Abstract:
:The differentiation of malaria from other causes of fever in the absence of microscopy is notoriously difficult. Clinical predictors of malaria have been studied in an area of low and unstable transmission on the western border of Thailand. In 1527 children aged 2-15 years who were followed prospectively for 7 months, 82% (1254) had at least one febrile episode. Malaria caused 24% (301) of the first febrile episodes (Plasmodium falciparum 128, P. vivax 151, P. malariae 1, mixed infections with P. falciparum and P. vivax 21). Each malaria case was matched with the next child of similar age presenting to the dispensary with another cause of fever. Clinical symptoms or signs associated with a final diagnosis of malaria were: confirmed fever (> or = 38 degrees C) (odds ratio [OR] 1.6, 95% confidence interval [95% CI] 1.4-1.9), headache (OR 1.5, 95% CI 1.3-1.9), muscle and/or joint pain (OR 2.0, 95% CI 1.6-2.8), nausea (OR 1.7, 95% CI 1.4-2.3), clinical anaemia (OR 1.4, 95% CI 1.3-3.3), palpable spleen (OR 1.3, 95% CI 1.1-1.7), palpable liver (OR 1.4, 95% CI 1.1-2.1), absence of cough (OR 1.6, 95% CI 1.4-2.0), and absence of diarrhoea (OR 1.5, 95% CI 1.2-2.4). None of these signs alone or in combination proved a good predictor of malaria. The best diagnostic algorithms (history of fever and headache without cough, and history of fever with an oral temperature > or = 38 degrees C [sensitivity 51% for both, specificity 72 and 71%, respectively]) would result in prescription of antimalarial drugs in 28-29% of the non-malaria febrile episodes, and only 49% of the true malaria cases. Thus half of the potentially life-threatening P. falciparum infections would not be treated. Although multivariate analysis identified vomiting, confirmed fever, splenomegaly and hepatomegaly as independent risk factors for a diagnosis of falciparum malaria, use of these signs to differentiate falciparum from vivax malaria, and thus to determine antimalarial treatment, was insufficiently sensitive or specific. Malaria diagnosis should be confirmed by microscopical examination of a blood slide or the use of specific dipstick tests in areas of low transmission where highly drug-resistant P. falciparum coexists with P. vivax.
journal_name
Trans R Soc Trop Med Hygauthors
Luxemburger C,Nosten F,Kyle DE,Kiricharoen L,Chongsuphajaisiddhi T,White NJdoi
10.1016/s0035-9203(98)90950-6subject
Has Abstractpub_date
1998-01-01 00:00:00pages
45-9issue
1eissn
0035-9203issn
1878-3503journal_volume
92pub_type
杂志文章abstract::Vector competence of Aedes aegypti populations from six locations in different bioclimatic zones and habitats of Senegal was assessed for sylvatic (ArD 140875) and epidemic (ArA 6894) dengue 2 virus (DENV-2) isolates. F1 generation mosquitoes were fed with a blood meal containing 10(6.5) and 1.6 x 10(7) tissue culture...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/j.trstmh.2008.02.010
更新日期:2008-05-01 00:00:00
abstract::Chloroquine can no longer be recommended as the first-line treatment for uncomplicated malaria in several parts of Africa because of the increasing prevalence of chloroquine resistance. However, chloroquine was a highly effective treatment for malaria not only because of its ability to kill parasites quickly but also ...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/s0035-9203(98)90962-2
更新日期:1998-01-01 00:00:00
abstract::Evaluating the performance of well child clinics on adherence to recommended perinatal hepatitis B prevention programmes as well as assessing the outcome of infants living with hepatitis B surface antigen (HBsAg)-positive parents is important. A retrospective study was performed of 336 babies who had at least one HBsA...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/j.trstmh.2010.12.001
更新日期:2011-04-01 00:00:00
abstract::We describe here a method, potentially suitable for field applications, for semi-quantitative detection of Mycobacterium leprae antigens in skin scrapings, which are taken normally for smear microscopy. Thirty acid-fast bacilli-negative paucibacillary (PB) leprosy patients comprised the main study group; eight acid-fa...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/j.trstmh.2007.02.026
更新日期:2007-07-01 00:00:00
abstract::Infantile visceral leishmaniasis (VL) was first reported from north Pakistan over 3 decades age in the remote valleys of the western Himalayas. These foci were reported as being completely devoid of domestic dogs. The later emergence of sporadic cases of infantile VL in the sub-Himalayan region of the country, where d...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(95)90409-3
更新日期:1995-11-01 00:00:00
abstract::Isolates of Plasmodium falciparum from patients in a Sudanese village exhibiting RI resistance to chloroquine have been typed for allelic variants of 2 merozoite surface antigens, MSP1 and MSP2. Blood forms were taken from each patient before chloroquine was administered, and after parasites had reappeared following t...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(94)90103-1
更新日期:1994-05-01 00:00:00
abstract::The objectives of this study were to establish the prevalence of Chagas' disease among HIV seropositive patients and to define the clinical profile of co-infected cases. Cross-sectional study: the prevalence of co-infected subjects was 1.3% and there was no significant difference between co-infected and non co-infecte...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/j.trstmh.2010.02.004
更新日期:2010-07-01 00:00:00
abstract:BACKGROUND:Leptospirosis has a mortality rate of 5-20%. Poor prognostic factors are older age; oliguria; elevated potassium, creatinine and/or bilirubin levels; and altered mental status. We conducted this retrospective study to analyse the predictors of mortality among Indian patients with leptospirosis. METHODS:Clin...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1093/trstmh/tru144
更新日期:2014-12-01 00:00:00
abstract::The efficacy of low dose chloroquine, characteristic pattern of relapse and the relapse rate in vivax malaria after high dose primaquine were investigated in 167 Thai patients. 87 patients were allocated at random to receive 300 mg, and 80 received 450 mg of chloroquine on the first day of admission. All patients in b...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/0035-9203(94)90305-0
更新日期:1994-03-01 00:00:00
abstract::Cold, acidified anthrone was used to test 200 wild-caught sandflies (Phlebotomus ariasi females) for the presence of fructose. This sugar, or others with a fructose moiety, were demonstrable in 157 (79%) of the flies; proportions of flies positive in different tests ranged from 44 to 91%. Higher proportions of flies g...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(80)90100-5
更新日期:1980-01-01 00:00:00
abstract::An attempt was made to estimate the prevalence of hydatid disease in nomadic pastoralists living in eastern Africa and to identify environmental, cultural and behavioural factors which may influence Echinococcus transmission. 18,565 nomadic pastoralists, from 12 different groups living in the vast, semi-desert regions...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(89)90664-0
更新日期:1989-03-01 00:00:00
abstract::We have shown previously that baboons (Papio anubis) develop high levels (greater than 80%) of protection against challenge infection following immunization with Schistosoma haematobium cercariae irradiated with 20 krad. In the present study baboons were immunized with schistosomula irradiated with either 20 krad or 6...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(90)90393-s
更新日期:1990-01-01 00:00:00
abstract::The avidin-biotin immunohistochemical (ABC) method was applied to the diagnosis of alveolar hydatid disease in patients from the hyperendemic region of western Alaska. The test was specific for larval cestodes of the genus Echinococcus, and exhibited high sensitivity. A negative reaction was obtained in all cases in w...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(88)90219-2
更新日期:1988-01-01 00:00:00
abstract::Out of 938 parasitologically confirmed patients with visceral leishmaniasis treated with amphotericin B (1 mg/kg bodyweight daily infused in 2 h for 20 days), 935 were cured clinically, 933 parasitologically and 931 ultimately (no relapse within 6 months). Two parasitologically 'not cured' and 4 relapsed patients were...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/s0035-9203(99)90037-8
更新日期:1999-05-01 00:00:00
abstract::This is the first report in which a marine mollusc, Oliva vidua fulminans (olives), generally not known to be poisonous, was responsible for death in five children after consuming boiled olives with tamarind. The onset of symptoms was rapid 10 to 20 min after consumption of the olives. Signs and symptoms included naus...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(86)90197-5
更新日期:1986-01-01 00:00:00
abstract::The bacterial flora of the upper intestine has been examined in symptomatic expatriate adults with mild tropical malabsorption, without steatorrhoea, persisting for many months after return to a western environment. Seven of the 11 patients had enterobacteria in luminal fluid or mucosal samples in numbers ranging from...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(80)90194-7
更新日期:1980-01-01 00:00:00
abstract::A survey at Richards Bay, the site of a new international harbour on the east coast of South Africa, revealed the presence of 11 anthropophilic mosquito species. These are discussed in relation to their known medical importance and to a complementary survey of arbovirus antibodies among residents of the area. Mansonia...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(87)90214-8
更新日期:1987-01-01 00:00:00
abstract::A study was conducted in rural Malawi to verify (a) whether the Partec CyFlow Counter((R)) for CD4+ T-cell lymphocyte counting in HIV-positive individuals could be introduced into a district hospital laboratory and (b) whether it would produce CD4 counts of acceptable quality. CD4+ cell counting was performed using th...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章,多中心研究
doi:10.1016/j.trstmh.2005.11.014
更新日期:2006-10-01 00:00:00
abstract:OBJECTIVE:To present the long-term outcome of multidrug-resistant tuberculosis (MDR TB) patients. METHODS:An observational study of 291 MDR TB cases that were diagnosed from 1990 to 2011 at the Fukujuji Hospital in Japan. RESULTS:The frequency of relapse after cure was 3/168 (1.8%) during a mean follow-up of 4.4 year...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1093/trstmh/tru080
更新日期:2014-09-01 00:00:00
abstract::Routine results of direct examination of sputum smears for acid-fast bacilli from 34 laboratories in Tanzania were analysed. These represented 8 regions providing 94 laboratory-years of work; 61,580 tuberculosis suspects were evaluated with the aid of 141,371 smears. The average proportion of cases found among suspect...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章,多中心研究
doi:10.1016/s0035-9203(96)90239-4
更新日期:1996-05-01 00:00:00
abstract::From June to December 1985 273 cases of hepatitis and jaundice were diagnosed in Maun, northern Botswana. It was known before the outbreak that most adults were immune to hepatitis A virus, most had markers indicating past infection with hepatitis B virus (HBV), there was a mean prevalence of 13.6% (57/418) HBsAg carr...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(89)90731-1
更新日期:1989-01-01 00:00:00
abstract::There are 4 recognized classes of Escherichia coli that cause diarrhoeal disease in humans: enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroinvasive (EIEC), and enterohaemorrhagic E. coli (EHEC). Preliminary analysis of enterotoxin production in a rural community in Ghana showed a prevalence of 11.0% LT-ST+, 9....
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(88)90173-3
更新日期:1988-01-01 00:00:00
abstract::We used a recently developed sandwich enzyme-linked immunosorbent assay to determine the kinetics of Schistosoma mansoni circulating soluble egg antigen (CSEA) after chemotherapy and compared these with previously determined levels of circulating cathodic antigen (CCA). Urine samples were collected from 35 Egyptian pa...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/s0035-9203(98)90809-4
更新日期:1998-11-01 00:00:00
abstract::The purpose of this study was to determine the prevalence of cholera in two groups: (i) people using covered latrine and piped water; (ii) people using uncovered surface latrine and pond and tubewell water. The study population consisted of cholera cases admitted to the ICDDR, B hospital from three refugee camps. In t...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(82)90194-8
更新日期:1982-01-01 00:00:00
abstract::Leishmania lainsoni has recently been recognized as a new peripylarian species belonging to the subgenus Viannia and the L. braziliensis complex. It has been isolated from its sandfly vector, reservoir host and cutaneous lesions of human patients. Microscopical examination has shown characteristics which are different...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(95)90509-x
更新日期:1995-03-01 00:00:00
abstract::Niclosamide was used to interrupt transmission of Schistosoma haematobium by Bulinus senegalensis in seasonal rainwater pools for a period of three years. Snail populations were progressively reduced to approximately 1% of the numbers in untreated pools. There was little or no evidence of acquisition of new infection ...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(84)90282-7
更新日期:1984-01-01 00:00:00
abstract::Using IFAT, it has been shown that isolated egg-shells and uterine fluid of Dipetalonema viteae are the most potent antigens in heterologous systems using human sera from patients infected with Wuchereria bancrofti, Onchocerca volvulus and Loa loa, as well as in homologous systems using sera from animals infected with...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(79)90045-2
更新日期:1979-01-01 00:00:00
abstract:BACKGROUND:The study aimed to determine factors contributing to the acceptability of home-based HIV counselling and testing (HBHCT) among commuters in Johannesburg inner city. METHODS:Simple random sampling was used to select participants in a venue based intercept survey at Noord Street taxi rank in Johannesburg cent...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1093/trstmh/tru122
更新日期:2014-10-01 00:00:00
abstract::TB remains a very significant global health burden. There is an urgent need for better tools for TB control, which include an effective vaccine. Bacillus Calmette-Guérin (BCG), the currently licensed vaccine, confers highly variable protection against pulmonary TB, the main source of TB transmission. Replacing BCG com...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章,评审
doi:10.1093/trstmh/tru206
更新日期:2015-03-01 00:00:00
abstract::Diarrhoeal diseases are a major cause of malnutrition, partly due to poor dietary practices. Misconceptions among the general population and medical personnel lead to withholding of food or avoiding the use of nutritious, locally available and affordable foods. Breast-feeding should not be interrupted during diarrhoea...
journal_title:Transactions of the Royal Society of Tropical Medicine and Hygiene
pub_type: 杂志文章
doi:10.1016/0035-9203(91)90138-o
更新日期:1991-01-01 00:00:00