Transactions of the Royal Society of Tropical Medicine and Hygiene
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From the early 1900s, visceral leishmaniasis (VL; kala-azar) has been among the most important health problems in Sudan, particularly in the main endemic area in the eastern and central regions. Several major epidemics have occurred, the most recent--in Western Upper Nile province in southern Sudan, detected in 1988--claiming over 100,000 lives. The disease spread to other areas that were previously not known to be endemic for VL. ⋯ Liposomal amphotericin B was effective, with few side effects. Control measures have not been implemented. Based on observations that VL does not occur in individuals who have a positive LST, probably because of previous cutaneous leishmaniasis, a vaccine containing heat-killed L. major promastigotes is currently undergoing a phase III trial.
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Trans. R. Soc. Trop. Med. Hyg. · Mar 2001
Randomized Controlled Trial Clinical TrialAlbendazole therapy and reduced decline in haemoglobin concentration during pregnancy (Sierra Leone).
WHO recommends that anthelmintic treatment be included in strategies to improve maternal nutrition in areas where hookworms are endemic and anaemia is prevalent. At present, few countries have adopted this recommendation, partly owing to the lack of data to support the adverse effects of hookworms on maternal health. A longitudinal study was conducted on 125 women in Sierra Leone (in 1995/96) to measure the impact of single-dose albendazole (400 mg) and daily iron-folate supplements (36 mg iron and 5 mg folate) on haemoglobin and serum ferritin concentration during pregnancy. ⋯ The corresponding value for iron-folate supplements was 13.7 g/L haemoglobin (P < 0.001). The effects of albendazole and iron-folate supplements were additive. These findings lend support to WHO's recommendation for anthelmintic treatment during pregnancy.
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Trans. R. Soc. Trop. Med. Hyg. · Mar 2001
Leishmania species, drug unresponsiveness and visceral leishmaniasis in Bihar, India.
Sixteen isolates obtained, in January 1998-December 1999, from splenic aspirates from sodium stibogluconate-resistant cases of visceral leishmaniasis (VL; Indian kala-azar) and drawn from different districts of Bihar (India) were identified as Leishmania donovani. By isoenzyme analysis, all the strains were found identical to the WHO reference strain L. donovani MON-2 and differed from L. tropica MON-5. ⋯ No new strain responsible for drug unresponsiveness emerged during this period and other cause or causes of emergence of drug resistance should be sought. All the patients were cured with amphotericin B.
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Trans. R. Soc. Trop. Med. Hyg. · May 2000
Clinical presentation of non-typhoidal Salmonella bacteraemia in Malawian children.
We report the clinical presentation and outcome of 299 Malawian children with non-typhoidal Salmonella (NTS) bacteraemia and no evidence of focal sepsis, admitted to Queen Elizabeth Central Hospital (QECH), Blantyre, over a 26-month period (February 1996-April 1998). A peak incidence during the rainy season was noted. Salmonella typhimurium (79%) and S. enteritidis (13%) were the commonest isolates. ⋯ Overall mortality was high (23%). Young age and clinical HIV infection were risk factors for mortality. Recurrences of NTS bacteraemia following antibiotic therapy were common among children with clinical HIV infection.