bluuebunny/crossref_metadata_2025_split huggingface dataset:
Forecasting malaria incidence from historical morbidity patterns in epidemic‐prone areas of Ethiopia: a simple seasonal adjustment method performs best
Authors: Abeku Tarekegn A. , De Vlas Sake J. , Borsboom Gerard , Teklehaimanot Awash , Kebede Asnakew , Olana Dereje , Van Oortmarssen Gerrit J. , Habbema J. D. F. 
Published: March 2003

SummaryThe aim of this study was to assess the accuracy of different methods of forecasting malaria incidence from historical morbidity patterns in areas with unstable transmission. We tested five methods using incidence data reported from health facilities in 20 areas in central and north‐western Ethiopia. The accuracy of each method was determined by calculating errors resulting from the difference between observed incidence and corresponding forecasts obtained for prediction intervals of up to 12 months. Simple seasonal adjustment methods outperformed a statistically more advanced autoregressive integrated moving average method. In particular, a seasonal adjustment method that uses mean deviation of the last three observations from expected seasonal values consistently produced the best forecasts. Using 3 years' observation to generate forecasts with this method gave lower errors than shorter or longer periods. Incidence during the rainy months of June–August was the most predictable with this method. Forecasts for the normally dry months, particularly December–February, were less accurate. The study shows the limitations of forecasting incidence from historical morbidity patterns alone, and indicates the need for improved epidemic early warning by incorporating external predictors such as meteorological factors.
Prevention of malaria in Afghanistan through social marketing of insecticide‐treated nets: evaluation of coverage and effectiveness by cross‐sectional surveys and passive surveillance
Authors: Rowland Mark , Webster Jayne , Saleh Padshah , Chandramohan Daniel , Freeman Tim , Pearcy Barbara , Durrani Naeem , Rab Abdur , Mohammed Nasir 
Published: March 2003

SummaryMalaria is often a major health problem in countries undergoing war or conflict owing to breakdown of health systems, displacement of vulnerable populations, and the increased risk of epidemics. After 23 years of conflict, malaria has become prevalent in many rural areas of Afghanistan. From 1993 to the present, a network of non‐governmental organizations, co‐ordinated by HealthNet International, has operated a programme of bednet sales and re‐treatment in lowland areas. To examine whether a strategy based on insecticide‐treated nets (ITN) is a viable public health solution to malaria, communities were given the opportunity to buy nets and then monitored to determine population coverage and disease control impact. This was carried out using two contrasting methods: cross‐sectional surveys and passive surveillance from clinics using a case–control design. Nets were purchased by 59% of families. Cross‐sectional surveys demonstrated a 59% reduction in the risk of Plasmodium falciparum infection among ITN users compared with non‐users (OR 0.41; 95% CI 0.25–0.66). The passive surveillance method showed a comparable reduction in the risk of symptomatic P. falciparum malaria among ITN users (OR 0.31; 95% CI 0.21–0.47). The cross‐sectional method showed a 50% reduction in risk of P. vivax infection in ITN users compared with non‐users (OR 0.50; 95% CI 0.17–1.49) but this effect was not statistically significant. The passive surveillance method showed a 25% reduction in the risk of symptomatic P. vivax malaria (OR 0.75; 95% CI 0.66–0.85). ITN appeared to be less effective against P. vivax because of relapsing infections; hence an effect took more than one season to become apparent. Passive surveillance was cheaper to perform and gave results consistent with cross‐sectional surveys. Untreated nets provided some protection. Data on socioeconomic status, a potential confounding factor, was not collected. However, at the time of net sales, there was no difference in malaria prevalence between buyers and non‐buyers. The abundance of Anopheles stephensi, the main vector, did not appear to be affected by ITN. ITN constitute one of the few feasible options for protection against malaria in chronic emergencies.
Short communication: A cluster of Marburg virus disease involving an infant*
Authors: Borchert Matthias , Muyembe‐Tamfum Jean Jacques , Colebunders Robert , Libande Modeste , Sabue Mulangu , Van der Stuyft Patrick 
Published: March 2003

SummaryA noteworthy cluster of six cases of Marburg haemorrhagic fever (MHF) was identified in the Democratic Republic of Congo. One of the cases is the first infant Marburg fever patient ever documented. Three of six cases presented surprisingly mild symptoms. The results of epidemiological and virological investigations are compatible with person‐to‐person transmission through body fluids and with mother‐to‐child transmission while nurturing. The findings show that mild cases of MHF have to be expected during an outbreak and point out the difficulty to base patient management decisions on clinical case definitions alone.
HIV‐1 epidemic trends in rural south‐west Uganda over a 10‐year period
Authors: Whitworth J. A. G. , Mahe C. , Mbulaiteye S. M. , Nakiyingi J. , Ruberantwari A. , Ojwiya A. , Kamali A. 
Published: March 2003

SummaryThe objective of this study was to examine the epidemic trends of HIV‐1 infection in a rural population cohort in Uganda followed for 10 years. The methods used were to assess incidence and prevalence trends in adults in this longitudinal cohort study. The results showed that incidence of infection has fallen significantly in all adults, and separately in males, females, young adults and older adults over the course of the study period. There was also a reduction in prevalence, especially in young men and women. There was some evidence of a cohort effect in women. The conclusions are that this study provides the first evidence of a falling incidence in a rural general population in Africa. This was an observational cohort exposed to national health education messages, giving hope that similar campaigns elsewhere in Africa could be used effectively in efforts to control the HIV epidemic.
Increasing antimalarial drug resistance in Uganda and revision of the national drug policy
Authors: Kamya M. R. , Bakyaita N. N. , Talisuna A. O. , Were W. M. , Staedke S. G. 
Published: March 2003

SummaryChloroquine (CQ) resistance was first documented in Uganda in 1988. Subsequent surveillance of antimalarial drug resistance, conducted by the Ugandan Ministry of Health and several research organizations, suggests that resistance to CQ is now widespread, reaching critical levels in many areas of the country. In June 2000, the Ministry of Health held a National Consensus Meeting to evaluate the available drug efficacy data and review the national antimalarial drug policy. After extensive debate, the combination of CQ + sulfadoxine–pyrimethamine (SP) was chosen to replace CQ as the first‐line treatment of uncomplicated malaria as an interim policy. This review evaluates the in vivo drug efficacy studies conducted in Uganda since 1988 and issues confronted in revision of the drug policy. The Ugandan experience illustrates the challenges faced by sub‐Saharan African countries confronted with rising CQ resistance but limited data on potential alternative options. The choice of CQ + SP as a provisional policy in the absence of prerequisite efficacy, safety and cost‐effectiveness data reflects the urgency of the malaria treatment problem, and growing pressure to adopt combination therapies. Surveillance of CQ + SP treatment efficacy, collection of additional data on alternative regimens and active consensus building among key partners in the malaria community will be necessary to develop a rational long‐term antimalarial treatment policy in Uganda.
Malaria control: constraints and opportunities
Authors: Kager P. A. 
Published: March 2003

SummaryThe malaria eradication campaign of the 1950s and 1960s achieved elimination of malaria from the industrialized world and drastic reduction of malaria elsewhere, especially Asia. In Africa, eradication was hardly attempted. For various reasons, results could not be maintained. Eradication had to be given up, control became the policy. Since 1992 malaria control is based on four principles: early diagnosis and treatment; selective and sustainable preventive measures, including vector control; detection, containment and prevention of epidemics, and building up of local capacity. Several constraints with the presently available tools are discussed. Major problems are drug resistance and poor performance of the health sector. International awareness of the problem and international co‐operation, the financial resources now available and scientific advances offer opportunities for a concerted effort to reduce the burden of malaria. Operational research, field research and implementation and improvement of the peripheral health service will be of paramount importance.
Seizure disorders among relatives of Kenyan children with severe falciparum malaria
Authors: Versteeg A. C. , Carter J. A. , Dzombo J. , Neville B. G. , Newton C. R. J. C. 
Published: March 2003

Summarypurpose  The cause of seizures in children with falciparum malaria is unclear. In malaria endemic areas, children who develop severe falciparum malaria with seizures may have a genetically higher risk of epilepsy or febrile seizures. We used the history of seizures in relatives of children previously admitted with malaria to determine if there is evidence for a familial predisposition of seizures in children admitted with malaria and seizures or cerebral malaria.methods  Family history of seizures were obtained from the parents/guardians of 81 children (35 children previously admitted with severe malaria and 46 children matched for age who had not been admitted with severe malaria). Data were collected on frequency, duration, age of onset, presence of fever and causes of seizures.results  The prevalence of seizures in the relatives of children not admitted with severe malaria was 4.3%, of whom 2.2% had a history of seizures compatible with febrile seizures, and 1.1% with epilepsy. Overall the odds ratio (OR) for relations of children admitted with malaria, to have a seizure disorder was 1.41 [95% confidence interval (CI) 1.06–1.88]. There was a significant risk of the relatives dying if they had epilepsy [relative risk 1.88 (95% CI 1.11–3.19)], but not for other seizure disorders (i.e. febrile, single or unclassifiable seizures).conclusion  Relatives of children admitted with severe falciparum malaria are more likely to have a seizure disorder compared with controls, but it is unclear if this is because of a genetic propensity or caused by exogenous factors such as malaria.
Health and nutritional status of orphans <6 years old cared for by relatives in western Kenya
Authors: Lindblade Kim A. , Odhiambo Frank , Rosen Daniel H. , DeCock Kevin M. 
Published: March 2003

SummaryOne of the consequences of the HIV/AIDS epidemic in sub‐Saharan Africa is the increase in the number of orphans, estimated to have reached 6–11% of children <15 years old in 2000. Orphans who stay in their communities may be at increased risk for poor health due to reduced circumstances and loss of parental care. We have used data from a population‐based study in rural western Kenya to compare basic health and nutritional indicators between non‐orphaned children <6 years old and children who lost either or both of their parents. In June 2000, all children <6 years old who had been recruited for a cross‐sectional survey in 60 villages of Rarieda Division, western Kenya, in June 1999 were invited to return for a follow‐up survey. Basic demographic characteristics, including the vital status of the child's parents, and health histories were requested from all 1190 participants of the follow‐up survey, along with a finger‐prick blood sample for determination of malaria parasite status and haemoglobin (Hb) levels. Height‐for‐age (H/A) and weight‐for‐height (W/H) Z‐scores were also calculated from anthropometric measurements. Overall, 7.9% of the children had lost one or both their parents (6.4% had lost their father, 0.8% had lost their mother and 0.7% had lost both parents). While there was no difference between orphans and non‐orphans regarding most of the key health indicators (prevalence of fever and malaria parasitaemia, history of illness, Hb levels, H/A Z scores), W/H Z‐scores in orphans were almost 0.3 standard deviations lower than those of non‐orphans. This association was more pronounced among paternal orphans and those who had lost a parent more than 1 year ago. These results suggest that the health status of surviving orphans living in their community is similar to that of the non‐orphan population, but longitudinal cohort studies should be conducted to determine better the overall impact of orphanhood on child health.
Effects of in utero retinoic acid exposure on mouse pelage hair follicle development
Authors: García‐Fernández Rosa A. , Pérez‐Martínez Claudia , Escudero‐Diez Alfredo , García‐Iglesias Maria J. 
Published: March 2003

Abstract We investigated in vivo the histological and immunohistochemical responses of mouse hair pelage follicle morphogenesis to prenatal exposure to a potentially nonteratogenic dose of all‐trans‐retinoic acid (RA), as a basis studying the preventive effect of RA on adult mouse skin carcinogenesis. In pregnant mice, a single oral dose of RA at 30 mg kg−1 body weight given on day 11.5 of gestation caused no RA‐induced changes in the morphology or temporal expression patterns of keratins during pelage hair follicle morphogenesis. The only differential effect of RA was a statistically significant increase in the number of BrdU‐positive nuclei in hair bulbs from RA exposed fetuses compared with nonexposed mice. The absence of adverse RA effects suggests that this experimental design may represent a valuable protocol for use in studies on the in vivo effects of this retinoid on different skin diseases.
Plasma amino acid concentrations in 36 dogs with histologically confirmed superficial necrolytic dermatitis
Authors: Outerbridge Catherine A. , Marks Stanley L. , Rogers Quinton R. 
Published: March 2003

AbstractPlasma amino acid concentrations were measured in 36 dogs diagnosed with superficial necrolytic dermatitis (SND) via skin biopsy. The median age of the dogs was 10 years, and 27 out of 36 (75%) were male. Twenty‐two out of 36 (61%) of the dogs were accounted for by six breeds; West Highland white terriers (six), Shetland sheepdogs (five), cocker spaniels (four), Scottish terriers (three), Lhasa apsos (two) and Border collies (two). The mean concentration (± standard deviation) was calculated for each measured plasma amino acid and compared to previously documented concentrations of plasma amino acids measured in dogs with acute and chronic hepatitis. The ratio of branched chain amino acids to aromatic amino acids in the dogs with SND was 2.6, slightly lower than that in normal dogs. The mean plasma amino acid concentrations for dogs with SND were significantly lower than for dogs with acute and chronic hepatitis. A metabolic hepatopathy in which there is increased hepatic catabolism of amino acids is hypothesized to explain the hypoaminoacidaemia seen in SND.
Demographics and clinical picture of nonseasonal canine atopic dermatitis – observations in 63 dogs
Authors: Bergvall K. E. , Saevik B. K. , Saijonmaa‐Koulumies L. , Holm B. , Holm L. , Hedhammar A. , Kristensen F. 
Published: March 2003

The objectives of this multicentre study were to describe demographics and clinical findings of a group of 63 dogs with nonseasonal atopic dermatitis (AD), where concurrent flea allergy dermatitis, ectoparasite infestation, food adverse reactions and secondary infections had been ruled out. The breed, sex, age of onset, distribution of skin lesions, prevalence of otitis externa, secondary skin infections and additional noncutaneous clinical signs were recorded. A veterinarian recorded skin lesions from 15 different body regions. Each body region was scored according to degree of erythema, alopecia, excoriations, scale, crusts, lichenification and hyperpigmentation that was present. An early age of onset (37% of the dogs being less than 1 year old) was more common in this group of dogs than described in the literature. The German shepherd breed was over‐represented (21% as compared with 7–9.9% of the veterinary clinic population) and approximately half of the German shepherd dogs (46%) started showing clinical signs before 1 year of age. Erythema was the overall most common type of skin lesion, with facial erythema and conjunctivitis being less commonly reported than in other studies. Feet, ears and groin were the most common sites for skin lesions. This study indicates that it is not uncommon for dogs with nonseasonal AD to have the onset of clinical signs start at a younger age (less than 1 year of age) and have clinical lesions that vary from previously published reports. This discrepancy might be allergen‐dependent or breed‐related. The study was funded by Boehringer Ingelheim Vetmedica, Denmark.
Evaluation of canine ACTH stimulation test with direct enzyme immunoassay for serum cortisol in Taiwan
Authors: Su B. , Chen C. M. , Guo I. C. , Chen C. 
Published: March 2003

In this study, we evaluated cortisol concentrations from 53 healthy dogs in response to ACTH stimulation test. The concentrations of serum cortisol were directly determined by a competitive enzyme immunoassay (EIA) with a 104‐fold diluted self‐made monoclonal antibody. The sensitivity of EIA was 0.1 ng mL−1 with intra‐assay and interassay coefficients of variation of 8.28 ± 0.09 and 14.60 ± 0.28%, respectively. The recovery rates for 1, 5 and 10 ng mL−1 of cortisol in dog serum were 77.8–128.7% with direct detection. The parallelism test revealed its reliability to detect directly the cortisol concentration in canine serum without extraction. In general, this EIA showed low crossreactivities with a variety of steroids. In the ACTH stimulation tests, we gave each dog 250 µg ACTH (Cortrosyn® Organon) intramuscularly and collected blood samples before and 1 h after administration of ACTH. The cortisol concentrations from 53 healthy dogs were 0.85–14.63 ng mL−1 pre‐ and 3.06–37.22 ng mL−1 post‐test, respectively. Sex and age did not significantly affect the cortisol concentrations in response to ACTH stimulation, but the large breeds (body weight > 25 kg; most of them were German shepherd dogs) showed lower cortisol responses than the smaller breeds. Thus, the results of this test suggested that body weight and breed might play an important role in adrenal dynamic tests.
Sugarbeet yield response to competition from Sinapis arvensis or Lolium perenne growing at three different distances from the beet and removed at various times during early growth
Authors: Heisel T , Andreasen C , Christensen S 
Published: March 2003

SummaryA sugarbeet field experiment was conducted in 1999 and 2000 to measure beet yield where Sinapis arvensis or Lolium perenne were growing in the crop row at 2, 4 or 8 cm from the beet plants. The weeds were removed by cutting once in the growing season in either late May, mid‐June or early July. The number of neighbouring beet plants to every target beet plant was recorded. Projected leaf cover of a subset of the data with non‐cut weeds was analysed by using image analysis to investigate whether this could be used to predict beet yield loss early in the growing season. Increasing the distance between beet and weed from 2 to 8 cm increased the beet yield significantly by an average of 20%, regardless of weed species. The dry weight of non‐cut and re‐growing weeds at harvest time decreased when cutting was postponed to the period between mid‐June and early July. The number of neighbours described a sigmoidal yield decline of the single beet plants. Results from image analysis showed that approximately 33 g of beet yield was lost in October/November for each per cent relative projected leaf cover of the weeds in May, despite variation in growing conditions. The results are discussed in relation to potentials for robotic in‐row weed control.
Epidemiology and in vitro activity of antimycotics against candidal vaginal/skin/nail infections in Singapore
Authors: Kwok Yew‐Kai‐Colin , Tay Yong‐Kwang , Goh Chee‐Leok , Kamarudin Ali , Koh Mong‐Teck , Seow Chew‐Swee 
Published: March 2003

BackgroundCandidal infections of the skin/nails and vagina are very common worldwide. Various in vitro test systems are available to help to determine the antifungal activity of drugs. The minimum inhibitory concentration (MIC) is a standard measure of the in vitro potency of drugs against yeasts. MethodsVaginal smears and skin/nail scrapings of 50 consecutive patients with candidal vaginitis and 46 consecutive patients (28 women, 18 men) with cutaneous/nail candidosis were used in the study. Direct microscopy and culture from vaginal smears and skin scrapings were performed on all patients. The MICs were determined using the broth dilution method. ResultsFor vaginal candidosis, the mean age of the patients was 28.2 years (range,9–49 years). Candida albicans accounted for 58% of the isolates, C. glabrata for 32%, C. tropicalis for 6%, and C. parasilosis for 4%. At the MIC of 4 mg/L, 65–95% of C. albicans, 66–94% of C. glabrata, 33–100% of C. tropicalis, and 0–50% of C. parasilosis were susceptible to the drugs tested (ketoconazole, itraconazole, nystatin, amorolfine, clotrimazole, and miconazole).For cutaneous/nail candidosis, the mean age of the patients was 45 years (range,19–82 years). C. albicans made up 59% of the isolates, C. parasilosis 20%, C. krusei 13%, C. glabrata 4%, and C. tropicalis 4%. At the MIC of 4 mg/L, 59–96% of C. albicans, 100% of C. glabrata, 83–100% of C. krusei, 89–100% of C. parasilosis, and 100% of C. tropicalis were susceptible to the drugs tested (ketoconazole, itraconazole, nystatin, amorolfine, clotrimazole, and miconazole). Conclusions
C. albicans is the most common Candida species causing cutaneous/nail and vaginal candidosis in Singapore. The in vitro antifungal activities of ketoconazole, itraconazole, nystatin, amorolfine, clotrimazole, and miconazole are similar against the various Candida species. C. parasilosis in vaginal candidosis appears to be less susceptible. Here, itraconazole and amorolfine may be more effective.
Immunoregulatory mechanisms and stress hormones in psoriasis (part 1)
Authors: Weigl MD Bea A. 
Published: March 2003

Background In an earlier paper, the author noted that psoriatic eruptions may be produced in phases of humoral and cellular immunodeficiency and in the presence of streptococcal antigen‐releasing inflammatory foci. In this study it was investigated as to whether stress hormones glucocorticoids, catecholamines) are substantially involved in the activity phases (eruptions) of psoriasis. Methods During a series of investigations over two years, the following were determined for 70 chronic psoriasis patients and 50 controls: cortisol‐adrenaline serum levels, polyclonal serum immunoglobulins IgM, IgG, IgA, total serum IgE, complements C3, C4, T‐cells and subpopulations, streptococcal antibody titres ASO/ADNase B. Results Phases of clinical inactivity are associated with a mechanism called immunologic regulation: elevated antibacterial titres and unremarkable findings for all other parameters. Phases of clinical activity (in 25/70 patient) showed absolutely elevated serum cortisol levels, absolutely decreased serum epinephrine levels, deficient serum IgM or IgG and IgE levels, increased C3, decreased C4 and T4:T8 ratio, and significantly elevated streptococcal titres. Conclusions The greatly elevated serum cortisol levels indicate that glucocorticoids are produced in excess via the pituitary adrenal axis and are significantly involved in the triggering of immunosuppressive phases (eruptions) in psoriasis.