A review of the malaria situation in Zimbabwe with special reference to the period 1972-1981

Information on the prevalence, incidence, and geographical distribution of malaria in Zimbabwe is reviewed. Malaria control operations carried out during the last 30 years are briefly described together with available information of their impact on malaria. From 1972 to 1981, 51,962 positive blood slides were submitted to Blair Research Laboratory from health institutions, of which 97.8% were Plasmodium falciparum, 1.8% P. malariae and 0.3% P. ovale. Blood slide surveys undertaken from 1969 to 1981 during which time 156,194 slides were examined showed P. falciparum to constitute 92.5% of malaria infections, P. malariae 8.3% and P. ovale 0.7%. The data from active and passive case finding are used to describe the seasonal and geographical pattern of malaria in Zimbabwe. The seasonal peak of transmission occurs from February to May each year with very low transmission from July to October. Endemicity of malaria is shown to be markedly influenced by altitude varying from hyperendemic in the low altitude areas to hypoendemic or absent on the central watershed.     

The genetics of drug resistance in malaria parasites

The available experimental data on the genetics of drug resistance in malaria parasites are reviewed. Seven possible mechanisms for the origin of drug resistance are considered, and it is pointed out that spontaneous gene mutation is probably the most important. Experiments on the production of pyrimethamine-resistant and chloroquine-resistant strains of rodent Plasmodium species, and on the inheritance of such drug resistance, are reviewed. Relevant biochemical data are also considered in relation to the genetics of drug resistance. Studies on competition between drug-sensitive and drug-resistant parasites in mixed populations of rodent plasmodia are described. The implications of these findings for drug resistance in P. falciparum are discussed.     

Prevention of drug resistance in rodent malaria by the use of drug mixtures

Development of resistance to chloroquine in rodent malaria is inhibited by giving this compound together with a potentiating mixture of pyrimethamine and sulfadoxine but this does not prevent the development of resistance to the last two compounds. The use of drug mixtures should be explored as a means of “protecting” chloroquine or new blood schizontocides intended for mass chemotherapy against human malaria. However, no general rule can be laid down without testing specific drug mixtures in long-term experiments in a suitable model such as rodent malaria.     

HIV infection in Poland (1985-96)

Reported numbers of HIV infections have provided an indication of the order of magnitude of the size of the HIV epidemic in Poland, and how it has evolved in time. To the end of 1996, most documented infections had been observed among intravenous drug users (IDUs, n=2, 933/3,470) and, to a lesser extent, men who have sex with men (MSM, 289/3,470). Reported infections among non-IDU prostitutes and other non-IDU heterosexuals remained low. In this paper we describe surveillance systems and epidemiologic data in Poland from 1985 to 1996 for AIDS cases, HIV infections and other STDs. We also discuss the contributions of different vulnerable groups. Finally we discuss factors influencing the past spread of HIV infection and the potential for future spread, and propose recommendations for surveillance and research.     

HIV infection in Ukraine (1987-96)

In Ukraine, the number of reported HIV infections increased extremely rapidly during the second half of the 1990s, from less than 50 per year until 1994 to more than 12,000 in 1996. The increase was initially observed and was particularly striking in the regions along the Black Sea. The majority of reported HIV infections were diagnosed in injecting drug users. The extend of HIV spread through sexual transmission is more difficult to assess because of the strong social stigma attached to homosexuality and the lack of information on sexual behaviour in general. The reported number of syphilis cases have also dramatically increased, from 3,000 cases in 1990 to nearly 80,000 cases in 1996. In this paper, we describe the surveillance systems for, and epidemiologic data on HIV infections, AIDS, and other STD in Ukraine from 1987 to 1996. We review the contributions of different vulnerable groups and we also discuss the factors influencing the past spread and the potential for future spread of HIV infection and make recommendations for surveillance, research and prevention.     

2004～2005年广西HIV-1耐药横断面调查

目的 了解广西壮族自治区未接受抗病毒治疗的HIV感染者和已经接受抗病毒治疗一段时间的AIDS病人中的耐药情况.方法 收集我区2004～2005年部分HIV感染者的伞血标本201份,其中未接受抗病毒治疗的56人(27.86%),已接受抗病毒治疗的145人(72.14%),分别对他们进行问卷调查,并采集10毫升的抗凝血,分...     

Medical syncretism with reference to malaria in a Tanzanian community

What happens when new health information is introduced into a community? We have explored this question in a semi-rural community of Southeastern Tanzania whose population has been in contact with biomedicine for many decades. With the example of malaria, we illustrate how biomedical knowledge transmitted in health messages coexists, interacts and merges with local pre-existing ideas and logics. The results are syncretic models, which may deviate considerably from what health promoters intended to transmit. Some of those may have implications for treatment of malaria, which may include delay in seeking treatment and non-compliance with therapy. Analysing this medical syncretism clearly demonstrates that even if comprehension of health messages is accurate, the way in which people interpret these messages may not be. Disentangling syncretic processes permits us to understand the dynamics of how information is processed by the recipients, and provides orientations for health promoters for adapting messages to the local context.     

广西耐药结核病可疑者耐药性筛查结果分析

目的：通过对广西耐药结核病可疑者筛查结果分析,了解可疑者耐药、耐多药疫情现状与特点。方法采用回顾性调查方法,对2012年1月至2014年6月期间结核病管理信息系统登记的耐药结核病可疑者筛查资料进行统计分析。结果共有657例患者有菌种鉴定和药敏试验结果,主要分布在南宁、柳州、桂林、梧州、北海、贵港和贺州等7个市。非结核分枝杆菌感染占患者总数的5.0%（33/657）,而在新患者中占3.4%（12/348）,在复治患者中占6.8%（21/309）。新患者总耐药率为19.6%（66/336）,复治患者总耐药率为56.3%（162/288）;新患者耐多药率为7.7%（26/336）,复治患者耐多药率为41.3%（119/288）,广泛耐多药率0.7%（2/288）。桂林市复治患者单耐利福平（RMR-TB）率高达18.8%（6/32）。结论广西结核病耐药可疑者耐药率、耐多药率高,个别市RMR-TB率、非结核分枝杆菌感染率高,应引起重视。     

湖南省1984-2015年血吸虫病流行趋势分析

目的 分析湖南省血吸虫病流行趋势,为控制和消除血吸虫病提供科学参考。方法 通过绘制动态趋势图分析1984-2015年湖南省居民及家畜血吸虫感染率变化规律;运用时间回归分析模型对血吸虫感染率进行拟合,并预测感染率近期变化趋势。结果 1984-2015年湖南省居民及家畜血吸虫感染率呈整体下降趋势,下降幅度分别为95.29%和95.16%。经直线回归模型拟合,该期间居民及家畜血吸虫感染率的实际值均处于预测值95% CI内;预计2016-2020年居民及家畜血吸虫感染率将继续下降。结论 湖南省血吸虫病疫情呈下降趋势。回归分析模型对血吸虫病疫情短期预测效果较好。     

武汉市2006～2007年细菌性痢疾监测及耐药性分析

目的了解武汉市细菌性痢疾的病原菌志贺氏菌型分布及其药物敏感状况,为细菌性痢疾临床治疗和预防控制提供依据。方法按《全国细菌性痢疾监测方案》的要求进行监测、采样并系统检测。结果临床初步诊断为细菌性痢疾标本539份,经复核鉴定为志贺氏菌的有17株,检出率为3．2％。其中宋内氏菌15株。福氏志贺氏菌2株,分别占检出菌株数的88．2％和11．8％。药敏试验显示17株志贺氏菌敏感药物为阿莫西林（100％）、环丙沙星（100％）,全部耐药的有利福平（100％）,且有5株菌出现了3种或3种以上的多重耐药现象。结论2006～2007年武汉市细菌性痢疾病原菌以宋内氏志贺氏菌为主,其次为福氏志贺氏菌,并对目前常用的抗生素表现一定的耐药性,应引起重视。     

关于JJG919—96pH计规程中高阻检定的商榷

本文是对ＪＪＧ９１９－９６ｐＨ计检定规程中高阻检定存在的问题进行商榷。     

Potential use of bendiocarb (Ficam VC) for malaria control in an area of Zimbabwe.

Ficam (bendiocarb) was tested for its residual efficacy and irritation in malaria vector control by using a laboratory bred colony of Anopheles arabiensis. In the study area, the insecticide remained active for up to 8 wk (96% mortality) on thatch. In similar, especially constructed huts, 74% mortality was achieved up to 20 wk on mud compared with up to 100% on thatch. In the special huts, release/capture studies indicated that the lethal effect of Ficam on the insects was more pronounced than its irritant effect. This was shown by the low recapture numbers in exit traps as compared with the hut-floor mortalities. The implications of these findings in relation to studies elsewhere and the potential of Ficam use in malaria control are discussed.     

The visceral lesions in simian malaria with special reference to the splenic reaction

A histopathological study of twelve cases of fatal monkey malaria due to infection with P. knowlesi has shown (1) the presence of a vascular mechanism that localizes the parasites in large numbers in the spleen; (2) the presence of a lymphoid reaction in the spleen; and (3) the activation of the reticulo-endothelial system as shown by histiocytic differentiation and active phagocytosis.     

The changing prevalence of neural tube defects: a population-based study in the north of England, 1984-96. Northern Congenital Abnormality Survey Steering Group

Using data from the Northern Congenital Abnormality Survey, we describe trends in the prevalence of neural tube defects (NTDs), maternal age-specific prevalence, outcome of pregnancy and the sensitivity of antenatal diagnosis of NTD-affected pregnancies in the Northern Region during 1984-96. This population-based sample consisted of 934 NTDs: there were 403 (43.1%) with anencephaly, 472 (50.5%) with spina bifida and 59 (6.3%) with encephalocele. The total prevalence at birth was 17.9 per 10,000 births and terminations (95% confidence interval [CI] = 16.7, 19.0) with a significant reduction over time (chi(2) for trend = 7.2; P = 0.007). The overall birth prevalence was 5.6 per 10,000 births [95% CI = 5.0, 6.3]; there was also a significant reduction in birth prevalence with time (chi(2) for trend = 68.3; P < 0.0001). Maternal age-specific prevalence rates decreased with increasing age. The proportion of NTD pregnancies terminated increased from 60.3% (325 cases) during 1984-90 to 78.6% (293 cases) during 1991-96, whereas the proportion of livebirths declined from 31.7% (171 cases) to 15.0% (56 cases) (P < 0.001). The sensitivity of antenatal diagnosis was consistently high for anencephaly (98%) and increased significantly for spina bifida from 60% during 1984-90 to 85% during 1991-96 (P < 0.05). Ascertainment of all cases of NTD in the Northern Region revealed a twofold reduction in birth prevalence between 1984-90 and 1991-96. This has resulted from improvements in the accuracy of antenatal detection of NTD-affected pregnancies with an increase in terminations of pregnancy.     

Long term cultivation of a simian malaria parasite (Plasmodium knowlesi) in a semi-automated apparatus

An apparatus is described and illustrated for the continuous semi-automated cultivation of Plasmodium knowlesi, The change of medium was automated and involved six operations. Parasites were maintained for 12 weeks, at which time the experiment ended. During this period, parasite density, morphology and serological specificity were monitored. Parasites retained synchromy and normal morphology only for the first cycle in culture. The maximum degree of morphological abnormality (90%) was reached at three weeks. Lysis of infected erythrocytes seemed to occur before full maturation of the parasites. Infected cells cultured for 31 days produced a normal, fulminating infection in a rhesus monkey.