatives may be able to reach by 2030 the sustainable development goal of eliminating malaria.

  8. Hyperventilation, cerebral perfusion, and syncope

    DEFF Research Database (Denmark)

    Immink, R V; Pott, F C; Secher, N H

    2014-01-01

    dioxide (PaCO2) and oxygen (PaO2) partial pressures so that hypercapnia/hypoxia increases and hypocapnia/hyperoxia reduces global cerebral blood flow. Cerebral hypoperfusion and TLOC have been associated with hypocapnia related to HV. Notwithstanding pronounced cerebrovascular effects of PaCO2...... the contribution of a low PaCO2 to the early postural reduction in middle cerebral artery blood velocity is transient. HV together with postural stress does not reduce cerebral perfusion to such an extent that TLOC develops. However when HV is combined with cardiovascular stressors like cold immersion or reduced...... cardiac output brain perfusion becomes jeopardized. Whether, in patients with cardiovascular disease and/or defect, cerebral blood flow cerebral control HV-induced hypocapnia elicits cerebral hypoperfusion, leading to TLOC, remains to be established....

  9. Recurrent cerebral thrombosis

    International Nuclear Information System (INIS)

    Iwamoto, Toshihiko; Abe, Shin-e; Kubo, Hideki; Hanyu, Haruo; Takasaki, Masaru

    1992-01-01

    Neuroradiological techniques were used to elucidate pathophysiology of recurrent cerebral thrombosis. Twenty-two patients with cerebral thrombosis who suffered a second attack under stable conditions more than 22 days after the initial stroke were studied. Hypertension, diabetes mellitus, and hypercholesterolemia were also seen in 20, 8, and 12 patients, respectively. The patients were divided into three groups according to their symptoms: (I) symptoms differed between the first and second strokes (n=12); (II) initial symptoms were suddenly deteriorated (n=6); and (III) symptoms occurring in groups I and II were seen (n=4). In group I, contralateral hemiparesis or suprabulbar palsy was often associated with the initial hemiparesis. The time of recurrent stroke varied from 4 months to 9 years. CT and MRI showed not only lacunae in both hemispheres, but also deep white-matter ischemia of the centrum semi-ovale. In group II, hemiparesis or visual field defect was deteriorated early after the initial stroke. In addition, neuroimaging revealed that infarction in the posterior cerebral artery was progressed on the contralateral side, or that white matter lesion in the middle artery was enlarged in spite of small lesion in the left cerebral hemisphere. All patients in group III had deterioration of right hemiparesis associated with aphasia. CT, MRI, SPECT, and angiography indicated deep white-matter ischemia caused by main trunk lesions in the left hemisphere. Group III seemed to be equivalent to group II, except for laterality of the lesion. Neuroradiological assessment of the initial stroke may help to predict the mode of recurrence, although pathophysiology of cerebral thrombosis is complicated and varies from patient to patient. (N.K.)

  10. Gammaherpesvirus Co-infection with Malaria Suppresses Anti-parasitic Humoral Immunity.

    Directory of Open Access Journals (Sweden)

    Caline G Matar

    2015-05-01

    Full Text Available Immunity to non-cerebral severe malaria is estimated to occur within 1-2 infections in areas of endemic transmission for Plasmodium falciparum. Yet, nearly 20% of infected children die annually as a result of severe malaria. Multiple risk factors are postulated to exacerbate malarial disease, one being co-infections with other pathogens. Children living in Sub-Saharan Africa are seropositive for Epstein Barr Virus (EBV by the age of 6 months. This timing overlaps with the waning of protective maternal antibodies and susceptibility to primary Plasmodium infection. However, the impact of acute EBV infection on the generation of anti-malarial immunity is unknown. Using well established mouse models of infection, we show here that acute, but not latent murine gammaherpesvirus 68 (MHV68 infection suppresses the anti-malarial humoral response to a secondary malaria infection. Importantly, this resulted in the transformation of a non-lethal P. yoelii XNL infection into a lethal one; an outcome that is correlated with a defect in the maintenance of germinal center B cells and T follicular helper (Tfh cells in the spleen. Furthermore, we have identified the MHV68 M2 protein as an important virus encoded protein that can: (i suppress anti-MHV68 humoral responses during acute MHV68 infection; and (ii plays a critical role in the observed suppression of anti-malarial humoral responses in the setting of co-infection. Notably, co-infection with an M2-null mutant MHV68 eliminates lethality of P. yoelii XNL. Collectively, our data demonstrates that an acute gammaherpesvirus infection can negatively impact the development of an anti-malarial immune response. This suggests that acute infection with EBV should be investigated as a risk factor for non-cerebral severe malaria in young children living in areas endemic for Plasmodium transmission.

  11. In-depth comparative analysis of malaria parasite genomes reveals protein-coding genes linked to human disease in Plasmodium falciparum genome.

    Science.gov (United States)

    Liu, Xuewu; Wang, Yuanyuan; Liang, Jiao; Wang, Luojun; Qin, Na; Zhao, Ya; Zhao, Gang

    2018-05-02

    Plasmodium falciparum is the most virulent malaria parasite capable of parasitizing human erythrocytes. The identification of genes related to this capability can enhance our understanding of the molecular mechanisms underlying human malaria and lead to the development of new therapeutic strategies for malaria control. With the availability of several malaria parasite genome sequences, performing computational analysis is now a practical strategy to identify genes contributing to this disease. Here, we developed and used a virtual genome method to assign 33,314 genes from three human malaria parasites, namely, P. falciparum, P. knowlesi and P. vivax, and three rodent malaria parasites, namely, P. berghei, P. chabaudi and P. yoelii, to 4605 clusters. Each cluster consisted of genes whose protein sequences were significantly similar and was considered as a virtual gene. Comparing the enriched values of all clusters in human malaria parasites with those in rodent malaria parasites revealed 115 P. falciparum genes putatively responsible for parasitizing human erythrocytes. These genes are mainly located in the chromosome internal regions and participate in many biological processes, including membrane protein trafficking and thiamine biosynthesis. Meanwhile, 289 P. berghei genes were included in the rodent parasite-enriched clusters. Most are located in subtelomeric regions and encode erythrocyte surface proteins. Comparing cluster values in P. falciparum with those in P. vivax and P. knowlesi revealed 493 candidate genes linked to virulence. Some of them encode proteins present on the erythrocyte surface and participate in cytoadhesion, virulence factor trafficking, or erythrocyte invasion, but many genes with unknown function were also identified. Cerebral malaria is characterized by accumulation of infected erythrocytes at trophozoite stage in brain microvascular. To discover cerebral malaria-related genes, fast Fourier transformation (FFT) was introduced to extract

  12. The role of vitamin D in malaria.

    Science.gov (United States)

    Lương, Khanh Vinh Quốc; Nguyễn, Lan Thi Hoàng

    2015-01-15

    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.

  13. Malaria in rural Burkina Faso: local illness concepts, patterns of traditional treatment and influence on health-seeking behaviour

    Directory of Open Access Journals (Sweden)

    Kouyaté Bocar

    2007-08-01

    Full Text Available Abstract Background The literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions. Methods In a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semi-structured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria. Results Sumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour. Conclusion The findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes.

  14. History of malaria research and its contribution to the malaria control success in Suriname: a review

    NARCIS (Netherlands)

    Breeveld, Florence J. V.; Vreden, Stephen G. S.; Grobusch, Martin P.

    2012-01-01

    Suriname has cleared malaria from its capital city and coastal areas mainly through the successful use of chloroquine and DDT (dichloro-diphenyl-trichloroethane) during the Global Malaria Eradication programme that started in 1955. Nonetheless, malaria transmission rates remained high in the

  15. CASE STUDY: Mexico — Fighting malaria without DDT | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-12-23

    Dec 23, 2010 ... ... spraying techniques, Mexico has dramatically reduced malaria transmission. ... and the parasite, community perceptions of malaria, statistical analyses, and ... epidemiology, informatics, entomology, and the social sciences.

  16. 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.

  17. 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...

  18. Can slide positivity rates predict malaria transmission?

    Directory of Open Access Journals (Sweden)

    Bi Yan

    2012-04-01

    Full Text Available Abstract Background Malaria is a significant threat to population health in the border areas of Yunnan Province, China. How to accurately measure malaria transmission is an important issue. This study aimed to examine the role of slide positivity rates (SPR in malaria transmission in Mengla County, Yunnan Province, China. Methods Data on annual malaria cases, SPR and socio-economic factors for the period of 1993 to 2008 were obtained from the Center for Disease Control and Prevention (CDC and the Bureau of Statistics, Mengla, China. Multiple linear regression models were conducted to evaluate the relationship between socio-ecologic factors and malaria incidence. Results The results show that SPR was significantly positively associated with the malaria incidence rates. The SPR (β = 1.244, p = 0.000 alone and combination (SPR, β = 1.326, p  Conclusion SPR is a strong predictor of malaria transmission, and can be used to improve the planning and implementation of malaria elimination programmes in Mengla and other similar locations. SPR might also be a useful indicator of malaria early warning systems in China.

  19. 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....

  20. Hysteresis in simulations of malaria transmission

    Science.gov (United States)

    Yamana, Teresa K.; Qiu, Xin; Eltahir, Elfatih A. B.

    2017-10-01

    Malaria transmission is a complex system and in many parts of the world is closely related to climate conditions. However, studies on environmental determinants of malaria generally consider only concurrent climate conditions and ignore the historical or initial conditions of the system. Here, we demonstrate the concept of hysteresis in malaria transmission, defined as non-uniqueness of the relationship between malaria prevalence and concurrent climate conditions. We show the dependence of simulated malaria transmission on initial prevalence and the initial level of human immunity in the population. Using realistic time series of environmental variables, we quantify the effect of hysteresis in a modeled population. In a set of numerical experiments using HYDREMATS, a field-tested mechanistic model of malaria transmission, the simulated maximum malaria prevalence depends on both the initial prevalence and the initial level of human immunity in the population. We found the effects of initial conditions to be of comparable magnitude to the effects of interannual variability in environmental conditions in determining malaria prevalence. The memory associated with this hysteresis effect is longer in high transmission settings than in low transmission settings. Our results show that efforts to simulate and forecast malaria transmission must consider the exposure history of a location as well as the concurrent environmental drivers.

  1. Learning discriminant face descriptor.

    Science.gov (United States)

    Lei, Zhen; Pietikäinen, Matti; Li, Stan Z

    2014-02-01

    Local feature descriptor is an important module for face recognition and those like Gabor and local binary patterns (LBP) have proven effective face descriptors. Traditionally, the form of such local descriptors is predefined in a handcrafted way. In this paper, we propose a method to learn a discriminant face descriptor (DFD) in a data-driven way. The idea is to learn the most discriminant local features that minimize the difference of the features between images of the same person and maximize that between images from different people. In particular, we propose to enhance the discriminative ability of face representation in three aspects. First, the discriminant image filters are learned. Second, the optimal neighborhood sampling strategy is soft determined. Third, the dominant patterns are statistically constructed. Discriminative learning is incorporated to extract effective and robust features. We further apply the proposed method to the heterogeneous (cross-modality) face recognition problem and learn DFD in a coupled way (coupled DFD or C-DFD) to reduce the gap between features of heterogeneous face images to improve the performance of this challenging problem. Extensive experiments on FERET, CAS-PEAL-R1, LFW, and HFB face databases validate the effectiveness of the proposed DFD learning on both homogeneous and heterogeneous face recognition problems. The DFD improves POEM and LQP by about 4.5 percent on LFW database and the C-DFD enhances the heterogeneous face recognition performance of LBP by over 25 percent.

  2. Cerebral localization in antiquity.

    Science.gov (United States)

    Rose, F Clifford

    2009-07-01

    Fragments of neurology can be found in the oldest medical writings in antiquity. Recognizable cerebral localization is seen in Egyptian medical papyri. Most notably, the Edwin Smith papyrus describes hemiplegia after a head injury. Similar echoes can be seen in Homer, the Bible, and the pre-Hippocratic writer Alcmaeon of Croton. While Biblical writers thought that the heart was the seat of the soul, Hippocratic writers located it in the head. Alexandrian anatomists described the nerves, and Galen developed the ventricular theory of cognition whereby mental functions are classified and localized in one of the cerebral ventricles. Medieval scholars, including the early Church Fathers, modified Galenic ventricular theory so as to make it a dynamic model of cognition. Physicians in antiquity subdivided the brain into separate areas and attributed to them different functions, a phenomenon that connects them with modern neurologists.

  3. Cerebral venous thrombosis

    International Nuclear Information System (INIS)

    Soralova, T.; Sevcikova, H.; Petersky, D.

    2014-01-01

    We decided to process this theme due to its nonspecific clinical features as they often cause diagnostic problems not only to clinicians but also to diagnostic. It is important to think of this disease mainly in young women who administer hormonal contraception. Imaging methods play the crucial role in diagnostic of cerebral venous sinus thrombosis. The gold standard is a native CT of brain which shows the venous sinus thrombosis as a hyperdense lesion in the locus of the sinus (dense triangle sign), CT venography shows the sinus thrombosis as a defect in a contrast filling of the venous sinus (empty delta sign). Other investigative methods are magnetic resonance imaging or MRA. In short we also mention quite a rare but more serious thrombosis of profound cerebral veins v. cerebri magna-Galeni, vv. cerebri internae). The importance of early diagnostic and non specificity of symptoms is presented in 3 clinical cases that are the part of this work. (author)

  4. Applications of cerebral SPECT

    Energy Technology Data Exchange (ETDEWEB)

    McArthur, C., E-mail: claire.mcarthur@nhs.net [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom); Jampana, R.; Patterson, J.; Hadley, D. [Department of Neuroradiology, Institute of Neurological Sciences, Glasgow (United Kingdom)

    2011-07-15

    Single-photon emission computed tomography (SPECT) can provide three-dimensional functional images of the brain following the injection of one of a series of radiopharmaceuticals that crosses the blood-brain barrier and distributes according to cerebral perfusion, neurotransmitter, or cell density. Applications include differentiating between the dementias, evaluating cerebrovascular disease, preoperative localization of epileptogenic foci, diagnosing movement disorders, and evaluation of intracerebral tumours, while also proving a useful research tool. Unlike positronemission tomography (PET), SPECT imaging is widely available and can be performed in any department that has access to a rotating gamma camera. The purpose of this review is to demonstrate the utility of cerebral SPECT and increase awareness of its role in the investigation of neurological and psychiatric disorders.

  5. [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.

  6. [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.

  7. 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.

  8. Cerebral ketone body metabolism.

    Science.gov (United States)

    Morris, A A M

    2005-01-01

    Ketone bodies (KBs) are an important source of energy for the brain. During the neonatal period, they are also precursors for the synthesis of lipids (especially cholesterol) and amino acids. The rate of cerebral KB metabolism depends primarily on the concentration in blood; high concentrations occur during fasting and on a high-fat diet. Cerebral KB metabolism is also regulated by the permeability of the blood-brain barrier (BBB), which depends on the abundance of monocarboxylic acid transporters (MCT1). The BBB's permeability to KBs increases with fasting in humans. In rats, permeability increases during the suckling period, but human neonates have not been studied. Monocarboxylic acid transporters are also present in the plasma membranes of neurons and glia but their role in regulating KB metabolism is uncertain. Finally, the rate of cerebral KB metabolism depends on the activities of the relevant enzymes in brain. The activities vary with age in rats, but reliable results are not available for humans. Cerebral KB metabolism in humans differs from that in the rat in several respects. During fasting, for example, KBs supply more of the brain's energy in humans than in the rat. Conversely, KBs are probably used more extensively in the brain of suckling rats than in human neonates. These differences complicate the interpretation of rodent studies. Most patients with inborn errors of ketogenesis develop normally, suggesting that the only essential role for KBs is as an alternative fuel during illness or prolonged fasting. On the other hand, in HMG-CoA lyase deficiency, imaging generally shows asymptomatic white-matter abnormalities. The ability of KBs to act as an alternative fuel explains the effectiveness of the ketogenic diet in GLUT1 deficiency, but its effectiveness in epilepsy remains unexplained.

  9. Radiopharmaceuticals for cerebral studies

    International Nuclear Information System (INIS)

    Leon Cabana, Alba

    1994-01-01

    For obtain good brain scintillation images in nuclear medicine must be used several radiopharmaceuticals. Cerebral studies give a tumors visual image as well as brain anomalities detection and are helpful in the diagnostic diseases . Are described in this work: a cerebrum radiopharmaceuticals classification,labelled compounds proceeding and Tc 99m good properties in for your fast caption, post administration and blood purification for renal way

  10. Controlling imported malaria cases in the United States of America.

    Science.gov (United States)

    Dembele, Bassidy; Yakubu, Abdul-Aziz

    2017-02-01

    We extend the mathematical malaria epidemic model framework of Dembele et al. and use it to ``capture" the 2013 Centers for Disease Control and Prevention (CDC) reported data on the 2011 number of imported malaria cases in the USA. Furthermore, we use our ``fitted" malaria models for the top 20 countries of malaria acquisition by USA residents to study the impact of protecting USA residents from malaria infection when they travel to malaria endemic areas, the impact of protecting residents of malaria endemic regions from mosquito bites and the impact of killing mosquitoes in those endemic areas on the CDC number of imported malaria cases in USA. To significantly reduce the number of imported malaria cases in USA, for each top 20 country of malaria acquisition by USA travelers, we compute the optimal proportion of USA international travelers that must be protected against malaria infection and the optimal proportion of mosquitoes that must be killed.

  11. 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.

  12. 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.

  13. Neonatal cerebral infarction

    International Nuclear Information System (INIS)

    Fujimoto, Shinji; Togari, Hajime; Sobajima, Hisanori; Suzuki, Shigesumi; Wada, Yoshiro; Yokochi, Kenji; Nishimura, Yutaka; Inukai, Kazuhisa; Futamura, Masahide.

    1992-01-01

    In a retrospective multi-center study, we investigated eighteen infants with unilateral cerebral infarctions confirmed by computed tomography (CT) scans. The initial symptoms were observed in all the patients between 0 and 3 days of age. Convulsions or apneic attacks were the initial symptoms in all but one. Only 4 patients had complicated obstetric histories and none showed polycythemia or electrolyte abnormalities. All of the initial CT scans revealed unilaterally localized hypodense areas. In 10, the initial CT scans were performed within 24 hours after the clinical onset. In 16, the lesions were within the territory of the middle cerebral artery, 9 of which also involved the cortico-spinal tract (CST). In the remaining 2 patients, the lesions were located whithin the territory of the posterior cerebral artery. None of the 9 patients without CST involvement developed hemiplegia, whereas 5 (56%) of the 9 with CST involvement had hemiplegia, which is a fairly low incidence compared with that in adult cases. This difference was thought to be related to neonatal brain plasticity. (author)

  14. Focal increase of cerebral blood flow during stereognostic testing in man

    DEFF Research Database (Denmark)

    Roland, E; Larsen, B

    1976-01-01

    An attempt was made to study the regional cerebral blood flow (rCBF) pattern during stereognostic discrimination in man. The rCBF was measured in 18 subjects who had no major neurological defects. The clearance from the hemisphere of xenon 133 injected (133Xe) into the carotid artery was measured...

  15. Translational Repression in Malaria Sporozoites

    Science.gov (United States)

    Turque, Oliver; Tsao, Tiffany; Li, Thomas; Zhang, Min

    2016-01-01

    Malaria is a mosquito-borne infectious disease of humans and other animals. It is caused by the parasitic protozoan, Plasmodium. Sporozoites, the infectious form of malaria parasites, are quiescent when they remain in the salivary glands of the Anopheles mosquito until transmission into a mammalian host. Metamorphosis of the dormant sporozoite to its active form in the liver stage requires transcriptional and translational regulations. Here, we summarize recent advances in the translational repression of gene expression in the malaria sporozoite. In sporozoites, many mRNAs that are required for liver stage development are translationally repressed. Phosphorylation of eukaryotic Initiation Factor 2α (eIF2α) leads to a global translational repression in sporozoites. The eIF2α kinase, known as Upregulated in Infectious Sporozoite 1 (UIS1), is dominant in the sporozoite. The eIF2α phosphatase, UIS2, is translationally repressed by the Pumilio protein Puf2. This translational repression is alleviated when sporozoites are delivered into the mammalian host. PMID:28357358

  16. Translational repression in malaria sporozoites

    Directory of Open Access Journals (Sweden)

    Oliver Turque

    2016-04-01

    Full Text Available Malaria is a mosquito-borne infectious disease of humans and other animals. It is caused by the parasitic protozoan, Plasmodium. Sporozoites, the infectious form of malaria parasites, are quiescent when they remain in the salivary glands of the Anopheles mosquito until transmission into a mammalian host. Metamorphosis of the dormant sporozoite to its active form in the liver stage requires transcriptional and translational regulations. Here, we summarize recent advances in the translational repression of gene expression in the malaria sporozoite. In sporozoites, many mRNAs that are required for liver stage development are translationally repressed. Phosphorylation of eukaryotic Initiation Factor 2α (eIF2α leads to a global translational repression in sporozoites. The eIF2α kinase, known as Upregulated in Infectious Sporozoite 1 (UIS1, is dominant in the sporozoite. The eIF2α phosphatase, UIS2, is translationally repressed by the Pumilio protein Puf2. This translational repression is alleviated when sporozoites are delivered into the mammalian host.

  17. Cerebral Oximetry in Cardiac Surgery

    Directory of Open Access Journals (Sweden)

    A. N. Shepelyuk

    2012-01-01

    Full Text Available Based on the data of numerous current references, the review describes different neuromonitoring methods during cardiac surgery under extracorporeal circulation. It shows that it is important and necessary to make neuromonitoring for the early diagnosis and prevention of neurological complications after cardiac surgery. Particular attention is given to cerebral oximetry; the possibilities and advantages of this technique are described. Correction of cerebral oximetric values is shown to improve survival rates and to reduce the incidence of postoperative complications. Lack of cerebral oximetry monitoring denudes a clinician of important information and possibilities to optimize patient status and to prevent potentially menacing complications, which allows one to conclude that it is necessary to use cerebral oximetry procedures within neu-romonitoring in cardiac surgery. Key words: extracorporeal circulation, cerebral oximetry, neurological dysfunction, cerebral oxygenation.

  18. Disturbance by optimal discrimination

    Science.gov (United States)

    Kawakubo, Ryûitirô; Koike, Tatsuhiko

    2018-03-01

    We discuss the disturbance by measurements which unambiguously discriminate between given candidate states. We prove that such an optimal measurement necessarily changes distinguishable states indistinguishable when the inconclusive outcome is obtained. The result was previously shown by Chefles [Phys. Lett. A 239, 339 (1998), 10.1016/S0375-9601(98)00064-4] under restrictions on the class of quantum measurements and on the definition of optimality. Our theorems remove these restrictions and are also applicable to infinitely many candidate states. Combining with our previous results, one can obtain concrete mathematical conditions for the resulting states. The method may have a wide variety of applications in contexts other than state discrimination.

  19. Human population, urban settlement patterns and their impact on Plasmodium falciparum malaria endemicity

    Directory of Open Access Journals (Sweden)

    Kabaria Caroline W

    2008-10-01

    Full Text Available Abstract Background The efficient allocation of financial resources for malaria control and the optimal distribution of appropriate interventions require accurate information on the geographic distribution of malaria risk and of the human populations it affects. Low population densities in rural areas and high population densities in urban areas can influence malaria transmission substantially. Here, the Malaria Atlas Project (MAP global database of Plasmodium falciparum parasite rate (PfPR surveys, medical intelligence and contemporary population surfaces are utilized to explore these relationships and other issues involved in combining malaria risk maps with those of human population distribution in order to define populations at risk more accurately. Methods First, an existing population surface was examined to determine if it was sufficiently detailed to be used reliably as a mask to identify areas of very low and very high population density as malaria free regions. Second, the potential of international travel and health guidelines (ITHGs for identifying malaria free cities was examined. Third, the differences in PfPR values between surveys conducted in author-defined rural and urban areas were examined. Fourth, the ability of various global urban extent maps to reliably discriminate these author-based classifications of urban and rural in the PfPR database was investigated. Finally, the urban map that most accurately replicated the author-based classifications was analysed to examine the effects of urban classifications on PfPR values across the entire MAP database. Results Masks of zero population density excluded many non-zero PfPR surveys, indicating that the population surface was not detailed enough to define areas of zero transmission resulting from low population densities. In contrast, the ITHGs enabled the identification and mapping of 53 malaria free urban areas within endemic countries. Comparison of PfPR survey results showed

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

    NARCIS (Netherlands)

    de Langen, Adrianus J.; van Dillen, Jeroen; de Witte, Piet; Mucheto, Samson; Nagelkerke, Nico; Kager, Piet

    2006-01-01

    OBJECTIVE: To evaluate the feasibility of automated malaria detection with the Cell-Dyn 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

  1. Cerebral malformations without antenatal diagnosis

    Energy Technology Data Exchange (ETDEWEB)

    Girard, Nadine J. [Diagnostic Neuroradiology, Hopital Timone, Marseille (France)

    2010-06-15

    Cerebral malformations are usually described following the different steps in development. Disorders of neurulation (dysraphisms), or diverticulation (holoprosencephalies and posterior fossa cysts), and total commissural agenesis are usually diagnosed in utero. In contrast, disorders of histogenesis (proliferation-differentiation, migration, organization) are usually discovered in infants and children. The principal clinical symptoms that may be a clue to cerebral malformation include congenital hemiparesis, epilepsy and mental or psychomotor retardation. MRI is the imaging method of choice to assess cerebral malformations. (orig.)

  2. 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...

  3. Molecular pathophysiology of cerebral edema

    Science.gov (United States)

    Gerzanich, Volodymyr; Simard, J Marc

    2015-01-01

    Advancements in molecular biology have led to a greater understanding of the individual proteins responsible for generating cerebral edema. In large part, the study of cerebral edema is the study of maladaptive ion transport. Following acute CNS injury, cells of the neurovascular unit, particularly brain endothelial cells and astrocytes, undergo a program of pre- and post-transcriptional changes in the activity of ion channels and transporters. These changes can result in maladaptive ion transport and the generation of abnormal osmotic forces that, ultimately, manifest as cerebral edema. This review discusses past models and current knowledge regarding the molecular and cellular pathophysiology of cerebral edema. PMID:26661240

  4. Sickle cell protection from malaria.

    Science.gov (United States)

    Eridani, Sandro

    2011-10-19

    A linkage between presence of Sickle Haemoglobin (HbS) and protection from malaria infection and clinical manifestations in certain areas was suspected from early observations and progressively elucidated by more recent studies. Research has confirmed the abovementioned connection, but also clarified how such protection may be abolished by coexistence of sickle cell trait (HbS trait) and alpha thalassemia, which may explain the relatively low incidence of HbS trait in the Mediterranean. The mechanisms of such protective effect are now being investigated: factors of genetic, molecular and immunological nature are prominent. As for genetic factors attention is given to the role of the red blood cell (RBC) membrane complement regulatory proteins as polymorphisms of these components seem to be associated with resistance to severe malaria; genetic ligands like the Duffy group blood antigen, necessary for erythrocytic invasion, and human protein CD36, a major receptor for P. falciparum-infected RBC's, are also under scrutiny: attention is focused also on plasmodium erythrocyte-binding antigens, which bind to RBC surface components. Genome-wide linkage and association studies are now carried out too, in order to identify genes associated with malaria resistance. Only a minor role is attributed to intravascular sickling, phagocytosis and haemolysis, while specific molecular mechanisms are the object of intensive research: among these a decisive role is played by a biochemical sequence, involving activation of haeme oxygenase (HMO-1), whose effect appears mediated by carbon monoxide (CO). A central role in protection from malaria is also played by immunological factors, which may stimulate antibody production to plasmodium antigens in the early years of life; the role of agents like pathogenic CD8 T-cells has been suggested while the effects of molecular actions on the immunity mechanism are presently investigated. It thus appears that protection from malaria can be

  5. Discrimination in Employment

    Science.gov (United States)

    Abzug, Bella

    1975-01-01

    This testimony, before a public hearing of the New York City Commission on Human Rights in May 1974, expressly focuses on discrimination in employment, asserting that this has had the most direct effect on minorities and women in the country; while legal protections have grown stronger, they have not been used effectively. (Author/JM)

  6. Discrimination? - Exhibition of posters

    OpenAIRE

    Jakimovska, Jana

    2017-01-01

    Participation in the exhibition with the students form the Art Academy. The exhibition consisted of 15 posters tackling the subjects of hate speech and discrimination. The exhibition happened thanks to the invitation of the Faculty of Law at UGD, and it was a part of a larger event of launching books on the aforementioned subjects.

  7. Discrimination Learning in Children

    Science.gov (United States)

    Ochocki, Thomas E.; And Others

    1975-01-01

    Examined the learning performance of 192 fourth-, fifth-, and sixth-grade children on either a two or four choice simultaneous color discrimination task. Compared the use of verbal reinforcement and/or punishment, under conditions of either complete or incomplete instructions. (Author/SDH)

  8. Discriminative Shape Alignment

    DEFF Research Database (Denmark)

    Loog, M.; de Bruijne, M.

    2009-01-01

    , not taking into account that eventually the shapes are to be assigned to two or more different classes. This work introduces a discriminative variation to well-known Procrustes alignment and demonstrates its benefit over this classical method in shape classification tasks. The focus is on two...

  9. Education and Gender Discrimination

    Science.gov (United States)

    Sumi, V. S.

    2012-01-01

    This paper discusses the status of women education in present education system and some measures to overcome the lags existing. Discrimination against girls and women in the developing world is a devastating reality. It results in millions of individual tragedies, which add up to lost potential for entire countries. Gender bias in education is an…

  10. Airborne particulate discriminator

    Science.gov (United States)

    Creek, Kathryn Louise [San Diego, CA; Castro, Alonso [Santa Fe, NM; Gray, Perry Clayton [Los Alamos, NM

    2009-08-11

    A method and apparatus for rapid and accurate detection and discrimination of biological, radiological, and chemical particles in air. A suspect aerosol of the target particulates is treated with a taggant aerosol of ultrafine particulates. Coagulation of the taggant and target particles causes a change in fluorescent properties of the cloud, providing an indication of the presence of the target.

  11. Plasmodium falciparum malaria associated with ABO blood ...

    African Journals Online (AJOL)

    The present study was carried out to investigate the relationship between blood group types and P. falciparum malaria, as well as malaria preventive measures. The venous blood specimens were collected, processed, Giemsa-stained and examined microscopically. ABO groups were determined by agglutination test using ...

  12. Plasmodium falciparum malaria and antimalarial interventions in ...

    African Journals Online (AJOL)

    Administrator

    The recent increases in malaria mortality rates in Africa ... the world's population at risk of malaria are in Africa. (WHO, 2000). ... understood to be both a disease of poverty and a cause ... anaemia and 8 to 14% of low birth weight in areas with.

  13. Is the Malaria Elimination Target Achievable?

    African Journals Online (AJOL)

    user

    in low and middle income countries (1-4). In. 2013, malaria killed over a billion people, mostly in sub-Saharan ... According to the 2016 report,. 27% of the population lives in high transmission areas while 41% ... Similarly several countries have reduced malaria transmission to levels low enough to allow them to embark on ...

  14. Attitudes to malaria, prevention, treatment and management ...

    African Journals Online (AJOL)

    SERVER

    2007-11-05

    Nov 5, 2007 ... consequences of malaria treatment pattern and management strategies in an urban center. Questionnaires were issued ... anopheles mosquitoes as malaria vector are some of the factors militating against prevention and proper management of the .... bush clearing, drainage and gutter control in preventing.

  15. Malaria vector control: current and future strategies

    NARCIS (Netherlands)

    Takken, W.; Knols, B.G.J.

    2009-01-01

    The recently announced call for malaria eradication represents a new page in the history of this disease. This has been triggered by remarkable reductions in malaria resulting from combined application of effective drugs and vector control. However, this strategy is threatened by development of

  16. 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...

  17. Malaria in Sokoto, North Western Nigeria

    African Journals Online (AJOL)

    STORAGESEVER

    2009-12-15

    Dec 15, 2009 ... Malaria prevalence studies had been undertaken in many parts of Nigeria but there is probably no data available from the far North Western region. This research study was undertaken to determine the prevalence, monthly distribution of malaria in Sokoto, North Western Nigeria in order to generate base-.

  18. Alanine metabolism in acute falciparum malaria

    NARCIS (Netherlands)

    Pukrittayakamee, S.; Krishna, S.; ter Kuile, F.; Wilaiwan, O.; Williamson, D. H.; White, N. J.

    2002-01-01

    We investigated the integrity of the gluconeogenic pathway in severe malaria using alanine metabolism as a measure. Alanine disposition and liver blood flow, assessed by indocyanine green (ICG) clearance, were measured simultaneously in 10 patients with falciparum malaria (six severe and four

  19. Neonatal malaria complicated by hypoglycaemia and ...

    African Journals Online (AJOL)

    There is no established and widely accepted guidelines for clinical management of severe neonatal malaria. The aim of this paper is to raise the alertness of physicians regarding the occurrence of severe malaria in the neonatal period and to describe the treatment modality we adopted (in the absence of an internationally ...

  20. The Malaria Season Is Upon Us

    African Journals Online (AJOL)

    imported or Odyssean malaria from countries such as Swaziland,. Mozambique ... can be administered.⁵ The only .... Treatment. With the introduction of an effective vaccine for Southern Africa .... Being prepared for a malaria infection by packing ... sulfadoxine-pyrimethamine against Plasmodium falciparum in Yemen and.

  1. Use of chloroquine in uncomplicated falciparum malaria ...

    African Journals Online (AJOL)

    Use of chloroquine in uncomplicated falciparum malaria chemotherapy: The past, the present and the future. ... regions. It was initially highly effective against the four Plasmodium species (P. falciparum, P. malaria, P. ovale and P. vivax) infecting human. It is also effective against gametocytes except those of P. falciparum.

  2. 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.

  3. The sick placenta - the role of malaria

    NARCIS (Netherlands)

    Brabin, B. J.; Romagosa, C.; Abdelgalil, S.; Menéndez, C.; Verhoeff, F. H.; McGready, R.; Fletcher, K. A.; Owens, S.; D'Alessandro, U.; Nosten, F.; Fischer, P. R.; Ordi, J.

    2004-01-01

    The human placenta is an ideal site for the accumulation of Plasmodium falciparum malaria parasites, and as a consequence serious health problems arise for the mother and her baby. The pathogenesis of placental malaria is only partially understood, but it is clear that it leads to a distinct

  4. A Feast of Malaria Parasite Genomes.

    Science.gov (United States)

    Carlton, Jane M; Sullivan, Steven A

    2017-03-08

    The Plasmodium genus has evolved over time and across hosts, complexifying our understanding of malaria. In a recent Nature paper, Rutledge et al. (2017) describe the genome sequences of three major human malaria parasite species, providing insight into Plasmodium evolution and raising the question of how many species there are. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Rodent malaria parasites : genome organization & comparative genomics

    NARCIS (Netherlands)

    Kooij, Taco W.A.

    2006-01-01

    The aim of the studies described in this thesis was to investigate the genome organization of rodent malaria parasites (RMPs) and compare the organization and gene content of the genomes of RMPs and the human malaria parasite P. falciparum. The release of the complete genome sequence of P.

  6. Handheld Computers for Malaria Monitoring (Mozambique) | IDRC ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Malaria is the principal cause of morbidity and mortality in Mozambique and is considered a major impediment to development. The effectiveness of any malaria control program depends on reliable data delivered in timely fashion, something that is currently lacking in the nation's health service. This grant will allow the ...

  7. Handheld Computers for Malaria Monitoring (Mozambique) | CRDI ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Malaria is the principal cause of morbidity and mortality in Mozambique and is considered a major impediment to development. The effectiveness of any malaria control program depends on reliable data delivered in timely fashion, something that is currently lacking in the nation's health service. This grant will allow the ...

  8. Combining malaria control with rural electrification

    NARCIS (Netherlands)

    Oria, Prisca A.

    2016-01-01

    Chapter 1 presents the background information relevant to the subject matter and methods of this thesis. These include the application of social and behavioural sciences in malaria control, the SolarMal project and malaria in Kenya. It also presents the research objective, question and design

  9. 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

  10. Community awareness about malaria, its treatment and mosquito ...

    African Journals Online (AJOL)

    Background: Despite the rapid expansion of malaria into highland areas of Ethiopia and the movement of malaria inexperienced people to endemic areas, there is no enough information about how highland communities perceive malaria. Objective: To assess communities' awareness of malaria and its mosquito vector in ...

  11. Transferring the Malaria Epidemic Prediction Model to Users in East ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    Transferring the Malaria Epidemic Prediction Model to Users in East Africa. In the highlands of East Africa, epidemic malaria is an emerging climate-related hazard that urgently needs addressing. Malaria incidence increased by 337% during the 1987 epidemic in Rwanda. In Tanzania, Uganda and Kenya, malaria incidence ...

  12. Malaria in pregnancy: ultrasound studies of fetal growth

    NARCIS (Netherlands)

    Rijken, M.J.

    2012-01-01

    Malaria has been a plague for human mankind. Each year roughly 125 million pregnancies are at risk for malaria infection. This thesis demonstrates the detrimental effects of malaria in pregnancy on the mother and the baby. To determine the effects of malaria in pregnancy on birth outcomes, accurate

  13. Malaria infection during pregnancy in area of stable transmission ...

    African Journals Online (AJOL)

    Malaria infection during pregnancy in area of stable transmission. ... (LBW), a leading cause of neonatal death in areas of stable malaria transmission. ... areas of stable malaria transmission and the effective strategies for prevention and control. Keywords: malaria, pregnancy, semi-immune women, anaemia, low birthweight

  14. Pulmonary manifestations of malaria : recognition and management.

    Science.gov (United States)

    Taylor, Walter R J; Cañon, Viviam; White, Nicholas J

    2006-01-01

    Lung involvement in malaria has been recognized for more than 200 hundred years, yet our knowledge of its pathogenesis and management is limited. Pulmonary edema is the most severe form of lung involvement. Increased alveolar capillary permeability leading to intravascular fluid loss into the lungs is the main pathophysiologic mechanism. This defines malaria as another cause of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).Pulmonary edema has been described most often in non-immune individuals with Plasmodium falciparum infections as part of a severe systemic illness or as the main feature of acute malaria. P.vivax and P.ovale have also rarely caused pulmonary edema.Clinically, patients usually present with acute breathlessness that can rapidly progress to respiratory failure either at disease presentation or, interestingly, after treatment when clinical improvement is taking place and the parasitemia is falling. Pregnant women are particularly prone to developing pulmonary edema. Optimal management of malaria-induced ALI/ARDS includes early recognition and diagnosis. Malaria must always be suspected in a returning traveler or a visitor from a malaria-endemic country with an acute febrile illness. Slide microscopy and/or the use of rapid antigen tests are standard diagnostic tools. Malaria must be treated with effective drugs, but current choices are few: e.g. parenteral artemisinins, intravenous quinine or quinidine (in the US only). A recent trial in adults has shown that intravenous artesunate reduces severe malaria mortality by a third compared with adults treated with intravenous quinine. Respiratory compromise should be managed on its merits and may require mechanical ventilation.Patients should be managed in an intensive care unit and particular attention should be paid to the energetic management of other severe malaria complications, notably coma and acute renal failure. ALI/ARDS may also be related to a coincidental bacterial

  15. Malaria infections in crews of Japanese ships.

    Science.gov (United States)

    Shoda, M; Shimizu, K; Nagano, M; Ishii, M

    2001-01-01

    Plasmodium falciparum malaria is the most dangerous infection for seafarers in West Africa. In December 1998, five cases of this infection occurred among Japanese seafarers in West Africa, two of them died, one on board ship, and another died five days after the admission to the hospital in Reunion island, East Africa. Six other cases of falciparum malaria infection occurred among Japanese seafarers on another ship in December 1999. Three infected persons were admitted to hospitals in Abidjan (Ivory Coast) and Point Noire (Congo). In Japan, over 100 cases of imported malaria were recorded each year during the period from 1990 to 1997, and about 40% of these cases were falciparum infections. It is not known how many of them occurred among seafarers. We estimate that at least 5% of all malaria cases in Japan are seafarers. Measures to protect crews of ships against malaria are discussed.

  16. Optimal control for Malaria disease through vaccination

    Science.gov (United States)

    Munzir, Said; Nasir, Muhammad; Ramli, Marwan

    2018-01-01

    Malaria is a disease caused by an amoeba (single-celled animal) type of plasmodium where anopheles mosquito serves as the carrier. This study examines the optimal control problem of malaria disease spread based on Aron and May (1982) SIR type models and seeks the optimal solution by minimizing the prevention of the spreading of malaria by vaccine. The aim is to investigate optimal control strategies on preventing the spread of malaria by vaccination. The problem in this research is solved using analytical approach. The analytical method uses the Pontryagin Minimum Principle with the symbolic help of MATLAB software to obtain optimal control result and to analyse the spread of malaria with vaccination control.

  17. Pengendalian Malaria dalam Upaya Percepatan Pencapaian Target Millennium Development Goals

    Directory of Open Access Journals (Sweden)

    Tri Rini Puji Lestari

    2012-08-01

    health official Malaria Center, and community leaders who observe malaria. Retrieval of data time is 10 – 16 April 2011 by in-depth interviews. It was found that malaria control programs have been implemented by the Departement of Health North Maluku Province, but have not been able to effectively reduce malaria morbidity. This is because malaria control is performed is not comprehensive. Handling is more directed to break the chain transmission to human, their habitats have not been touched up. Key words: Control of malaria, millennium development goals, malaria morbidity

  18. 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

  19. Cerebral Amyloid Angiopathy

    Directory of Open Access Journals (Sweden)

    Mahmut Edip Gürol

    2009-03-01

    Full Text Available Cerebral amyloid angiopathy (CAA is characterized by the accumulation of amyloid beta-peptides (Ab in the walls of leptomeningeal arteries, arterioles, and veins. Despite the fact that these pathological changes were first described in 1909, major advancement in our understanding of the clinicoradiological manifestations, neurobiology, and course of CAA has occurred only during the last 30 years. No significant associations have been shown between CAA and other systemic/visceral amyloidoses or vascular risk factors, including hypertension. CAA is well known as the most common cause of spontaneous and anticoagulant-related lobar parenchymal ICH in the elderly. It also causes lobar cerebral microbleeds (CMBs, small dot-like dark susceptibility artifacts visible with gradient recalled echo (GRE-magnetic resonance imaging (MRI. CMBs are important markers of disease severity and predictors of CAA progression. Amyloid angiopathy is also a common cause of ischemic microvascular white matter disease (WMD and deep cerebral infarctions. Such WMD is defined as subcortical and periventricular white matter changes without obvious infarction, as well as a dark appearance on computerized tomography (CT and a bright appearance on fluid attenuated inversion recovery (FLAIR-MRI. CAA-related vascular dysfunction, with its hemorrhagic and ischemic complications, is a recognized contributor to vascular cognitive impairment in the elderly, an independent effect that is synergistically increased by Alzheimer pathologies, such as plaques and tangles. A set of clinicoradiological criteria was established for the accurate diagnosis of CAA. According to the Boston Criteria, patients aged 55 years and older with multiple hemorrhages (on CT or GRE-MRI restricted to the lobar, cortical, or corticosubcortical regions (cerebellar hemorrhage allowed are diagnosed as probable CAA when no other etiology is found; a single hemorrhage in the same region is classified as possible

  20. Examining Workplace Discrimination in a Discrimination-Free Environment

    OpenAIRE

    Braxton, Shawn Lamont

    2010-01-01

    Examining Workplace Discrimination in a Discrimination-Free Environment Shawn L. Braxton Abstract The purpose of this study is to explore how racial and gender discrimination is reproduced in concrete workplace settings even when anti-discrimination policies are present, and to understand the various reactions utilized by those who commonly experience it. I have selected a particular medical center, henceforth referred to by a pseudonym, â The Bliley Medical Centerâ as my case ...

  1. Interfaces para control cerebral

    OpenAIRE

    Spinelli, Enrique Mario

    2000-01-01

    La función de una interfaz para control cerebral basada en señales de electroencefalograma (EEG), en forma general denominada BCI (Brain control Interface), es establecer un enlace directo entre el cerebro y una máquina, sin utilizar acciones motoras directas. Una BCI permite realizar operaciones simples a partir de la interpretación de las señales de EEG. Su desarrollo está principalmente orientado hacia la ayuda a personas con discapacidades motoras severas, que poseen deterioros en el sist...

  2. Techniques in cerebral protection.

    Science.gov (United States)

    Fanelli, Fabrizio; Bezzi, Mario; Boatta, Emanuele; Passariello, Roberto

    2006-10-01

    Carotid angioplasty and stenting is a valid alternative option to conventional carotid endarterectomy in the treatment of carotid artery stenosis. During the stenting process, however, distal embolization can occur with neurological consequences. To avoid this, cerebral protection devices have been introduced. Three principal types of protection system have been developed: distal balloon occlusion, distal filters and proximal protection with or without reversal of flow. As protection devices became the focus of interest by manufactures and physicians, several trials are going on worldwide to analyze the characteristics of each of them and to evaluate their efficacy to reduce the rate of distal embolization.

  3. Acceptability by community health workers in Senegal of combining community case management of malaria and seasonal malaria chemoprevention

    DEFF Research Database (Denmark)

    Tine, Roger Ck; Ndiaye, Pascal; Ndour, Cheikh T

    2013-01-01

    Community case management of malaria (CCMm) and seasonal malaria chemoprevention (SMC) are anti-malarial interventions that can lead to substantial reduction in malaria burden acting in synergy. However, little is known about the social acceptability of these interventions. A study was undertaken...... to assess whether combining the interventions would be an acceptable approach to malaria control for community health workers (CHWs)....

  4. How well are malaria maps used to design and finance malaria control in Africa?

    Directory of Open Access Journals (Sweden)

    Judy A Omumbo

    Full Text Available Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed.An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated.91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control.The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes, strategic planning will be necessary to guide appropriate

  5. How well are malaria maps used to design and finance malaria control in Africa?

    Science.gov (United States)

    Omumbo, Judy A; Noor, Abdisalan M; Fall, Ibrahima S; Snow, Robert W

    2013-01-01

    Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed. An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated. 91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control. The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes, strategic planning will be necessary to guide appropriate financing for malaria

  6. Assessment of climate-driven variations in malaria incidence in Swaziland: toward malaria elimination.

    Science.gov (United States)

    Chuang, Ting-Wu; Soble, Adam; Ntshalintshali, Nyasatu; Mkhonta, Nomcebo; Seyama, Eric; Mthethwa, Steven; Pindolia, Deepa; Kunene, Simon

    2017-06-01

    Swaziland aims to eliminate malaria by 2020. However, imported cases from neighbouring endemic countries continue to sustain local parasite reservoirs and initiate transmission. As certain weather and climatic conditions may trigger or intensify malaria outbreaks, identification of areas prone to these conditions may aid decision-makers in deploying targeted malaria interventions more effectively. Malaria case-surveillance data for Swaziland were provided by Swaziland's National Malaria Control Programme. Climate data were derived from local weather stations and remote sensing images. Climate parameters and malaria cases between 2001 and 2015 were then analysed using seasonal autoregressive integrated moving average models and distributed lag non-linear models (DLNM). The incidence of malaria in Swaziland increased between 2005 and 2010, especially in the Lubombo and Hhohho regions. A time-series analysis indicated that warmer temperatures and higher precipitation in the Lubombo and Hhohho administrative regions are conducive to malaria transmission. DLNM showed that the risk of malaria increased in Lubombo when the maximum temperature was above 30 °C or monthly precipitation was above 5 in. In Hhohho, the minimum temperature remaining above 15 °C or precipitation being greater than 10 in. might be associated with malaria transmission. This study provides a preliminary assessment of the impact of short-term climate variations on malaria transmission in Swaziland. The geographic separation of imported and locally acquired malaria, as well as population behaviour, highlight the varying modes of transmission, part of which may be relevant to climate conditions. Thus, the impact of changing climate conditions should be noted as Swaziland moves toward malaria elimination.

  7. How Well Are Malaria Maps Used to Design and Finance Malaria Control in Africa?

    Science.gov (United States)

    Omumbo, Judy A.; Noor, Abdisalan M.; Fall, Ibrahima S.; Snow, Robert W.

    2013-01-01

    Introduction Rational decision making on malaria control depends on an understanding of the epidemiological risks and control measures. National Malaria Control Programmes across Africa have access to a range of state-of-the-art malaria risk mapping products that might serve their decision-making needs. The use of cartography in planning malaria control has never been methodically reviewed. Materials and Methods An audit of the risk maps used by NMCPs in 47 malaria endemic countries in Africa was undertaken by examining the most recent national malaria strategies, monitoring and evaluation plans, malaria programme reviews and applications submitted to the Global Fund. The types of maps presented and how they have been used to define priorities for investment and control was investigated. Results 91% of endemic countries in Africa have defined malaria risk at sub-national levels using at least one risk map. The range of risk maps varies from maps based on suitability of climate for transmission; predicted malaria seasons and temperature/altitude limitations, to representations of clinical data and modelled parasite prevalence. The choice of maps is influenced by the source of the information. Maps developed using national data through in-country research partnerships have greater utility than more readily accessible web-based options developed without inputs from national control programmes. Although almost all countries have stratification maps, only a few use them to guide decisions on the selection of interventions allocation of resources for malaria control. Conclusion The way information on the epidemiology of malaria is presented and used needs to be addressed to ensure evidence-based added value in planning control. The science on modelled impact of interventions must be integrated into new mapping products to allow a translation of risk into rational decision making for malaria control. As overseas and domestic funding diminishes, strategic planning will be

  8. Targeting imported malaria through social networks: a potential strategy for malaria elimination in Swaziland.

    Science.gov (United States)

    Koita, Kadiatou; Novotny, Joseph; Kunene, Simon; Zulu, Zulizile; Ntshalintshali, Nyasatu; Gandhi, Monica; Gosling, Roland

    2013-06-27

    Swaziland has made great progress towards its goal of malaria elimination by 2015. However, malaria importation from neighbouring high-endemic Mozambique through Swaziland's eastern border remains a major factor that could prevent elimination from being achieved. In order to reach elimination, Swaziland must rapidly identify and treat imported malaria cases before onward transmission occurs. A nationwide formative assessment was conducted over eight weeks to determine if the imported cases of malaria identified by the Swaziland National Malaria Control Programme could be linked to broader social networks and to explore methods to access these networks. Using a structured format, interviews were carried out with malaria surveillance agents (6), health providers (10), previously identified imported malaria cases (19) and people belonging to the networks identified through these interviews (25). Most imported malaria cases were Mozambicans (63%, 12/19) making a living in Swaziland and sustaining their families in Mozambique. The majority of imported cases (73%, 14/19) were labourers and self-employed contractors who travelled frequently to Mozambique to visit their families and conduct business. Social networks of imported cases with similar travel patterns were identified through these interviews. Nearly all imported cases (89%, 17/19) were willing to share contact information to enable network members to be interviewed. Interviews of network members and key informants revealed common congregation points, such as the urban market places in Manzini and Malkerns, as well as certain bus stations, where people with similar travel patterns and malaria risk behaviours could be located and tested for malaria. This study demonstrated that imported cases of malaria belonged to networks of people with similar travel patterns. This study may provide novel methods for screening high-risk groups of travellers using both snowball sampling and time-location sampling of networks to

  9. Cerebral aneurysms – an audit

    African Journals Online (AJOL)

    Enrique

    Abstract. We performed an audit to determine the profile of cerebral aneurysms at the Universitas Hospital Bloem- fontein, the only government hospital with a vascular suite in the Free State and Northern Cape area. Two hun- dred and twenty-three government patients, diagnosed with cerebral aneurysms during the period.

  10. Sustainable malaria control: transdisciplinary approaches for translational applications

    Science.gov (United States)

    2012-01-01

    With the adoption of the Global Malaria Action Plan, several countries are moving from malaria control towards elimination and eradication. However, the sustainability of some of the approaches taken may be questionable. Here, an overview of malaria control and elimination strategies is provided and the sustainability of each in context of vector- and parasite control is assessed. From this, it can be concluded that transdisciplinary approaches are essential for sustained malaria control and elimination in malaria-endemic communities. PMID:23268712

  11. Sustainable malaria control: transdisciplinary approaches for translational applications

    Directory of Open Access Journals (Sweden)

    Birkholtz Lyn-Marie

    2012-12-01

    Full Text Available Abstract With the adoption of the Global Malaria Action Plan, several countries are moving from malaria control towards elimination and eradication. However, the sustainability of some of the approaches taken may be questionable. Here, an overview of malaria control and elimination strategies is provided and the sustainability of each in context of vector- and parasite control is assessed. From this, it can be concluded that transdisciplinary approaches are essential for sustained malaria control and elimination in malaria-endemic communities.

  12. Malaria and tuberculosis: our concerns.

    Science.gov (United States)

    Shiva, M

    1997-01-01

    In 1978 the concept of primary health care was adopted by 116 countries at Alma Ata, yet the negative impact of structural readjustment programs in Africa and South America could be felt due to the cuts in expenditures on health, education, and social matters. The result is a resurgence of communicable diseases such as malaria and tuberculosis. Another factor in this resurgence is extreme poverty. In 1994 over 1000 people died in Rajasthan, India, of a malaria epidemic, and during the same time in Delhi over 300 deaths were attributed to hemorrhagic dengue fever. Malariogenic and tuberculous conditions continue to flourish owing to distorted development patterns and commercialization of medical care as public health and community health services are being replaced by profit-oriented curative care, 80% of which is in private hands. This has resulted in spiraling medical care costs and rural indebtedness. Socioeconomic deprivation in developing countries threatens TB control. Factors contributing to the spread of TB were established in 1899 and are still valid in India and other developing countries: TB contamination of air, inadequate food, overcrowded dwelling, and low state of physical health. Even in developed countries TB is on the rise: there were 172 cases in 1991 in England vs. 305 cases in 1993, half of them among immigrants. The increase occurred in the poorest 30% of the population. The World Bank is providing loans for a revised TB and malaria strategy, and the Disability Adjusted Life Year has been used to identify the greatest burden of diseases. On the other hand, the Indian National Health Policy has not been revised since 1983. Priority must be given to those living in extreme poverty to curb the resurgence of once controlled diseases.

  13. Therapeutic interventions in cerebral palsy.

    Science.gov (United States)

    Patel, Dilip R

    2005-11-01

    Various therapeutic interventions have been used in the management of children with cerebral palsy. Traditional physiotherapy and occupational therapy are widely used interventions and have been shown to be of benefit in the treatment of cerebral palsy. Evidence in support of the effectiveness of the neurodevelopmental treatment is equivocal at best. There is evidence to support the use and effectiveness of neuromuscular electrical stimulation in children with cerebral palsy. The effectiveness of many other interventions used in the treatment of cerebral palsy has not been clearly established based on well-controlled trials. These include: sensory integration, body-weight support treadmill training, conductive education, constraint-induced therapy, hyperbaric oxygen therapy, and the Vojta method. This article provides an overview of salient aspects of popular interventions used in the management of children with cerebral palsy.

  14. The treatment of severe malaria.

    Science.gov (United States)

    Dondorp, Arjen M; Day, Nick P J

    2007-07-01

    In the SEAQUAMAT trial, parenteral artesunate was shown to be associated with a considerably lower mortality than quinine, and is now the recommended treatment for severe malaria in low-transmission areas and in the second and third trimesters of pregnancy. A trial is underway to establish its role in African children. The development of artesunate suppositories may provide the means to treat patients with severe disease in remote rural settings, potentially buying the time needed to reach a health care facility. The increasing availability of basic intensive care facilities in developing countries also has the potential to further reduce mortality.

  15. Plasmodium strain determines dendritic cell function essential for survival from malaria.

    Directory of Open Access Journals (Sweden)

    Michelle N Wykes

    2007-07-01

    Full Text Available The severity of malaria can range from asymptomatic to lethal infections involving severe anaemia and cerebral disease. However, the molecular and cellular factors responsible for these differences in disease severity are poorly understood. Identifying the factors that mediate virulence will contribute to developing antiparasitic immune responses. Since immunity is initiated by dendritic cells (DCs, we compared their phenotype and function following infection with either a nonlethal or lethal strain of the rodent parasite, Plasmodium yoelii, to identify their contribution to disease severity. DCs from nonlethal infections were fully functional and capable of secreting cytokines and stimulating T cells. In contrast, DCs from lethal infections were not functional. We then transferred DCs from mice with nonlethal infections to mice given lethal infections and showed that these DCs mediated control of parasitemia and survival. IL-12 was necessary for survival. To our knowledge, our studies have shown for the first time that during a malaria infection, DC function is essential for survival. More importantly, the functions of these DCs are determined by the strain of parasite. Our studies may explain, in part, why natural malaria infections may have different outcomes.

  16. Deletion of a malaria invasion gene reduces death and anemia, in model hosts.

    Directory of Open Access Journals (Sweden)

    Noé D Gómez

    Full Text Available Malaria parasites induce complex cellular and clinical phenotypes, including anemia, cerebral malaria and death in a wide range of mammalian hosts. Host genes and parasite 'toxins' have been implicated in malarial disease, but the contribution of parasite genes remains to be fully defined. Here we assess disease in BALB/c mice and Wistar rats infected by the rodent malaria parasite Plasmodium berghei with a gene knock out for merozoite surface protein (MSP 7. MSP7 is not essential for infection but in P. falciparum, it enhances erythrocyte invasion by 20%. In vivo, as compared to wild type, the P. berghei Δmsp7 mutant is associated with an abrogation of death and a decrease from 3% to 2% in peak, circulating parasitemia. The Δmsp7 mutant is also associated with less anemia and modest increase in the size of follicles in the spleen. Together these data show that deletion of a single parasite invasion ligand modulates blood stage disease, as measured by death and anemia. This work is the first to assess the contribution of a gene present in all plasmodial species in severe disease.

  17. Fast timing discriminator

    International Nuclear Information System (INIS)

    Lo, C.C.

    1977-01-01

    The processing of pulses with very fast risetimes for timing purposes involves many problems because of the large equivalent bandwidths involved. For pulses with risetimes in the 150 ps range (and full widths at half maximum (FWHM) of 400 ps) bandwidths in excess of 1GHz are required. Furthermore, these very narrow pulses with current amplitudes as small as 1 mA carry very small charges ( -12 coulomb), therefore, requiring very sensitive trigger circuits. The difficulty increases when timing characteristics in the picosecond range are sought especially when a wide input signal amplitude range causes a time-walk problem. The fast timing discriminator described has a time-walk of approximately +-75 ps over the input signal range from 80 mV to 3V. A schematic of the discriminator is included, and operation and performance are discussed

  18. Cerebral imaging in pediatrics

    International Nuclear Information System (INIS)

    Gordon, I.

    1998-01-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics

  19. Cerebral imaging in pediatrics

    Energy Technology Data Exchange (ETDEWEB)

    Gordon, I [London, Great Ormond Street Hospital for Children (United Kingdom)

    1998-06-01

    Radioisotope brain imaging has focused mainly on regional cerebral blood flow (rCBF). However the use of ligand which go to specific receptor sites is being introduced in pediatrics, mainly psychiatry. rCBF is potentially available in many institutions, especially with the availability of multi-headed gamma cameras. The use of this technique in pediatrics requires special attention to detail in the manner of data acquisition and handling the child. The interpretation of the rCBF study in a child requires knowledge of normal brain maturation. The major clinical use in pediatrics is epilepsy because of the advances in surgery and the frequency of complex partial seizures. Other indications in pediatric neurology include brain death, acute neurological loss including stroke, language disorders, cerebral palsy, hypertension due to renovascular disease, traumatic brain injury and migraine. There are pediatric physiological conditions in which rCBF has been undertaken, these include anorexia nervosa, autism, Gilles de la Tourette syndrome (GTS) and attention deficit disorder-hyperactivity (ADHD). Research using different ligands to specific receptor sites will also be reviewed in pediatrics.

  20. Cerebral cartography and connectomics.

    Science.gov (United States)

    Sporns, Olaf

    2015-05-19

    Cerebral cartography and connectomics pursue similar goals in attempting to create maps that can inform our understanding of the structural and functional organization of the cortex. Connectome maps explicitly aim at representing the brain as a complex network, a collection of nodes and their interconnecting edges. This article reflects on some of the challenges that currently arise in the intersection of cerebral cartography and connectomics. Principal challenges concern the temporal dynamics of functional brain connectivity, the definition of areal parcellations and their hierarchical organization into large-scale networks, the extension of whole-brain connectivity to cellular-scale networks, and the mapping of structure/function relations in empirical recordings and computational models. Successfully addressing these challenges will require extensions of methods and tools from network science to the mapping and analysis of human brain connectivity data. The emerging view that the brain is more than a collection of areas, but is fundamentally operating as a complex networked system, will continue to drive the creation of ever more detailed and multi-modal network maps as tools for on-going exploration and discovery in human connectomics. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  1. Cerebral Gluconeogenesis and Diseases

    Science.gov (United States)

    Yip, James; Geng, Xiaokun; Shen, Jiamei; Ding, Yuchuan

    2017-01-01

    The gluconeogenesis pathway, which has been known to normally present in the liver, kidney, intestine, or muscle, has four irreversible steps catalyzed by the enzymes: pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose 1,6-bisphosphatase, and glucose 6-phosphatase. Studies have also demonstrated evidence that gluconeogenesis exists in brain astrocytes but no convincing data have yet been found in neurons. Astrocytes exhibit significant 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 activity, a key mechanism for regulating glycolysis and gluconeogenesis. Astrocytes are unique in that they use glycolysis to produce lactate, which is then shuttled into neurons and used as gluconeogenic precursors for reduction. This gluconeogenesis pathway found in astrocytes is becoming more recognized as an important alternative glucose source for neurons, specifically in ischemic stroke and brain tumor. Further studies are needed to discover how the gluconeogenesis pathway is controlled in the brain, which may lead to the development of therapeutic targets to control energy levels and cellular survival in ischemic stroke patients, or inhibit gluconeogenesis in brain tumors to promote malignant cell death and tumor regression. While there are extensive studies on the mechanisms of cerebral glycolysis in ischemic stroke and brain tumors, studies on cerebral gluconeogenesis are limited. Here, we review studies done to date regarding gluconeogenesis to evaluate whether this metabolic pathway is beneficial or detrimental to the brain under these pathological conditions. PMID:28101056

  2. Cerebral Gluconeogenesis and Diseases.

    Science.gov (United States)

    Yip, James; Geng, Xiaokun; Shen, Jiamei; Ding, Yuchuan

    2016-01-01

    The gluconeogenesis pathway, which has been known to normally present in the liver, kidney, intestine, or muscle, has four irreversible steps catalyzed by the enzymes: pyruvate carboxylase, phosphoenolpyruvate carboxykinase, fructose 1,6-bisphosphatase, and glucose 6-phosphatase. Studies have also demonstrated evidence that gluconeogenesis exists in brain astrocytes but no convincing data have yet been found in neurons. Astrocytes exhibit significant 6-phosphofructo-2-kinase/fructose-2,6-bisphosphatase-3 activity, a key mechanism for regulating glycolysis and gluconeogenesis. Astrocytes are unique in that they use glycolysis to produce lactate, which is then shuttled into neurons and used as gluconeogenic precursors for reduction. This gluconeogenesis pathway found in astrocytes is becoming more recognized as an important alternative glucose source for neurons, specifically in ischemic stroke and brain tumor. Further studies are needed to discover how the gluconeogenesis pathway is controlled in the brain, which may lead to the development of therapeutic targets to control energy levels and cellular survival in ischemic stroke patients, or inhibit gluconeogenesis in brain tumors to promote malignant cell death and tumor regression. While there are extensive studies on the mechanisms of cerebral glycolysis in ischemic stroke and brain tumors, studies on cerebral gluconeogenesis are limited. Here, we review studies done to date regarding gluconeogenesis to evaluate whether this metabolic pathway is beneficial or detrimental to the brain under these pathological conditions.

  3. Gender wage discrimination

    OpenAIRE

    Hirsch, Boris

    2016-01-01

    There are pronounced and persistent wage differences between men and women in all parts of the world. A significant element of these wage disparities can be attributed to differences in worker and workplace characteristics, which are likely to mirror differences in worker productivity. However, a large part of these differences remains unexplained, and it is common to attribute them to discrimination by the employer that is rooted in prejudice against female workers. Yet recent empirical evid...

  4. Diversity, discrimination, and performance

    OpenAIRE

    Leonard, Jonathan S.; Levine, David I.

    2003-01-01

    Employee diversity may affect business performance both as a result of customer discrimination and as a result of how members of a group work with each other in teams. We test for both channels with data from more than 800 retail stores employing over 70,000 individuals matched to Census data on the demographics of the community. We find little payoff to matching employee demographics to those of potential customers except when the customers do not speak English. Although age diversity doe...

  5. [Comment on] Statistical discrimination

    Science.gov (United States)

    Chinn, Douglas

    In the December 8, 1981, issue of Eos, a news item reported the conclusion of a National Research Council study that sexual discrimination against women with Ph.D.'s exists in the field of geophysics. Basically, the item reported that even when allowances are made for motherhood the percentage of female Ph.D.'s holding high university and corporate positions is significantly lower than the percentage of male Ph.D.'s holding the same types of positions. The sexual discrimination conclusion, based only on these statistics, assumes that there are no basic psychological differences between men and women that might cause different populations in the employment group studied. Therefore, the reasoning goes, after taking into account possible effects from differences related to anatomy, such as women stopping their careers in order to bear and raise children, the statistical distributions of positions held by male and female Ph.D.'s ought to be very similar to one another. Any significant differences between the distributions must be caused primarily by sexual discrimination.

  6. Workplace discrimination and cancer.

    Science.gov (United States)

    McKenna, Maureen A; Fabian, Ellen; Hurley, Jessica E; McMahon, Brian T; West, Steven L

    2007-01-01

    Data from the Equal Employment Opportunity Commission (EEOC) Integrated Mission System database were analyzed with specific reference to allegations of workplace discrimination filed by individuals with cancer under ADA Title One. These 6,832 allegations, filed between July 27, 1992 and September 30, 2003, were compared to 167,798 allegations from a general disability population on the following dimensions: type of workplace discrimination; demographic characteristics of the charging parties (CPs); the industry designation, location, and size of employers; and the outcome or resolution of EEOC investigations. Results showed allegations derived from CPs with cancer were more likely than those in the general disability population to include issues involving discharge, terms and conditions of employment, lay-off, wages, and demotion. Compared to the general disability group, CPs with cancer were more likely to be female, older, and White. Allegations derived from CPs with cancer were also more likely to be filed against smaller employers (15-100 workers) or those in service industries. Finally, the resolution of allegations by CPs with cancer were more likely to be meritorious than those filed from the general disability population; that is, actual discrimination is more likely to have occurred.

  7. Price Discrimination: A Classroom Experiment

    Science.gov (United States)

    Aguiló, Paula; Sard, Maria; Tugores, Maria

    2016-01-01

    In this article, the authors describe a classroom experiment aimed at familiarizing students with different types of price discrimination (first-, second-, and third-degree price discrimination). During the experiment, the students were asked to decide what tariffs to set as monopolists for each of the price discrimination scenarios under…

  8. Transgender Discrimination and the Law

    Science.gov (United States)

    Trotter, Richard

    2010-01-01

    An emerging area of law is developing regarding sex/gender identity discrimination, also referred to as transgender discrimination, as distinguished from discrimination based on sexual orientation. A transgendered individual is defined as "a person who has a gender-identity disorder which is a persistent discomfort about one?s assigned sex or…

  9. The neural network involved in a bimanual tactile-tactile matching discrimination task: a functional imaging study at 3 T

    Energy Technology Data Exchange (ETDEWEB)

    Habas, Christophe; Cabanis, Emmanuel A. [UPMC Paris 6, Service de NeuroImagerie, Hopital des Quinze-Vingts, Paris (France)

    2007-08-15

    The cerebral and cerebellar network involved in a bimanual object recognition was studied in blood oxygenation dependent level functional magnetic resonance imaging (fMRI). Nine healthy right-handed volunteers were scanned (1) while performing bilateral finger movements (nondiscrimination motor task), and (2) while performing a bimanual tactile-tactile matching discrimination task using small chess pieces (tactile discrimination task). Extensive activations were specifically observed in the parietal (SII, superior lateral lobule), insular, prefrontal, cingulate and neocerebellar cortices (HVIII), with a left predominance in motor areas, during the tactile discrimination task in contrast to the findings during the nondiscrimination motor task. Bimanual tactile-tactile matching discrimination recruits multiple sensorimotor and associative cerebral and neocerebellar networks (including the cerebellar second homunculus, HVIII), comparable to the neural circuits involved in unimanual tactile object recognition. (orig.)

  10. An epidemiological overview of malaria in Bangladesh.

    Science.gov (United States)

    Islam, Nazrul; Bonovas, Stefanos; Nikolopoulos, Georgios K

    2013-01-01

    Bangladesh is one of the four major malaria-endemic countries in South-East Asia having approximately 34% of its population at risk of malaria. This paper aims at providing an overview of the malaria situation in this country. Relevant information was retrieved from published articles and reports in PubMed and Google Scholar. Malaria in Bangladesh is concentrated in 13 districts with a prevalence ranging between 3.1% and 36%, and is mostly caused by Plasmodium falciparum. Geographical conditions pose a potential risk for Plasmodium knowlesi malaria. Resistance to a number of drugs previously recommended for treatment has been reported. Low socio-economic status, poor schooling and close proximity to water bodies and forest areas comprise important risk factors. Despite the significant steps in Long Lasting Insecticide Net (LLIN)/Insecticide Treated Net (ITN) coverage in Bangladesh, there are still many challenges including the extension of malaria support to the remote areas of Bangladesh, where malaria prevalence is higher, and further improvements in the field of referral system and treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Socio-Economic-Political-Cultural Aspects in Malaria Control Programme Implementation in Southern India

    Directory of Open Access Journals (Sweden)

    S. K. Ghosh

    2012-01-01

    Full Text Available Objective. A Socio-economic-political-cultural (SEPC study was undertaken under the Roll Back Malaria (RBM initiative to understand the process of programme implementation and how far in the changing malaria context, the broader environment has been understood and programme components have undergone changes. Material and Methods. Two studies were carried out; first in four villages under the primary health unit (PHU Banavaralu in Tiptur Taluka in September 2002 and the second one in April 2003 in four villages in Chitradurga district, namely, Kappagere, Kellodu in Hosadurga Taluka, and Vani Vilas Puram and Kathrikenhally in Hiriyur Taluka. Focus group discussion and key interviews were adopted to collect the qualitative data. Results. Gender discrimination and lack of empowerment of women came out strongly in social analysis. In the rural elected bodies called Panchayats, the concept of health committees was not known. Health committees as one of the important statutory committees under every Panchayat were nonexistent in reality in these villages. Financial difficulties at Grama Panchayat level and also meager budget allocation for health have led to indifferent attitude of Panchayat members towards health. It was observed that there were generally no specific cultural practices in relation to malaria cure. Cultural and traditional practices in malaria-related issues were not predominant in the community except for some sporadic instances. Conclusion and Recommendation. SEPC study is an important indicator in malaria control programme. It is ultimately the community that takes the major decision directly or indirectly and the health authority must guide them in right direction.

  12. Malaria transmission in Tripura: Disease distribution & determinants.

    Science.gov (United States)

    Dev, Vas; Adak, Tridibes; Singh, Om P; Nanda, Nutan; Baidya, Bimal K

    2015-12-01

    Malaria is a major public health problem in Tripura and focal disease outbreaks are of frequent occurrence. The state is co-endemic for both Plasmodium falciparum and P. vivax and transmission is perennial and persistent. The present study was aimed to review data on disease distribution to prioritize high-risk districts, and to study seasonal prevalence of disease vectors and their bionomical characteristics to help formulate vector species-specific interventions for malaria control. Data on malaria morbidity in the State were reviewed retrospectively (2008-2012) for understanding disease distribution and transmission dynamics. Cross-sectional mass blood surveys were conducted in malaria endemic villages of South Tripura district to ascertain the prevalence of malaria and proportions of parasite species. Mosquito collections were made in human dwellings of malaria endemic villages aiming at vector incrimination and to study relative abundance, resting and feeding preferences, and their present susceptibility status to DDT. The study showed that malaria was widely prevalent and P. falciparum was the predominant infection (>90%), the remaining were P. vivax cases. The disease distribution, however, was uneven with large concentration of cases in districts of South Tripura and Dhalai coinciding with vast forest cover and tribal populations. Both Anopheles minimus s.s. and An. baimaii were recorded to be prevalent and observed to be highly anthropophagic and susceptible to DDT. Of these, An. minimus was incriminated (sporozoite infection rate 4.92%), and its bionomical characteristics revealed this species to be largely indoor resting and endophagic. For effective control of malaria in the state, it is recommended that diseases surveillance should be robust, and vector control interventions including DDT spray coverage, mass distribution of insecticide-treated nets/ long-lasting insecticidal nets should be intensified prioritizing population groups most at risk to

  13. Malaria vaccine offers hope. International / Africa.

    Science.gov (United States)

    1995-03-13

    Colombian professor Manuel Patarroyo developed a new malaria vaccine (SPF66). In February 1995, WHO and the Colombian government agreed to establish a manufacturing plant in Colombia for mass production of SPF66. This vaccine is likely to be available to persons in Africa, where 90% of all annual global cases live. In fact, Africa witnesses one million of 1.5 million annual malaria cases. Many children die from malaria. An extensive clinical trial of the SPF66 vaccine in Colombia achieved a 22-77% protection rate. The young and the very old had the high protection rates. A series of human clinical trials in the Gambia and Tanzania indicate that SPF66 produces a strong immune response against malaria without any harmful side effects. The results of field tests in the Gambia and Thailand and of trials in Colombia are expected in 1995. If the vaccine could reduce the incidence of malaria by just 50%, the lives of as many as 500,000 African children could be saved. SPF66 contains a combination of synthetic peptides (=or 2 amino acids). Mass production would make it affordable (estimated $5/injection). At least five other malaria vaccines hold promise and are ready for human testing in endemic countries. SPF66 is approximately three years ahead of all other promising malaria vaccines. 20 more vaccines are in the development stage. The large scale production of SPF66 in Colombia could begin within three years. Professor Patarroyo has financed his 12-year-old research himself because he wants to protect the lives of persons in developing countries. In 1992, the Congo's president petitioned the international community at the WHO summit in Amsterdam to join the fight against malaria since it is now in a position to defeat malaria since it finished the cold war.

  14. Epidemiology of Plasmodium vivax Malaria in Peru.

    Science.gov (United States)

    Rosas-Aguirre, Angel; Gamboa, Dionicia; Manrique, Paulo; Conn, Jan E; Moreno, Marta; Lescano, Andres G; Sanchez, Juan F; Rodriguez, Hugo; Silva, Hermann; Llanos-Cuentas, Alejandro; Vinetz, Joseph M

    2016-12-28

    Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s-2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005-2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine-primaquine for P. vivax Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination. © The American Society of Tropical Medicine and Hygiene.

  15. Forecasting Malaria in the Western Amazon

    Science.gov (United States)

    Pan, W. K.; Zaitchik, B. F.; Pizzitutti, F.; Berky, A.; Feingold, B.; Mena, C.; Janko, M.

    2017-12-01

    Reported cases of malaria in the western Amazon regions of Peru, Colombia and Ecuador have more than tripled since 2011. Responding to this epidemic has been challenging given large-scale environmental impacts and demographic changes combined with changing financial and political priorities. In Peru alone, malaria cases increased 5-fold since 2011. Reasons include changes in the Global Malaria Fund, massive flooding in 2012, the "mega" El Nino in 2016, and continued natural resource extraction via logging and mining. These challenges prompted the recent creation of the Malaria Cero program in 2017 with the goal to eradicate malaria by 2021. To assist in malaria eradiation, a team of investigators supported by NASA have been developing an Early Warning System for Malaria. The system leverages demographic, epidemiological, meteorological and land use/cover data to develop a four-component system that will improve detection of malaria across the western Amazon Basin. System components include a land data assimilation system (LDAS) to estimate past and future hydrological states and flux, a seasonal human population model to estimate population at risk and spatial connectivity to high risk transmission areas, a sub-regional statistical model to identify when and where observed malaria cases have exceeded those expected, and an Agent Based Model (ABM) to integrate human, environmental, and entomological transmission dynamics with potential strategies for control. Data include: daily case detection reports between 2000 and 2017 from all health posts in the region of Loreto in the northern Peruvian Amazon; LDAS outputs (precipitation, temperature, humidity, solar radiation) at a 1km and weekly scale; satellite-derived estimates of land cover; and human population size from census and health data. This presentation will provide an overview of components, focusing on how the system identifies an outbreak and plans for technology transfer.

  16. Prevalence of Malaria Plasmodium in Abeokuta, Nigeria

    Directory of Open Access Journals (Sweden)

    Okonko, I. O.

    2009-01-01

    Full Text Available This study reports the prevalence of malaria caused by plasmodium between genders in Abeokuta, the capital city of Ogun State located in the forest zone of southwestern Nigeria between January 2002 and December 2004. Blood film examination for malaria parasites in 708 patients; 366 males and 342 females. Microscopic examination of thick films techniques was employed for this study. Of the 708 (100% patients examined, 577 (81.5% were Plasmodium-positive. A high malaria parasite prevalence rate of 81.5% was noted in this study. Female subjects were more infected (42.4% than males (41.9% however, there was no significant difference in the sex of the subjects studied (p=0.05. A high malaria parasite prevalence rate of 86.9% was noted in samples collected in year 2003 than in other years studied. There was significant difference in the years under study (p=0.05. This study shows that a good percentage of people were infested by malaria Plasmodium. This could be attributed to lack of adequate accommodation and poor sanitary conditions in the area under study. Although several efforts have been made to effectively control the high incidence of malaria in Nigeria, these have been largely unsuccessful due to a number of reasons such as irrigated urban agriculture which can be the malaria vector’s breeding ground in the city, stagnant gutters and swamps in our environment where mosquitoes breed in millions, and lack of political will and commitment of the government in its disease management program, low awareness of the magnitude of malaria problem, poor health practices by individuals and communities and resistance to drugs. Therefore, future interventions in Nigeria should be directed toward controlling malaria in the context of a moderate transmission setting; thus, large-scale distribution of insecticide-treated nets or widespread use of indoor residual spraying may be less cost-effective than enhanced surveillance with effective case management or

  17. Epidemiology of Plasmodium vivax Malaria in Peru

    Science.gov (United States)

    Rosas-Aguirre, Angel; Gamboa, Dionicia; Manrique, Paulo; Conn, Jan E.; Moreno, Marta; Lescano, Andres G.; Sanchez, Juan F.; Rodriguez, Hugo; Silva, Hermann; Llanos-Cuentas, Alejandro; Vinetz, Joseph M.

    2016-01-01

    Malaria in Peru, dominated by Plasmodium vivax, remains a public health problem. The 1990s saw newly epidemic malaria emerge, primarily in the Loreto Department in the Amazon region, including areas near to Iquitos, the capital city, but sporadic malaria transmission also occurred in the 1990s–2000s in both north-coastal Peru and the gold mining regions of southeastern Peru. Although a Global Fund-supported intervention (PAMAFRO, 2005–2010) was temporally associated with a decrease of malaria transmission, from 2012 to the present, both P. vivax and Plasmodium falciparum malaria cases have rapidly increased. The Peruvian Ministry of Health continues to provide artemesinin-based combination therapy for microscopy-confirmed cases of P. falciparum and chloroquine–primaquine for P. vivax. Malaria transmission continues in remote areas nonetheless, where the mobility of humans and parasites facilitates continued reintroduction outside of ongoing surveillance activities, which is critical to address for future malaria control and elimination efforts. Ongoing P. vivax research gaps in Peru include the following: identification of asymptomatic parasitemics, quantification of the contribution of patent and subpatent parasitemics to mosquito transmission, diagnosis of nonparasitemic hypnozoite carriers, and implementation of surveillance for potential emergence of chloroquine- and 8-aminoquinoline-resistant P. vivax. Clinical trials of tafenoquine in Peru have been promising, and glucose-6-phosphate dehydrogenase deficiency in the region has not been observed to be a limitation to its use. Larger-scale challenges for P. vivax (and malaria in general) in Peru include logistical difficulties in accessing remote riverine populations, consequences of government policy and poverty trends, and obtaining international funding for malaria control and elimination. PMID:27799639

  18. Malaria infection has spatial, temporal, and spatiotemporal heterogeneity in unstable malaria transmission areas in northwest Ethiopia.

    Directory of Open Access Journals (Sweden)

    Kassahun Alemu

    Full Text Available BACKGROUND: Malaria elimination requires successful nationwide control efforts. Detecting the spatiotemporal distribution and mapping high-risk areas are useful to effectively target pockets of malaria endemic regions for interventions. OBJECTIVE: The aim of the study was to identify patterns of malaria distribution by space and time in unstable malaria transmission areas in northwest Ethiopia. METHODS: Data were retrieved from the monthly reports stored in the district malaria offices for the period between 2003 and 2012. Eighteen districts in the highland and fringe malaria areas were included and geo-coded for the purpose of this study. The spatial data were created in ArcGIS10 for each district. The Poisson model was used by applying Kulldorff methods using the SaTScan™ software to analyze the purely temporal, spatial and space-time clusters of malaria at a district levels. RESULTS: The study revealed that malaria case distribution has spatial, temporal, and spatiotemporal heterogeneity in unstable transmission areas. Most likely spatial malaria clusters were detected at Dera, Fogera, Farta, Libokemkem and Misrak Este districts (LLR =197764.1, p<0.001. Significant spatiotemporal malaria clusters were detected at Dera, Fogera, Farta, Libokemkem and Misrak Este districts (LLR=197764.1, p<0.001 between 2003/1/1 and 2012/12/31. A temporal scan statistics identified two high risk periods from 2009/1/1 to 2010/12/31 (LLR=72490.5, p<0.001 and from 2003/1/1 to 2005/12/31 (LLR=26988.7, p<0.001. CONCLUSION: In unstable malaria transmission areas, detecting and considering the spatiotemporal heterogeneity would be useful to strengthen malaria control efforts and ultimately achieve elimination.

  19. Observation of Blood Donor-Recipient Malaria Parasitaemia Patterns in a Malaria Endemic Region

    OpenAIRE

    Jamilu Abdullahi Faruk; Gboye Olufemi Ogunrinde; Aisha Indo Mamman

    2017-01-01

    Background. Asymptomatic malaria parasitaemia has been documented in donor blood in West Africa. However, donated blood is not routinely screened for malaria parasites (MPs). The present study therefore aimed to document the frequency of blood transfusion-induced donor-recipient malaria parasitaemia patterns, in children receiving blood transfusion in a tertiary health-centre. Methodology. A cross-sectional, observational study involving 140 children receiving blood transfusion was carried ou...

  20. Management of imported malaria in Europe

    Directory of Open Access Journals (Sweden)

    Askling Helena H

    2012-09-01

    Full Text Available Abstract In this position paper, the European Society for Clinical Microbiology and Infectious Diseases, Study Group on Clinical Parasitology, summarizes main issues regarding the management of imported malaria cases. Malaria is a rare diagnosis in Europe, but it is a medical emergency. A travel history is the key to suspecting malaria and is mandatory in patients with fever. There are no specific clinical signs or symptoms of malaria although fever is seen in almost all non-immune patients. Migrants from malaria endemic areas may have few symptoms. Malaria diagnostics should be performed immediately on suspicion of malaria and the gold- standard is microscopy of Giemsa-stained thick and thin blood films. A Rapid Diagnostic Test (RDT may be used as an initial screening tool, but does not replace urgent microscopy which should be done in parallel. Delays in microscopy, however, should not lead to delayed initiation of appropriate treatment. Patients diagnosed with malaria should usually be hospitalized. If outpatient management is preferred, as is the practice in some European centres, patients must usually be followed closely (at least daily until clinical and parasitological cure. Treatment of uncomplicated Plasmodium falciparum malaria is either with oral artemisinin combination therapy (ACT or with the combination atovaquone/proguanil. Two forms of ACT are available in Europe: artemether/lumefantrine and dihydroartemisinin/piperaquine. ACT is also effective against Plasmodium vivax, Plasmodium ovale, Plasmodium malariae and Plasmodium knowlesi, but these species can be treated with chloroquine. Treatment of persistent liver forms in P. vivax and P. ovale with primaquine is indicated after excluding glucose 6 phosphate dehydrogenase deficiency. There are modified schedules and drug options for the treatment of malaria in special patient groups, such as children and pregnant women. The potential for drug interactions and the role of food in the

  1. Prevalence of cerebral palsy in Uganda: a population-based study.

    Science.gov (United States)

    Kakooza-Mwesige, Angelina; Andrews, Carin; Peterson, Stefan; Wabwire Mangen, Fred; Eliasson, Ann Christin; Forssberg, Hans

    2017-12-01

    probable cause of cerebral palsy in 24 (25%) of 97 children. Cerebral palsy prevalence was higher in rural Uganda than in high-income countries (HICs), where prevalence is about 1·8-2·3 cases per 1000 children. Children younger than 8 years were more likely to have severe cerebral palsy than older children. Fewer older children than younger children with cerebral palsy suggested a high mortality in severely affected children. The small number of preterm-born children probably resulted from low preterm survival. About five times more children with post-neonatal cerebral palsy in Uganda than in HICs suggested that cerebral malaria and seizures were prevalent risk factors in this population. Swedish Research Council, Promobilia. Copyright © 2017 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.

  2. Low power constant fraction discriminator

    International Nuclear Information System (INIS)

    Krishnan, Shanti; Raut, S.M.; Mukhopadhyay, P.K.

    2001-01-01

    This paper describes the design of a low power ultrafast constant fraction discriminator, which significantly reduces the power consumption. A conventional fast discriminator consumes about 1250 MW of power whereas this low power version consumes about 440 MW. In a multi detector system, where the number of discriminators is very large, reduction of power is of utmost importance. This low power discriminator is being designed for GRACE (Gamma Ray Atmospheric Cerenkov Experiments) telescope where 1000 channels of discriminators are required. A novel method of decreasing power consumption has been described. (author)

  3. Clinical malaria case definition and malaria attributable fraction in the highlands of western Kenya.

    Science.gov (United States)

    Afrane, Yaw A; Zhou, Guofa; Githeko, Andrew K; Yan, Guiyun

    2014-10-15

    In African highland areas where endemicity of malaria varies greatly according to altitude and topography, parasitaemia accompanied by fever may not be sufficient to define an episode of clinical malaria in endemic areas. To evaluate the effectiveness of malaria interventions, age-specific case definitions of clinical malaria needs to be determined. Cases of clinical malaria through active case surveillance were quantified in a highland area in Kenya and defined clinical malaria for different age groups. A cohort of over 1,800 participants from all age groups was selected randomly from over 350 houses in 10 villages stratified by topography and followed for two-and-a-half years. Participants were visited every two weeks and screened for clinical malaria, defined as an individual with malaria-related symptoms (fever [axillary temperature≥37.5°C], chills, severe malaise, headache or vomiting) at the time of examination or 1-2 days prior to the examination in the presence of a Plasmodium falciparum positive blood smear. Individuals in the same cohort were screened for asymptomatic malaria infection during the low and high malaria transmission seasons. Parasite densities and temperature were used to define clinical malaria by age in the population. The proportion of fevers attributable to malaria was calculated using logistic regression models. Incidence of clinical malaria was highest in valley bottom population (5.0% cases per 1,000 population per year) compared to mid-hill (2.2% cases per 1,000 population per year) and up-hill (1.1% cases per 1,000 population per year) populations. The optimum cut-off parasite densities through the determination of the sensitivity and specificity showed that in children less than five years of age, 500 parasites per μl of blood could be used to define the malaria attributable fever cases for this age group. In children between the ages of 5-14, a parasite density of 1,000 parasites per μl of blood could be used to define the

  4. Evaluación del estres oxidativo en pacientes con malaria

    Directory of Open Access Journals (Sweden)

    Margarita Zuleta

    2000-02-01

    Full Text Available

    El estrés oxidativo se define como un imbalance entre la generación de especies reactivas del oxígeno y la cantidad de enzimas y compuestos antioxidantes.

    En malaria, el estrés oxidativo se presenta con la generación aumentada de especies reactivas del oxígeno como anión superóxido, peróxido de hidrógeno, radical hidroxilo y peroxinitrito; éstas son producidas por el sistema inmune del hospedero con el objetivo de controlar la parasitemia y directamente por el parásito intraeritrocítico, cuando en la vacuola digestiva transforman la hemoglobina en metahemoglobina. La producción de especies reactivas del oxígeno en malaria se ha demostrado por la peroxidación lipídica en eritrocitos infectados con plasmodium durante la fase aguda de la infección, determinada por métodos indirectos como el incremento en los niveles del ácido tiobarbitúrico en eritrocitos infectados o por el incremento en los niveles de malondialdehido en pacientes con malaria cerebral y por la disminución en la cadena de ácidos grasos poliinsaturados en los eritrocitos infectados.

    El estrés oxidativo en malaria también se presenta con la disminución de enzimas y sustancias antioxidantes como la albúmina, el tocoferol plasmático, los niveles de enzimas como catalasa, glutatión peroxidasa y superóxido dismutasa en pacientes con malaria tanto causado por P. vivax como por P. falciparum. El estrés oxidativo en malaria se ha asociado con complicaciones como la malaria cerebral, porque las especies reactivas del oxígeno están involucradas en el daño del endotelio vascular del hospedero y con altas parasitemias en pacientes infectados con P. falciparum.

    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 PfEMP1 family of adhesive proteins is responsible for this sequestration by mediating interactions with diverse human ligands. In addition, as the primary targets of acquired, protective immunity, the PfEMP1s are potential vaccine candidates. PfEMP1s contain large extracellular ectodomains made from......, intercellular adhesion molecule-1 (ICAM-1). We show through small angle x-ray scattering that IT4VAR13 is rigid, elongated, and monomeric. We also show that it interacts with ICAM-1 through the DBLß domain alone, forming a 1:1 complex. These studies provide a first low resolution structural view of a PfEMP1...

  5. The history of 20th century malaria control in Peru.

    Science.gov (United States)

    Griffing, Sean M; Gamboa, Dionicia; Udhayakumar, Venkatachalam

    2013-08-30

    Malaria has been part of Peruvian life since at least the 1500s. While Peru gave the world quinine, one of the first treatments for malaria, its history is pockmarked with endemic malaria and occasional epidemics. In this review, major increases in Peruvian malaria incidence over the past hundred years are described, as well as the human factors that have facilitated these events, and concerted private and governmental efforts to control malaria. Political support for malaria control has varied and unexpected events like vector and parasite resistance have adversely impacted morbidity and mortality. Though the ready availability of novel insecticides like DDT and efficacious medications reduced malaria to very low levels for a decade after the post eradication era, malaria reemerged as an important modern day challenge to Peruvian public health. Its reemergence sparked collaboration between domestic and international partners towards the elimination of malaria in Peru.

  6. Changing pattern of malaria in Bissau, Guinea Bissau

    DEFF Research Database (Denmark)

    Rodrigues, Amabelia; Schellenberg, Joanna Armstrong; Kofoed, Poul-Erik

    2008-01-01

    OBJECTIVE: To describe the epidemiology of malaria in Guinea-Bissau, in view of the fact that more funds are available now for malaria control in the country. METHODS: From May 2003 to May 2004, surveillance for malaria was conducted among children less than 5 years of age at three health centres...... covering the study area of the Bandim Health Project (BHP) and at the outpatient clinic of the national hospital in Bissau. Cross-sectional surveys were conducted in the community in different malaria seasons. RESULTS: Malaria was overdiagnosed in both health centres and hospital. Sixty-four per cent...... of the children who presented at a health centre were clinically diagnosed with malaria, but only 13% of outpatient children who tested for malaria had malaria parasitaemia. Only 44% (963/2193) of children admitted to hospital with a diagnosis of malaria had parasitaemia. The proportion of positive cases...

  7. Cerebral toxoplasmosis in AIDS

    International Nuclear Information System (INIS)

    Christ, F.; Steudel, H.; Klotz, D.; Bonn Univ.; Bonn Univ.

    1986-01-01

    Since 1982 (Hauser and co-workers), literature has reported focal cerebral tissue charges in AIDS patients whose diagnosis was unclear at first but which could be identified finally as florid toxoplasmosis encephalitis by biopsy and autopsy. It was found that the value of otherwise reliable serological tests (KBR, Sabin-Feldmann tests, etc.) is questionable in patients with severely impaired or incompetent immune systems, and, in particular, that a negative or uncharacteristic test result may not preclude any opportunistic infection process. Furthermore, isolation of Toxoplasma gondii or specific antibodies from the cerebrospinal fluid will be successful in exceptional cases only. In patients with AIDS or lymphadenopathy syndrome, the differential diagnosis will have to include - first and foremost - reactivated toxoplasma infection (not newly acquired, as a rule) if central neurological symptoms occur. (orig.) [de

  8. Cerebral white matter hypoplasia

    International Nuclear Information System (INIS)

    Dietrich, R.B.; Shields, W.D.; Sankar, R.

    1990-01-01

    This paper demonstrates the MR imaging findings in children with cerebral white matter hypoplasia (CWMH). The MR studies of four children, aged 3-7 y (mean age, 2.3 y) with a diagnosis of CWMH were reviewed. In all cases multiplanar T1-weighted and T2-weighted spin-echo images were obtained. All children had similar histories of severe developmental delay and nonprogressive neurologic deficits despite normal gestational and birth histories. In two cases there was a history of maternal cocaine abuse. Autopsy correlation was available in one child. The MR images of all four children demonstrated diffuse lack of white matter and enlarged ventricles but normal-appearing gray matter. The corpus callosum, although completely formed, was severely thinned. There was no evidence of gliosis or porencephaly, and the distribution of myelin deposition was normal for age in all cases. Autopsy finding in one child correlated exactly with the MR finding

  9. Multiple cerebral hydatid cysts

    Energy Technology Data Exchange (ETDEWEB)

    Banzo, J.; Pina, J.I.; Abos, M.D.; Rios, G.; Garcia, D.; Marin, F.; Diaz, F.J.

    1984-12-01

    A 39-year-old woman was admitted to hospital with headaches, vomiting, psychic impairment and diplopia. Three hydatid cysts of the lung had been previously removed. An avascular mass in the left hemisphere with left-to-right displacement of the anterior cerebral arteries was noted during a brain angioscintigraphy. A cerebralthrombosis (CT) brain scan showed two cystic lesions situated in the left-frontal and occipital regions. A CT abdominal scan showed multiple cysts in the liver, spleen and both kidneys. At operation, two brain cysts were totally extirpated without rupture. The definite pathological diagnosis was secondry hydatid cysts. The headaches, vomiting and diplopia were persistent in the post-operative period. Seven days after the operation, a CT brain scan showed an infratenrorial cyst. The patient rejected any surgical intervention.

  10. Remote Sensing as a Landscape Epidemiologic Tool to Identify Villages at High Risk for Malaria Transmission

    Science.gov (United States)

    Beck, Louisa R.; Rodriquez, Mario H.; Dister, Sheri W.; Rodriquez, Americo D.; Rejmankova, Eliska; Ulloa, Armando; Meza, Rosa A.; Roberts, Donald R.; Paris, Jack F.; Spanner, Michael A.; hide

    1994-01-01

    A landscape approach using remote sensing and Geographic Information System (GIS) technologies was developed to discriminate between villages at high and low risk for malaria transmission, as defined by adult Anopheles albimanus abundance. Satellite data for an area in southern Chiapas, Mexico were digitally processed to generate a map of landscape elements. The GIS processes were used to determine the proportion of mapped landscape elements surrounding 40 villages where An. albimanus data had been collected. The relationships between vector abundance and landscape element proportions were investigated using stepwise discriminant analysis and stepwise linear regression. Both analyses indicated that the most important landscape elements in terms of explaining vector abundance were transitional swamp and unmanaged pasture. Discriminant functions generated for these two elements were able to correctly distinguish between villages with high ind low vector abundance, with an overall accuracy of 90%. Regression results found both transitional swamp and unmanaged pasture proportions to be predictive of vector abundance during the mid-to-late wet season. This approach, which integrates remotely sensed data and GIS capabilities to identify villages with high vector-human contact risk, provides a promising tool for malaria surveillance programs that depend on labor-intensive field techniques. This is particularly relevant in areas where the lack of accurate surveillance capabilities may result in no malaria control action when, in fact, directed action is necessary. In general, this landscape approach could be applied to other vector-borne diseases in areas where: 1. the landscape elements critical to vector survival are known and 2. these elements can be detected at remote sensing scales.

  11. Merozoite surface protein-1 genetic diversity in Plasmodium malariae and Plasmodium brasilianum from Brazil.

    Science.gov (United States)

    Guimarães, Lilian O; Wunderlich, Gerhard; Alves, João M P; Bueno, Marina G; Röhe, Fabio; Catão-Dias, José L; Neves, Amanda; Malafronte, Rosely S; Curado, Izilda; Domingues, Wilson; Kirchgatter, Karin

    2015-11-16

    The merozoite surface protein 1 (MSP1) gene encodes the major surface antigen of invasive forms of the Plasmodium erythrocytic stages and is considered a candidate vaccine antigen against malaria. Due to its polymorphisms, MSP1 is also useful for strain discrimination and consists of a good genetic marker. Sequence diversity in MSP1 has been analyzed in field isolates of three human parasites: P. falciparum, P. vivax, and P. ovale. However, the extent of variation in another human parasite, P. malariae, remains unknown. This parasite shows widespread, uneven distribution in tropical and subtropical regions throughout South America, Asia, and Africa. Interestingly, it is genetically indistinguishable from P. brasilianum, a parasite known to infect New World monkeys in Central and South America. Specific fragments (1 to 5) covering 60 % of the MSP1 gene (mainly the putatively polymorphic regions), were amplified by PCR in isolates of P. malariae and P. brasilianum from different geographic origin and hosts. Sequencing of the PCR-amplified products or cloned PCR fragments was performed and the sequences were used to construct a phylogenetic tree by the maximum likelihood method. Data were computed to give insights into the evolutionary and phylogenetic relationships of these parasites. Except for fragment 4, sequences from all other fragments consisted of unpublished sequences. The most polymorphic gene region was fragment 2, and in samples where this region lacks polymorphism, all other regions are also identical. The low variability of the P. malariae msp1 sequences of these isolates and the identification of the same haplotype in those collected many years apart at different locations is compatible with a low transmission rate. We also found greater diversity among P. brasilianum isolates compared with P. malariae ones. Lastly, the sequences were segregated according to their geographic origins and hosts, showing a strong genetic and geographic structure. Our data

  12. B and T lymphocyte attenuator restricts the protective immune response against experimental malaria.

    Science.gov (United States)

    Adler, Guido; Steeg, Christiane; Pfeffer, Klaus; Murphy, Theresa L; Murphy, Kenneth M; Langhorne, Jean; Jacobs, Thomas

    2011-11-15

    The immune response against the blood stage of malaria has to be tightly regulated to allow for vigorous antiplasmodial activity while restraining potentially lethal immunopathologic damage to the host like cerebral malaria. Coinhibitory cell surface receptors are important modulators of immune activation. B and T lymphocyte attenuator (BTLA) (CD272) is a coinhibitory receptor expressed by most leukocytes, with the highest expression levels on T and B cells, and is involved in the maintenance of peripheral tolerance by dampening the activation of lymphocytes. The function of BTLA is described in several models of inflammatory disorders and autoimmunity, but its function in infectious diseases is less well characterized. Also, little is known about the influence of BTLA on non-T cells. In this study, we analyzed the function of BTLA during blood-stage malaria infection with the nonlethal Plasmodium yoelii strain 17NL. We show that BTLA knockout mice exhibit strongly reduced parasitemia and clear the infection earlier compared with wild-type mice. This increased resistance was seen before the onset of adaptive immune mechanisms and even in the absence of T and B cells but was more pronounced at later time points when activation of T and B cells was observed. We demonstrate that BTLA regulates production of proinflammatory cytokines in a T cell-intrinsic way and B cell intrinsically regulates the production of P. yoelii 17NL-specific Abs. These results indicate that the coinhibitory receptor BTLA plays a critical role during experimental malaria and attenuates the innate as well as the subsequent adaptive immune response.

  13. determination of some haematological parameters in malaria

    African Journals Online (AJOL)

    USER

    2015-06-01

    Jun 1, 2015 ... Bayero Journal of Pure and Applied Sciences, 8(1): 80 – 83. Received: April ... INFECTED SUBJECTS IN USMANU DANFODIYO UNIVERSITY TEACHING. HOSPITAL ... genus contains over 125 species that cause malaria.

  14. Approach to malaria in rural hospitals

    Directory of Open Access Journals (Sweden)

    Jency Maria Koshy

    2014-01-01

    Full Text Available Malaria is one of the most common parasitic infections in the developing countries. In Rural India, most patients would be treated by primary and secondary care physicians. This article is aimed at providing a feasible approach to the cases of malaria in mission hospitals and other rural hospitals taking into account all the resource limitations. A study done over one year on patients detected to have malaria at Jiwan Jyoti Christian Hospital in Sonbhadra district has helped the authors to identify the various challenges faced by doctors working in the rural hospitals. The article has looked at the various complications associated with malaria and their management. It has also stressed upon the increasing incidence of chloroquine resistance.

  15. Health promotion: From malaria control to elimination

    African Journals Online (AJOL)

    2011 - 2014 of the National Department of Health (NDoH) lists key objectives in achieving malaria .... message' through industrial theatre or comedy shows for schools, workplaces with the ... Health Care Re-engineering. Pretoria: NDoH, 2011.

  16. NNDSS - Table II. Legionellosis to Malaria

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Legionellosis to Malaria - 2017. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding...

  17. NNDSS - Table II. Legionellosis to Malaria

    Data.gov (United States)

    U.S. Department of Health & Human Services — NNDSS - Table II. Legionellosis to Malaria - 2018. In this Table, provisional cases of selected notifiable diseases (≥1,000 cases reported during the preceding...

  18. Malaria in pregnancy: pathogenesis and immunity

    DEFF Research Database (Denmark)

    Rogerson, Stephen J; Hviid, Lars; Duffy, Patrick E

    2007-01-01

    Understanding of the biological basis for susceptibility to malaria in pregnancy was recently advanced by the discovery that erythrocytes infected with Plasmodium falciparum accumulate in the placenta through adhesion to molecules such as chondroitin sulphate A. Antibody recognition of placental...... infected erythrocytes is dependent on sex and gravidity, and could protect from malaria complications. Moreover, a conserved parasite gene-var2csa-has been associated with placental malaria, suggesting that its product might be an appropriate vaccine candidate. By contrast, our understanding of placental...... immunopathology and how this contributes to anaemia and low birthweight remains restricted, although inflammatory cytokines produced by T cells, macrophages, and other cells are clearly important. Studies that unravel the role of host response to malaria in pathology and protection in the placenta...

  19. White Blood Cell Counts and Malaria

    National Research Council Canada - National Science Library

    McKenzie, F. E; Prudhomme, Wendy A; Magill, Alan J; Forney, J. R; Permpanich, Barnyen; Lucas, Carmen; Gasser, Jr., Robert A; Wongsrichanalai, Chansuda

    2005-01-01

    White blood cells (WBCs) were counted in 4697 individuals who presented to outpatient malaria clinics in Maesod, Tak Province, Thailand, and Iquitos, Peru, between 28 May and 28 August 1998 and between 17 May and 9 July 1999...

  1. Predicting Malaria's Changing Course | IDRC - International ...

    International Development Research Centre (IDRC) Digital Library (Canada)

    2010-12-09

    Dec 9, 2010 ... James Sang of the Kenyan government's Malaria Control Unit says the disease hits ... During the 1998 epidemic, almost four times more school-aged children caught ... This gave birth to the current phase of the project.

  2. Community Involvement and Preception towards Malaria Prevention ...

    African Journals Online (AJOL)

    Community Involvement and Preception towards Malaria Prevention and Control Strategies in Rural Areas of Kersa District in Jimma Zone, Southwest Ethiopia. Wondimu Tesgera, Makonnen Aseffa, Bishaw Deboch, Wondwossen Kassahun ...

  3. Coexistence of Malaria and Thalassemia in Malaria Endemic Areas of Thailand

    Science.gov (United States)

    Kuesap, Jiraporn; Chaijaroenkul, W.; Rungsihirunrat, K.; Pongjantharasatien, K.; Na-Bangchang, Kesara

    2015-01-01

    Hemoglobinopathy and malaria are commonly found worldwide particularly in malaria endemic areas. Thalassemia, the alteration of globin chain synthesis, has been reported to confer resistance against malaria. The prevalence of thalassemia was investigated in 101 malaria patients with Plasmodium falciparum and Plasmodium vivax along the Thai-Myanmar border to examine protective effect of thalassemia against severe malaria. Hemoglobin typing was performed using low pressure liquid chromatography (LPLC) and α-thalassemia was confirmed by multiplex PCR. Five types of thalassemia were observed in malaria patients. The 2 major types of thalassemia were Hb E (18.8%) and α-thalassemia-2 (11.9%). There was no association between thalassemia hemoglobinopathy and malaria parasitemia, an indicator of malaria disease severity. Thalassemia had no significant association with P. vivax infection, but the parasitemia in patients with coexistence of P. vivax and thalassemia was about 2-3 times lower than those with coexistence of P. falciparum and thalassemia and malaria without thalassemia. Furthermore, the parasitemia of P. vivax in patients with coexistence of Hb E showed lower value than coexistence with other types of thalassemia and malaria without coexistence. Parasitemia, hemoglobin, and hematocrit values in patients with coexistence of thalassemia other than Hb E were significantly lower than those without coexistence of thalassemia. Furthermore, parasitemia with coexistence of Hb E were 2 times lower than those with coexistence of thalassemia other than Hb E. In conclusion, the results may, at least in part, support the protective effect of thalassemia on the development of hyperparasitemia and severe anemia in malaria patients. PMID:26174819

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

    Directory of Open Access Journals (Sweden)

    Convelbo Natalie

    2005-09-01

    Full Text Available 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 malaria statistics indicated that seasonality of malaria transmission was marked. In the health facilities, the number of clinical cases diminished quickly at the start of the cold and dry season and the prevalence of parasitaemia detected in febrile and non-febrile cases was 21.1% and 22.0%, respectively. The health facilities were likely to overestimate the malaria incidence and the age-specific fractions of malaria-attributable fevers were low (0–0.13. Peak prevalence tended to occur in older children (aged 6–15 years. Mapping of Anopheles sp. breeding sites indicated a gradient of endemicity between the urban centre and the periphery of Ouagadougou. A remarkable link was found between urban agriculture activities, seasonal availability of water supply and the occurrence of malaria infections in this semi-arid area. The study also demonstrated that the usage of insecticide-treated nets and the education level of family caretakers played a key role in reducing malaria infection rates. Conclusion These findings show that determining local endemicity and the rate of clinical malaria cases are urgently required in order to target control activities and avoid over-treatment with antimalarials. The case management needs to be tailored to the level of the prevailing endemicity.

  5. Malaria in South Asia: Prevalence and control

    Science.gov (United States)

    Kumar, Ashwani; Chery, Laura; Biswas, Chinmoy; Dubhashi, Nagesh; Dutta, Prafulla; Dua, Virendra Kumar; Kacchap, Mridula; Kakati, Sanjeeb; Khandeparkar, Anar; Kour, Dalip; Mahajanj, Satish N.; Maji, Ardhendu; Majumder, Partha; Mohanta, Jagadish; Mohapatra, Pradyumna K.; Narayanasamy, Krishnamoorthy; Roy, Krishnangshu; Shastri, Jayanthi; Valecha, Neena; Vikash, Rana; Wani, Reena; White, John; Rathod, Pradipsinh K

    2013-01-01

    The “Malaria Evolution in South Asia” (MESA) program project is an International Center of Excellence for Malaria Research (ICEMR) sponsored by the US National Institutes of Health. This US–India collaborative program will study the origin of genetic diversity of malaria parasites and their selection on the Indian subcontinent. This knowledge should contribute to a better understanding of unexpected disease outbreaks and unpredictable disease presentations from Plasmodium falciparum and Plasmodium vivax infections. In this first of two reviews, we highlight malaria prevalence in India. In particular, we draw attention to variations in distribution of different human-parasites and different vectors, variation in drug resistance traits, and multiple forms of clinical presentations. Uneven malaria severity in India is often attributed to large discrepancies in health care accessibility as well as human migrations within the country and across neighboring borders. Poor access to health care goes hand in hand with poor reporting from some of the same areas, combining to possibly distort disease prevalence and death from malaria in some parts of India. Corrections are underway in the form of increased resources for disease control, greater engagement of village-level health workers for early diagnosis and treatment, and possibly new public–private partnerships activities accompanying traditional national malaria control programs in the most severely affected areas. A second accompanying review raises the possibility that, beyond uneven health care, evolutionary pressures may alter malaria parasites in ways that contribute to severe disease in India, particularly in the NE corridor of India bordering Myanmar Narayanasamy et al., 2012. PMID:22248528

  6. Combining malaria control with rural electrification

    OpenAIRE

    Oria, Prisca A.

    2016-01-01

    Chapter 1 presents the background information relevant to the subject matter and methods of this thesis. These include the application of social and behavioural sciences in malaria control, the SolarMal project and malaria in Kenya. It also presents the research objective, question and design that informed this thesis. Chapter 2 systematically documented and analysed how the mosquito trapping technology and related social contexts mutually shaped each other and how this mutual shaping impacte...

  7. Cerebral Laterality and Verbal Processes

    Science.gov (United States)

    Sherman, Jay L.; And Others

    1976-01-01

    Research suggests that we process information by way of two distinct and functionally separate coding systems. Their location, somewhat dependent on cerebral laterality, varies in right- and left-handed persons. Tests this dual coding model. (Editor/RK)

  8. Hydrocephalus in cerebral venous thrombosis

    NARCIS (Netherlands)

    Zuurbier, Susanna M.; van den Berg, René; Troost, Dirk; Majoie, Charles B.; Stam, Jan; Coutinho, Jonathan M.

    2015-01-01

    Increased intracranial pressure is common in cerebral venous thrombosis (CVT), but hydrocephalus is rarely reported in these patients. We examined the frequency, pathophysiology and associated clinical manifestations of hydrocephalus in patients with CVT admitted to our hospital between 2000 and

  9. Cerebral infarcts resulting from trauma

    International Nuclear Information System (INIS)

    Busch, G.

    1985-01-01

    Vascular occlusions due to cerebral trauma have always been regarded as great rarities. However, we have found hypo-dense foci of vascular distribution in 3.5% of 3500 CT examinations for trauma during the late phase. Lesions in the vascular territory of the posterior cerebral artery are usually the result of supratentorial pressure rise from epidural and subdural haematomas, leading to compression of the vessels against the edge of the tentorium. Typical infacts in the territory of the medial and anterior cerebral arteries were found only rarely by CT after cerebral trauma. Infarcts at the watersheds between the three vascular territories were found with surprising frequency and small infarcts were found in the basal ganglia. It is assumed that these were due to ischaemic or hypoxic events due to cardiac or pulmonary complications during the initial phase. (orig.) [de

  10. Cerebral Cavernous Malformation and Hemorrhage

    Science.gov (United States)

    ... Text Size: SMALL • LARGE Cerebral Cavernous Angioma and Hemorrhage By Jack Hoch; Reviewed by Dr. Issam Awad ... for years, the mechanism by which these lesions hemorrhage remains poorly understood. Hemorrhage Types Since cavernous angiomas ...

  11. MRI of cerebral alveolar echinococcosis

    International Nuclear Information System (INIS)

    Tunaci, M.; Tunaci, A.; Engin, G.; Oezkorkmaz, B.; Ahishali, B.; Rozanes, I.

    1999-01-01

    Cerebral alveolar echinococcosis is rare. We report a case with multiple intracranial masses which show cauliflower-like contrast enhancement pattern on MRI. The lesions originated from hepatic involvement with invasion of the inferior vena cava. (orig.)

  12. Learn More About Cerebral Palsy

    Centers for Disease Control (CDC) Podcasts

    2008-03-30

    This podcast describes the causes, preventions, types, and signs and symptoms of cerebral palsy.  Created: 3/30/2008 by National Center on Birth Defects and Developmental Disabilities.   Date Released: 3/21/2008.

  13. Haptic Discrimination of Distance

    Science.gov (United States)

    van Beek, Femke E.; Bergmann Tiest, Wouter M.; Kappers, Astrid M. L.

    2014-01-01

    While quite some research has focussed on the accuracy of haptic perception of distance, information on the precision of haptic perception of distance is still scarce, particularly regarding distances perceived by making arm movements. In this study, eight conditions were measured to answer four main questions, which are: what is the influence of reference distance, movement axis, perceptual mode (active or passive) and stimulus type on the precision of this kind of distance perception? A discrimination experiment was performed with twelve participants. The participants were presented with two distances, using either a haptic device or a real stimulus. Participants compared the distances by moving their hand from a start to an end position. They were then asked to judge which of the distances was the longer, from which the discrimination threshold was determined for each participant and condition. The precision was influenced by reference distance. No effect of movement axis was found. The precision was higher for active than for passive movements and it was a bit lower for real stimuli than for rendered stimuli, but it was not affected by adding cutaneous information. Overall, the Weber fraction for the active perception of a distance of 25 or 35 cm was about 11% for all cardinal axes. The recorded position data suggest that participants, in order to be able to judge which distance was the longer, tried to produce similar speed profiles in both movements. This knowledge could be useful in the design of haptic devices. PMID:25116638

  14. Haptic discrimination of distance.

    Directory of Open Access Journals (Sweden)

    Femke E van Beek

    Full Text Available While quite some research has focussed on the accuracy of haptic perception of distance, information on the precision of haptic perception of distance is still scarce, particularly regarding distances perceived by making arm movements. In this study, eight conditions were measured to answer four main questions, which are: what is the influence of reference distance, movement axis, perceptual mode (active or passive and stimulus type on the precision of this kind of distance perception? A discrimination experiment was performed with twelve participants. The participants were presented with two distances, using either a haptic device or a real stimulus. Participants compared the distances by moving their hand from a start to an end position. They were then asked to judge which of the distances was the longer, from which the discrimination threshold was determined for each participant and condition. The precision was influenced by reference distance. No effect of movement axis was found. The precision was higher for active than for passive movements and it was a bit lower for real stimuli than for rendered stimuli, but it was not affected by adding cutaneous information. Overall, the Weber fraction for the active perception of a distance of 25 or 35 cm was about 11% for all cardinal axes. The recorded position data suggest that participants, in order to be able to judge which distance was the longer, tried to produce similar speed profiles in both movements. This knowledge could be useful in the design of haptic devices.

  15. Discriminative Relational Topic Models.

    Science.gov (United States)

    Chen, Ning; Zhu, Jun; Xia, Fei; Zhang, Bo

    2015-05-01

    Relational topic models (RTMs) provide a probabilistic generative process to describe both the link structure and document contents for document networks, and they have shown promise on predicting network structures and discovering latent topic representations. However, existing RTMs have limitations in both the restricted model expressiveness and incapability of dealing with imbalanced network data. To expand the scope and improve the inference accuracy of RTMs, this paper presents three extensions: 1) unlike the common link likelihood with a diagonal weight matrix that allows the-same-topic interactions only, we generalize it to use a full weight matrix that captures all pairwise topic interactions and is applicable to asymmetric networks; 2) instead of doing standard Bayesian inference, we perform regularized Bayesian inference (RegBayes) with a regularization parameter to deal with the imbalanced link structure issue in real networks and improve the discriminative ability of learned latent representations; and 3) instead of doing variational approximation with strict mean-field assumptions, we present collapsed Gibbs sampling algorithms for the generalized relational topic models by exploring data augmentation without making restricting assumptions. Under the generic RegBayes framework, we carefully investigate two popular discriminative loss functions, namely, the logistic log-loss and the max-margin hinge loss. Experimental results on several real network datasets demonstrate the significance of these extensions on improving prediction performance.

  16. Parálisis cerebral :

    OpenAIRE

    Cabrero Izquierdo, María del Carmen

    2012-01-01

    Se aborda el tema de la parálisis cerebral definiendo qué es, clasificando los tipos de parálisis dependiendo de la afectación y las características principales. Se explican algunos de sus tratamientos, se dan sistemas alternativos y/o aumentativos de comunicación para un alumno con PC (parálisis cerebral).

  17. Cerebral candidiasis. Computed tomography appearance

    International Nuclear Information System (INIS)

    Chaabane, M.; Ladeb, M.F.; Bouhaouala, M.H.; Ben Hammouda, M.; Ataalah, R.; Gannouni, A.; Krifa, H.

    1989-01-01

    A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodefinciency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. (orig.)

  18. Cerebral candidiasis. Computed tomography appearance

    Energy Technology Data Exchange (ETDEWEB)

    Chaabane, M.; Ladeb, M.F.; Bouhaouala, M.H.; Ben Hammouda, M.; Ataalah, R.; Gannouni, A.; Krifa, H.

    1989-07-01

    A three year old child who had been suffering from oral candidiasis since the age of 1 year presented with osteitis of the clavicle, 2 cerebral frontal abscesses and an occipital abscess which extended across the calvaria and was associated with osteolysis. Histological and microbiological studies following surgery confirmed the diagnosis of candidiasis in this girl who was found to have IgA immunodefinciency. The authors report the computed tomographic appearance of the cerebral lesions and review the literature. (orig.).

  19. Steady progress toward a malaria vaccine.

    Science.gov (United States)

    Lyke, Kirsten E

    2017-10-01

    Great progress has been made in reducing malaria morbidity and mortality, yet the parasite continues to cause a startling 200 million infections and 500 000 deaths annually. Malaria vaccine development is pushing new boundaries by steady advancement toward a licensed product. Despite 50 years of research, the complexity of Plasmoidum falciparum confounds all attempts to eradicate the organism. This very complexity has pushed the boundaries of vaccine development to new heights, yet it remains to be seen if an affordable vaccine can provide durable and high-level protection. Novel vaccines such as RTS,S/AS01E are on the edge of licensure, but old techniques have resurged with the ability to deliver vialed, whole organism vaccines. Novel adjuvants, multistage/multiantigen approaches and transmission blocking vaccines all contribute to a multipronged battle plan to conquer malaria. Vaccines are the most cost-effective tools to control infectious diseases, yet the complexity of malaria has frustrated all attempts to develop an effective product. This review concentrates on recent advances in malaria vaccine development that lend hope that a vaccine can be produced and malaria eradicated.

  20. Malaria drives T cells to exhaustion

    Directory of Open Access Journals (Sweden)

    Michelle N Wykes

    2014-05-01

    Full Text Available Malaria is a significant global burden but after >30 years of effort there is no vaccine on the market. While the complex life cycle of the parasite presents several challenges, many years of research have also identified several mechanisms of immune evasion by Plasmodium spp.. Recent research on malaria, has investigated the Programmed cell death-1 (PD-1 pathway which mediates exhaustion of T cells, characterized by poor effector functions and recall responses and in some cases loss of the cells by apoptosis. Such studies have shown exhaustion of CD4+ T cells and an unappreciated role for CD8+ T cells in promoting sterile immunity against blood stage malaria. This is because PD-1 mediates up to a 95% reduction in numbers and functional capacity of parasite-specific CD8+ T cells, thus masking their role in protection. The role of T cell exhaustion during malaria provides an explanation for the absence of sterile immunity following the clearance of acute disease which will be relevant to future malaria-vaccine design and suggests the need for novel therapeutic solutions. This review will thus examine the role of PD-1-mediated T cell exhaustion in preventing lasting immunity against malaria.