Measles enteritis in Gunung Wenang General Hospital Manado.

The incidence and mortality rate of 48 measles enteritis cases has been evaluated retrospectively, during the period of January 1986 to December 1989. Children under 2 years old were 21 cases (43.8%), between 2-5 years old 16 cases (33.3%) and more than 5 years old 11 cases (22.9%). Nutritional status based on the classification of Wellcome Trust Working Party revealed normal 33 (68.8%), moderate malnutrition 12 (25%) and severe malnutrition 3 cases (6.3%). Diarrhea and mild dehydration was found in 36 (75%), moderate dehydration 10 (20.83%) and severe dehydration 2 cases (4.2%) Six (12.5%) out of 48 cases had had measles vaccination. Twenty four cases (50%) of measles enteritis had other complications. The mortality rate was 2.1% comprising one patient, who suffered from measles enteritis with severe dehydration, bronchopneumonia, encephalitis and severe malnutrition.

Pattern of diseases associated with fever among infants aged 1-6 months.

This study was carried out retrospectively to evaluate the pattern of diseases associated with fever among infants aged 1-6 months at Gunung Wenang General Hospital Manado. During the period of January 1988-December 1989, 189 infants with age ranging 1-6 months, were evaluated. Diseases associated with fever predominantly occurred in infants of 3 months old (73.0%). The final clinical diagnosis of diseases associated with fever were gastroenteritis (39.15%), pneumonia (28.05%), meningitis (9%), respiratory tract infection (15.4%), post vaccination (4.20%) and septicemia (4.3%). The fever ranged from 37.8-38.3 degrees C (38%), 38.4-39.5 degrees C (49%), 39.6-41 degrees C (10%) and more than 41 degrees C (3%). The elevated body temperature was significantly related to the duration of fever (p 0.01). Increased erythrocyte sedimentation rate and thrombocytopenia were not correlated significantly (p greater than 0.05) with elevated body temperature while the total white cell count had a significant relationship (p less than 0.05).

The efficacy of sulphate quinine compared to fansidar in treating falciparum malaria in children 6 months-7 years old.

From January 1989 until February 1990, 65 children suffering from falciparum malaria without complication at the Department of Child Health Medical School Sam Ratulangi University/Gunung Wenang Hospital Manado were randomly allocated into two groups. The first group was treated with sulphate quinine based on the dose of 30 mg/kg bw/day in three divided doses and the other one was treated with single dose fansidar (sulphadoxine-pyrimethamine) based on the dose of sulphadoxine 20-30 mg/kg bw/day. The group treated with quinine showed much shorter duration of parasitemia compared with the group treated with fansidar. Fever subsided more rapidly in children treated with quinine compared with those treated with fansidar.

Comparative efficacy study of combination fansidar-sulphate quinine and fansidar-HCl tetracycline in falciparum malaria in children above 7 years old.

The objective of this study is to compare the results of treatment of children with falciparum malaria with the combinations of fansidar-sulphate quinine and fansidar-chlortetracycline as an alternative treatment of chloroquine resistant falciparum malaria. This study was carried out prospectively on 45 cases with the age equal or above 7 years, who had been admitted in the Pediatric Department, Gunung Wenang Hospital Manado during the period of January 1989-December 1989. Twenty three cases had been treated with fansidar-sulphate quinine and 22 cases with fansidar-chlortetracycline, all of them underwent blood examinations for malaria for 7 consecutive days (day 0-8). Asexual parasitemia and fever in the fansidar-sulphate quinine group significantly disappeared more rapidly than in the fansidar-chlortetracycline group (p less than 0.03 and less than 0.005). There occurred neither drug resistance nor serious side effect in both groups.

Comparative efficacy of combination fansidar-sulphate quinine and fansidar-chloroquine in mixed malaria infections of P. falciparum-P. vivax in children.

From January 1987 until March 1990, 61 children suffering from mixed malaria infections of P. falciparum and P. vivax entered the Department of Child Health Medical School Sam Ratulangi University/Gunung Wenang General Hospital, Manado. Only 41 patients were evaluated as 20 patients did not fulfill the inclusion criteria. Twenty patients were treated with fansidar-quinine (Group I), and 21 patients with fansidar chloroquine (Group II). In group II, the asexual form of P. vivax disappeared in 2 days after having been treated with fansidar-chloroquine. Conversely, in group I the asexual form of P. vivax disappeared after 5 days of treatment. Statistical analysis showed a significant difference (p less than 0.001). No significant difference could be detected between the duration of asexual parasitemia of P. falciparum in these two groups (p = 0.3085). No statistically significant difference could be detected concerning the duration of fever and the length of hospitalization between these two groups.

Cerebral malaria in children. Comparative study between heparin, dexamethasone and placebo.

From January 1987 up to April 1990, sixty two patients diagnosed as cerebral malaria were admitted to the Department of Child Health, Medical School Sam Ratulangi University, Gunung Wenang General Hospital were included in this study. They were treated with quinine dihydrochloride intravenously continued orally for a total of 7 days combined with fansidar by nasogastric tube for 2 days. All patients were also receiving intravenous fluid drips and other symptomatic treatment. They were divided into three groups. Group I received heparin 300 u/kg body weight intramuscularly once daily for 3 consecutive days; group II received dexamethasone 0.5 mg/kg body weight intravenously, three times daily for three consecutive days; group III didn't receive dexamethasone nor heparin. The mortality rate of the three group combined was 1 out of 21 patients (1.61%). In group I, all 21 patients were alive. One out of 21 patients of group II died (4.76%). In group III, all 20 patients were alive. The average period of regaining consciousness was 1.45 days in group I, 2.85 days in group II and 2.76 days in group III. There was a significant difference between group I and II, and also between group I and III. The average duration of fever was 2.60 days in group I, 2.40 days in group II and 3.69 days in group III. There was a significant difference between group I and III and also between group II and III. The average hospitalization days was 8.0 days in group I, 11.1 days in group II and 10.5 days in group III.(ABSTRACT TRUNCATED AT 250 WORDS)

Billious malaria with early chloroquine-resistant type I. A case report.

An early chloroquine-resistant type I billious malaria case has been reported. He was treated with the combination of a quinine-tetracycline regimen, and thereafter the peripheral blood film examinations did not show parasites. He was hospitalized for 21 days and was discharged in a good condition.

Congenital falciparum malaria with chloroquine resistance type II.

A case of congenial falciparum malaria has been reported. The diagnosis was based on history of illness, clinical manifestations, age of the child and presence of the ring form falciparum malaria in the peripheral blood films. Treatment with chloroquine showed resistance type II, though treatment with quinine was successful. In malaria endemic areas, although rare, one must be aware of the possibility of congenital malaria.

Chloroquine resistant falciparum malaria in children.

From March 1981 until August 1985, 79 children suffering from falciparum malaria were treated with chloroquine upon admission to the Department of Child Health, Medical School Sam Ratulangi University/Gunung Wenang General Hospital, Manado. Twenty-one out of 79 patients were within range of the criteria of resistance as established by WHO: Standard field test or 7 days test. Six (28.6%) out of 21 patients belonged to resistance II (R II) to chloroquine. The duration of fever in the 6 patients with R II to chloroquine was 2-7 days, with the average of 3.3 days. Patients with R II to chloroquine were treated with Fansidar, and all of them were cured.

Problem of infant feeding practices: implications for immediate action.

PIP: A survey on infant feeding practices and its problems was conducted in an attempt to improve child health, particularly during the first 2 years of life, when breastmilk should be the primary source of an infant's nutrition. Although breastfeeding was a generally accepted norm during the initial 1-year period, the majority of infants were not breastfed after 1 year of age. It was clearly observed that early cessation of breastfeeding, particularly during the first 6 months of age, not only increased the risk of malnutrition, but also increased the risk of diarrheal diseases, which in turn affected significantly the nutritional status. Early introduction of supplementary food, particularly around 3 months of age, reduced the risk of malnutrition. Since the practice of breastfeeding naturally decreases after 6 months of age, the improvement in types and quantity of supplementary food is important indeed, to maintain the beneficial effects of breastfeeding.^ieng