ABSTRACT
Many studies of Dengue Hemorrhagic Fever (DHF) have been done but only a few revealed the respiratory status. Respiratory problems arise because of plasma leakage through the damaged capillaries, causing lung edema and in turn result in hypoxemia. This later on will be compensated by a hyperventilation state. During a 6-month-period (May to September 1988), two aspects were studied in 85 patients hospitalized with DHF. First, the ventilatory pattern and second, the result of giving oxygen support in improving the respiratory disturbance, in this case alveolar hyperventilation. The incidence of alveolar hyperventilation in DHF grade II (DHF II) and Dengue Shock Syndrome (DSS) differed significantly. Hypoxemia occurred in DHF II and DSS with no significant differences. The difference of the incidence of metabolic acidosis in DHF II and DSS were significant. In DHF II patients having had hyperventilation state, oxygen therapy decreased respiration rate significantly and increased the PaCO2 though not significantly.
Subject(s)
Dengue/complications , Hyperventilation/therapy , Oxygen Inhalation Therapy , Acidosis, Respiratory/etiology , Blood Gas Analysis , Carbon Dioxide/blood , Child , Child, Preschool , Dengue/blood , Female , Humans , Hyperventilation/blood , Hyperventilation/etiology , Hypoxia/etiology , Male , RespirationABSTRACT
The overall world malaria situation has remained static in recent years, but the disease continues to be a major public health problem in endemic countries. Of a total world population of 4,818 million in 1985, about 2,316 million (48%) live in areas where antimalarial measures are carried out. About 405 million people inhabit areas where no specific measures are undertaken to control malaria transmission, and the prevalence of malaria remains virtually unchanged. In Asia west of India, 186 out of 222 million people live in originally malarious areas. Fifteen million people live in areas which have been freed from the disease, and 35 million in areas with limited risk. About 4 million people are not protected by specific antimalarial measures. In Middle South Asia, with a total population of about 884 million, 850 million (96%) are exposed to malaria risk of varying degrees. With the exception of a small area in Nepal, all originally malarious areas are included under malaria control operations. Of a total population of 1,670 million in the East Asia and Oceania region, 1,324 million live in originally malarious areas. Malaria has been eradicated from areas where 244 million live, and the risk is considered to be limited in areas with a population of 531 million. In view of the goal of health for all by the year 2000, malaria control programs must be an important part of the overall health program in malarious countries. These programs would require participation of many different disciplines, including some not specifically related to health care. This must be done with an understanding of malaria epidemiology and the local ecological situation, and tailored to economic reality in the malarious region being considered.
Subject(s)
Malaria , Asia , Humans , Malaria/epidemiology , Malaria/prevention & controlSubject(s)
Dengue/therapy , Fluid Therapy , Hydrocortisone/therapeutic use , Shock/therapy , Child , Child, Preschool , Clinical Trials as Topic , Dengue/drug therapy , Double-Blind Method , Female , Humans , Male , Random Allocation , Shock/drug therapy , SyndromeABSTRACT
Dengue haemorrhagic fever (DHF) was first recognized in Indonesia in the cities of Jakarta and Surabaya in 1968, 15 years after its recognition in the Philippines. During the 1968 outbreak, a total of 58 clinical cases with 24 deaths were reported. The number of reported cases since then has increased sharply, with the highest number of cases recorded in the years 1973 (10, 189 cases), 1983 (13,668 cases), and 1985 (13,588 cases). Outbreaks of the disease have spread to involve most of the major urban areas, as well as some of the rural areas. In 1985, the disease had spread to 26 of 27 Provinces and 160 of 300 regencies or municipalities. At present, the disease is endemic in many large cities and small towns. Interestingly, DHF has not been reported in some cities, even though dengue virus transmission rates in those cities are high. The epidemic pattern of DHF for the country as a whole has become irregular. Since 1982, the intensity and spread of DHF has created an increasing public health problem in Indonesia, particularly in Java where 60% of the total population of the country resides. Java contributed about 71% of all cases occurring in the country in 1982, 84% in 1983, and 91% in 1984. The peak monthly incidence of DHF was frequently reported during October through April, months which coincide with the rainy season. The morbidity rate for Indonesia, estimated from reported cases over five years (1981-1985), ranged between 3.39 to 8.65 per 100,000 population.
