ABSTRACT
When young children are infected with P. falciparum; meningitis is often incidentally associated with parasitaemia and can be difficult to distinguish clinically from cerebral malaria. There is yet no clear evidence that lumbar puncture is dangerous in cerebral malaria and it is reasonable to do lumbar punctures to exclude bacterial meningitis in children with fever and coma in areas where malaria is endemic
Subject(s)
Malaria , Meningitis , Plasmodium falciparum , Spinal PunctureABSTRACT
Chloroquine has been reported to antagonize the anti-parasitic action of quinine against Plasmodium falciparum in vitro. The authors looked for evidence of any such antagonism in vivo. In 123 Malawian children with cerebral malaria treated with parenteral quinine; the likelihood of survival and the rate of recovery were much the same in patients who had taken chloroquine and those who had not. In these circumstances there was no evidence of chloroquine/quinine antagonism
Subject(s)
Child , Chloroquine , Malaria , Plasmodium falciparum , QuinineABSTRACT
Presenting hypoglycaemia must be looked for in all patients with cerebral malaria; since it carries a poor prognosis and can be corrected. Several possible mechanisms for its development are discussed. It is important to continue to consider hypoglycaemia during treatment; since it may recur. Regular glucose supplementation must be given during quinine treatment; to prevent starvation hypoglycaemia. Quinine-induced hypoglycaemia does not seem to be a major problem in these circumstances; although the possibility must not be neglected; especially if treatment is prolonged
Subject(s)
Hypoglycemia , MalariaABSTRACT
Dr Molyneux; first editor of the Medical Quarterly; works at the Liverpool School of Tropical Medicine which has strong links with Malawi in the fields of training and research. Here he discusses aspects of parasitic diseases and programmes to combat them
Subject(s)
Parasitic Diseases , Tropical MedicineABSTRACT
This paper is a description of the clinical features of cerebral malaria in children; based on the author's experience in a study of this disease in Malawi; Africa. The presenting symptoms; physical signs and laboratory features are described; and the course of the illness during treatment is outlined. Cerebral malaria can resemble many other childhood illnesses; accurate diagnosis is essential if correct treatment is to be provided quickly. Even with optimal treatment the mortality is about 20 percent ; and some children are left with neurological sequelae
Subject(s)
MalariaABSTRACT
Two clinical trials of the phenanthrene treatment of Plasmodium falciparum were conducted in Malawi; in areas where the parasite was known to be chloroquine resistant. Of 49 children followed up for 14 days; 47 became aparasitaemic -ie; the cure rate was 96 percent. In both trials the drug was very well tolerated. Halofantrine hydrochloride seems to be effective against P. falciparum chloroquine sensitive and resistant strains in Africa
Subject(s)
Malaria , Plasmodium falciparumABSTRACT
A study of 96 children with altered consciousness and Plasmodium falciparum parasitaemia in the period January-June 1987 at Queen Elizabeth Central Hospital in Blantyre. It was observed that the most closely associated feature with a poor prognosis is hypoglycemia
Subject(s)
Malaria , PediatricsABSTRACT
A study of epidemiological patterns of bacterial meningitis in Lilongwe using laboratory records from the period 1983-1986 and clinical records of patients admitted to Kamuzu Central Hospital
Subject(s)
MeningitisABSTRACT
Of 33 patients with acute hepatitis in Malawi; 21 had infection by hepatitis-B virus (HBV); five by hepatitis-A virus (HAV) and seven; who had no markers of current HBV or HAV infections; were probably infected by the agent(s) of non-A; non-B; hepatitis. 87 of 88 sera from persons without liver disease contained antibody to HAV and 49 antibody to hepatitis-B surface antigen (anti-HBs) (six were positive for hepatitis-B surface antigen). The diagnosis of recent infection by HAV was made by detecting HAV-specific IGM in single serum samples and; although such tests showed that HAV caused acute hepatitis; its absence in patients with chronic liver disease suggests that; unlike HBV; infection by HAV does not play a role in chronic liver disease in Malawi. Anti-hepatis-B core antigen (anti-HBc)-specific IgM was detected in 19 of 21 patients with acute HBV infection; in three of five HbsAg-positive patients with cirrhosis; but in none of five Hbs Ag-positive patients with hepatoma