[Sleeping sickness is awake again].
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Africa↗
Biomedical subjects
K P David
Publications and source records attributed to K P David.
[Dengue fever among 44 Danish travellers investigated in the department of epidemics at the Rigshospitalet during 1988-1998].
Dengue fever is a major cause of febrile illness in the tropics, and we describe 44 patients with dengue fever seen at Rigshospitalet, Copenhagen from 1988-98. A worldwide increase in transmission of dengue fever was reflected in the number of patients seen in 1997-1998. All patients had fever and headache, and were biochemically characterised by thrombocytopenia, leucopenia, increased levels of alanine aminotransferase and a rise in haematocrit. One patient had dengue haemorrhagic fever, and two patients exhibited unusual reactions to the infection, one in the form of extended febrile neutropenia complicated by an episode of of E. coli septicaemia, and one patient developed progressive paralysis of both legs, and remains partially paretic.
Adolescent↗
[Plasmodium falciparum malaria in a pregnant woman six months after stay in an endemic area].
A case of P. falciparum malaria in a 22 year old West African primigravida with no possible exposure to malaria seven months before detection and six months before the infection became symptomatic is presented. We connect the altered immunity against malaria induced by the pregnancy with the presence of subclinical low-level persistent parasitaemia in semi-immune individuals from areas with intense malaria transmission.
Adult↗
Hyperpigmented dermal macules in children following the administration of Maloprim for malaria chemoprophylaxis.
The occurrence of an unexpected side effect following the use of Maloprim (pyrimethamine/dapsone) for malaria chemosuppression in 3-59 months old children in Sierra Leone is reported. As part of a trial of chemoprophylaxis and insecticide-impregnated bed nets, 2000 children received either Maloprim or placebo; 4% of children who received Maloprim fortnightly for more than 3 months developed hyperpigmented macules, whereas none of the children who received placebo did so. Histopathological examination of full thickness skin biopsies showed macrophages containing melanin in the dermal layer. Clustering of cases was noted among siblings, suggesting the possible involvement of genetic factors in the pathogenesis of these skin reactions. One child was accidentally re-exposed to Maloprim after the drug had been withdrawn and he developed a severe reaction. No other serious side effect was noted. Hyperpigmented lesions similar to those reported in this study have been described previously in patients with leprosy treated with dapsone, and the dapsone component of Maloprim is the likely cause of the skin reactions seen in children given this drug for malaria chemoprophylaxis.
Anti-Infective Agents↗