Onchocerciasis in Malawi. 2. Subjective complaints and decreased weight in persons infected with Onchocerca volvulus in the Thyolo highlands

In the course of an onchocerciasis survey in southern Malawi; body weight was recorded for 10;335 persons aged 20 years and older; and the body mass index was calculated for 5572. A history of symptomatic complaints was elicited from 5653 persons 20 years of age and older. Persons with microfilariae in the skin snips weighed significantly less than persons with negative skin snips. Symptomatic complaints of musculoskeletal pains; itching; dizziness and poor vision were reported more commonly in the group with microfilariae. These findings suggest that onchocerciasis should no longer be considered a disease affecting the eye and skin only but an infection which produces systemic effects as well. Systemic effects of onchocerciasis may lessen productivity of an endemic region by a process distinct from the effects of visual impairment

Onchocerciasis in Malawi. 1. Prevalence; intensity and geographical distribution of Onchocerca volvulus infection in the Thyolo highlands

Skin snips from 23;373 persons living in the Thyolo (formerly Cholo) highlands focus of southern Malawi showed infection with Onchocerca volvulus to be unevenly distributed within the highland area. In the centre of the focus most adults were infected; though intensity of infection was light; not exceeding a geometric mean of 8 microfilariae per mg of skin. It was estimated that 327;000 persons live in areas where prevalence of infection exceeds 10 percent and; of these; 94;500 persons over the age of one year are infected with O. volvulus. There is a significant relationship between infection with O. volvulus and bilateral blindness in the Thyolo focus; although the number of persons blind from onchocerciasis is probably less than 300

HIV seropositivity and tuberculosis in a rural Malawi hospital

This study was undertaken to determine the extent to which human immunodeficiency virus (HIV) infection has increased hospital admissions for tuberculosis (TB) in a rural population of southern Malawi. The notes and chest X-rays of TB patients admitted to Malamulo hospital in 1983 and 1984; before the recognition of acquired immune deficiency syndrome (AIDS) in Malawi; were compared with those of patients admitted in 1987 and 1988. We found a 160 percent increase in TB admissions between the 2 periods. Extrapulmonary TB; especially pleural TB; was much commoner in 1987-1988 and occurred in a younger age group. HIV seroreactivity was measured in a third group of 152 tuberculosis patients admitted during 1988-1989. HIV seropositivity was found in 52 percent of all tuberculosis admissions and in 75 percent of those with extrapulmonary disease. There was no difference in clinical response to TB therapy between the HIV seropositive patients and those who were seronegative. Extrapulmonary TB should be considered in all HIV seropositive patients; especially in areas where the prevalence of TB is high. Health personnel involved in TB programmes where HIV and TB infections are prevalent should plan for a large increase in the TB case load secondary to the HIV pandemic

The immune system in malaria: part II; immunologic changes in malaria

When a host; infected with malaria; is challenged with several antigens; the immune system may be altered by different mechanisms for each antigen involved. The article looks at some of these responses

Progress toward onchocerciasis control in Malawi

"Discusses a project by the Liverpool School of Tropical Medicine and the Ministry of Health to study the breeding habits of the simulium fly; which is responsible for the spread of onchocerciasis or ""river blindness""; in order to formulate vector control strategies"

Malarial immunity: part III

A review of attempts to make a vaccine against malaria to counteract the growing resistance to chloroquine