Endemic malaria still exists in the Republic of Vanuatu, an 80-island archipelago that sits astride the southeast margin of the Southeast Asian-Melanesian malaria band (Buxton Line 170 degrees E, 20 degrees S). The annual parasite incidence has decreased dramatically over the past decade, which has been attributed to an intensive insecticide-treated bednet distribution program and implementation of a revised Plasmodium falciparum treatment policy that employs combination chloroquine + sulfadoxinelpyrimethamine as a first-line therapy. Standard malariometric surveys were conducted at 10 locations in 2 provinces, screening 2351 adults and children towards the end of the peak transmission season. Spleen rates were consistent with mesoendemic malaria. Examination of blood slides revealed a mean slide-positive rate of 22% (range 4% to 33%). P. falciparum predominated, accounting for 73% of infections, followed by P. vivax (25%). Among 396 individuals with P. falciparum, the gametocyte rate was 54%, with 37% presenting gametocytes alone without asexual stages. Only 8% and 4% of persons with asexual stage P. falciparum and P. vivax parasitaemia, respectively, were symptomatic. These data suggest that malaria transmission has increased in some locations in Vanuatu over the past decade and this report underscores the importance of appropriate bednet use and vector control in this setting as well as the impact of adding sulfadoxine/pyrimethamine and removing primaquine from the national malaria treatment formulary.
Malaria ; upper case pea ; Vanuatu ; control ; asexual

We examined the usefulness of serum leptin concentration as an index for the diagnosis of fatty liver. Twenty-two patients diagnosed with fatty liver by abdominal ultrasonography, participated in this study together with 7 indinduels as controls. As laboratory findings showed, body fat percentage (29.5±1.4 vs 19.1±1.6%, P<0.001), BMI (25.7±0.7 vs 20.8±1.0 kg/m2, P<0.005), procollagen III peptide (P III P) (0.58±0.04 vs 0.42±0.04 U/ml, P<0.05), and serum leptin levels (7.3±1.0 vs 2.9±0.5 ng/ml, P<0.001) were significantly higher in the fatty liver group than in the control group. Serum leptin levels were correlated significantly with body fat percentage (r=0.76, P<0.0001) and BMI (r=0.61, P<0.001), though there was a significant correlation between serum leptin levels and liver-kidney contrast (r=0.47, P<0.05) only in males. In addition, when the fatty liver group was classified into two groups by GPT levels, m-GOT (mitochondrial glutamate-oxaloacetate transaminase) (8.6±1.0 vs 5.7±1.0 IU/l/37°C, P<0.05) and P III P (0.65±0.06 vs 0.49±0.04 U/ml, P<0.05) were significantly higher in the elevated GPT group than in the normal GPT group.These results suggest that serum leptin levels may be indicative of fatty liver and that fatty liver is not always a reversible disease.
upper case pea ; Fatty Liver ; Leptin ; Serum ; Lower case are

Clinic ; upper case pea ; upper case aitch ; upper case gee ; Corneal Diseases

With a renewed interest in large-scale malaria interventions, knowledge about the possible long-term effects of such interventions on the nature of malaria transmission is essential. We document complex changes in malaria epidemiology over the last 40 years associated with changing malaria control activities in Karimui, an isolated area in Papua New Guinea. An initially equal distribution of Plasmodium falciparum, P. vivax and P. malariae changed to currently 68% P. falciparum, after passing through a phase of transitory P. vivax dominance, when control started to fail. Initial drops in malaria prevalence proved difficult to sustain and present post-control levels are significantly higher than pre-control levels. The example of Karimui indicates that unsustained control can lead to changes in malaria patterns that may leave a population worse off.
Malaria ; control ; upper case pea ; Papua New Guinea ; epidemiologic

Although not strictly a highlands province, Morobe encompasses large highlands areas, the most important being Aseki, Menyamya and Wau-Bulolo. A series of rapid malaria surveys conducted in both the wet and dry seasons found malaria to be clearly endemic in areas below 1400 m in Menyamya and Wau-Bulolo, with overall prevalence rates in the wet season (25.5%, range: 9.1%-39.2%) greatly exceeding those in the dry season (8.3%, range: 2.4%-22.8%; p < 0.001). In the wet season surveys Plasmodium falciparum was the clearly predominant species, accounting for 63% of all infections. P. vivax increased in frequency in the dry season (from 27% to 46%, p < 0.001), while P. falciparum and P. malariae decreased. In line with past surveys a low prevalence of malaria was found in the Aseki area. Malaria was found to be the main source of febrile illness in the wet season with at least 60% of measured or reported fever associated with parasitaemia. Other causes of febrile illness dominated in the dry. In villages with parasite prevalence rates < 20% mean haemoglobin levels and prevalence of severe anaemia were strongly correlated with overall parasite prevalence. In addition concurrent malarial infections were associated with a strong reduction of individual haemoglobin levels (-1.2 g/dl) and there was increased risk of moderate-to-severe anaemia with concurrent malaria. Malarial infections are thus the most significant cause of febrile illness and anaemia in the highlands fringe populations in Morobe. As a consequence all villages below 1500-1600 m in Morobe Province should be included in malaria control activities.
Malaria ; Seasons ; Prevalence aspects ; Fever ; upper case pea

The epidemiology of malaria in Eastern Highlands Province (EHP) is characterized by generally very low-level or no local malaria transmission but a considerable risk of epidemics. In non-epidemic situations, parasite prevalence was under 5% in all but one area, Lufa Valley, where P. vivax was the most common parasite (prevalence rate of 58%). During epidemics, however, 23% (range 8-63%) of people were infected, with P. falciparum the predominant parasite. Mixed infections were very common (12%) but P. malariae and P. ovale were rare. Outside epidemics, malaria was only a minor source of febrile illness and enlarged spleens and anaemia (haemoglobin level < 7.5 g/dl) were virtually absent. However, epidemics were associated with a high incidence of relatively severe morbidity, both in terms of fevers and moderate to severe anaemia. Epidemic prevention, surveillance and response therefore are priorities in malaria control in EHP.
Malaria ; upper case pea ; epidemic aspects ; Study of epidemiology ; Parasites

A cross-sectional malaria survey of the Pabrabuk area in the Western Highlands Province found that all 4 human malaria species were present in a single village, with an overall parasite prevalence rate of 27%. Plasmodium falciparum was the most frequently detected infection (14%) followed by P. vivax (11%), P. malariae (5%) and P. ovale (3%). 10 of the 51 infections were mixed. Anopheles punctulatus was the most frequent vector species in the area, but both An. farauti no. 6 and An. karwari were also present in low numbers. This diversity in both parasite and vector populations indicates that complex malaria patterns are found in Papua New Guinea even at the moderate transmission levels found in low-lying inter-montane valleys.
Malaria ; upper case pea ; Papua New Guinea ; Study of epidemiology ; Complex

Two very distinct malaria zones can be found within Simbu Province. The north of the province is characterized by the absence or very low level of local malaria transmission, but there is a considerable risk of epidemics prevalent in the lower-lying parts. During non-epidemic periods, parasite prevalence was usually under 5%, with similar frequencies for Plasmodium falciparum and P. vivax (47% each), and malaria was an only minor source of febrile illness. During epidemics, however, 13-36% of people were infected, predominantly with P. falciparum (64%), and high levels of severe morbidity were present. In south Simbu malaria is clearly endemic with an overall prevalence of 35%, combined with a strong age-dependence of infections, low haemoglobin levels, high rates of enlarged spleen and moderate to severe anaemia (haemoglobin level < 7.5 g/dl) in children. The malaria epidemiology in south Simbu is thus more similar to the lowlands than to other highlands areas. Epidemic prevention, surveillance and response in the north, and bednet distribution and strengthening of curative services in the south, are therefore the priorities for malaria control in Simbu Province.
Malaria ; Study of epidemiology ; upper case pea ; Prevalence aspects ; epidemic aspects

Despite a resurgence of malaria in many Papua New Guinea highlands and highlands fringe areas after the cessation of control activities in the early 1980s the malaria situation in these areas has received little attention. A series of cross-sectional surveys were therefore carried out to provide accurate and up-to-date information on the prevalence of malaria and the risk of epidemics and to propose adequate malaria control strategies. Studies in 24 villages in Western Highlands Province found the prevalence of malarial infections to be strongly correlated with altitude, ranging from 1.6% at altitudes of 1500-1800 m to over 30% in villages below 900 m. Malaria outbreaks were observed at the end of the rainy season. All four human malaria species were present with P. falciparum infections clearly dominating. The relative importance of P. vivax increased with altitude, while both P. malariae and P. ovale were rare. Many infections were of low density. While malaria is an important source of febrile illness in endemic areas below 1500 m altitude, only few observed or reported fevers are due to malarial infections in higher, nonendemic areas. Rates of enlarged spleens, mean haemoglobin levels and the prevalence of anaemia (Hb <7.5 g/dl) were strongly linked to the level of malaria found in each community and were associated with both altitude and concurrent malarial infection. Based on the survey results, areas of different malaria epidemiology are delineated and options for control in each area are discussed.
Malaria ; upper case pea ; Altitude ; Study of epidemiology ; Western Herbs and Botanicals

Orofacial clefts, particularly non-syndromic cleft lip with or without cleft palate (CL/P) are the most common craniofacial deformities, affecting one in every 700 to 1000 newborns worldwide. Numerous efforts have been made to understand the etiology of CL/P so as to predict its occurrence and to prevent it from occurring in the future. In the recent years, advances in genetics and molecular biology have begun to reveal the basis of craniofacial development. Various genetic approaches, including genome-wide and candidate gene association studies as well as linkage analysis, have been undertaken to identify aetiologic factors, but results have often been inconclusive or contradictory. These results may support the presence of aetiologic heterogeneity among populations and the presence of multiple genes involved in the aetiology of CL/P. Despite these difficulties, several different genes have been implicated in harbouring genes that contribute to the aetiology of CL/P. In conclusion, the genetic basis of CL/P is still controversial because of genetic complexity of clefting.
Chloride Ion ; upper case pea ; Genetic ; Cleft Lip ; Palate