AIDS - malaria, cause or CURE?!

April 27, 2003

Subject:

AIDS - malaria, cause or cure?

From:

Bob <recbo@...>

Date:

Sun, 27 Apr 2003 03:34:07 -0400

Malaria is one of many burdens that can weigh down immunity

to the point of AIDS. This is rebuttal material regarding the

Heimlich Maneuver's Dr. Heimlich and his new theory that

malaria is a cure for AIDS. Once again the fascists show

military style strategy as they start us off on the lowest ground

around, the notion that a cause of AIDS is actually a CURE for

AIDS. Fight your way onto a hummock of grass in that swamp

and you're still in the swampy low ground under the big guns

bellowing that HIV is cause of AIDS. I have to laugh every time

I see the offer of the lowest ground around as starting point,

since what I really see is the military mind as fascist mercenary,

and I'm sure the next tactic will be the lowest trick around,

some sort of cheap leaden credibility bullet like using Heimlich's

name and ignoring specifics, or disaccreditization by name

calling and then ignoring specifics. Take the high ground; malaria

is one of many causes of AIDS--

" repeated malaria infections make young children more susceptible

to other common childhood illnesses, such as diarrhoea and respiratory

infections, and thus contribute indirectly to mortality "

malarial AIDS can lead to diarrhea, and some underweight babies get

malaria and

diarrhea in the first month of life--

" low birth weight - frequently the consequence of malaria infection in

pregnant women - is the major risk factor for death in the first month

of life "

" Let them eat HIV pillcakes " concedes the field to the fascist death

camp thought guards, as does Heimlich malaria therapy. So who are

the AIDS deniers who kill by default, and who are the flat-earthers, if

not the superstitious pseudo-scientists for hire?

-Bob

>Date: Fri, 25 Apr 2003 17:05:05 -0000

>From: " sidharthur " <sidharthur@...>

>Subject: On April 25th, we will all celebrate Africa Malaria Day

>

>http://www.rbm.who.int/amd2003/amr2003/amr_toc.htm

>

>http://mosquito.who.int/amd2003/

>

>Roll Back Malaria,

>Protect Women and Children

>

>On April 25th, we will all celebrate Africa Malaria Day.

>

>The theme for this year's event is

>

>'Insecticide Treated Nets and effective malaria treatment for

>pregnant women and young children by 2005'

>

>and the slogan is

>

>'Roll Back Malaria, Protect Women and Children!'

>

>Africa Malaria Day 2003 marks the third anniversary of the Abuja

>Declaration.

>

>We hope that these pages will inspire you to begin planning events

>and/or take part in activities to celebrate Africa Malaria Day 2003.

>Let's use this opportunity to join forces and get behind Roll Back

>Malaria's efforts to halve the burden of malaria by 2010.

>

>We would love to hear about how you are getting involved and what

>events are being organised in your community. You can tell us what is

>going on by e-mailing us at InfoRBM@.... Also, if you take any

>photographs or have any reports from Africa Malaria Day, then send

>them to us and we will share them with the world.

>

>----------

>

>http://www.who.int/en/

>

>25 April 2003

>

>More than 3000 children die each day due to malaria

> 25 April 2003 -- The death toll from malaria remains high and effective

anti-malarial drugs are not reaching those who need them, according the Africa

Malaria Report released today by WHO and UNICEF. The report, launched to mark

Africa Malaria Day 2003, also stresses that far too few children at risk of

malaria are protected by life-saving insecticide-treated nets.

>Press release | Report | Africa Malaria Day

>

>Feature:

>Lives at risk: malaria in pregnancy

>In Africa, 30 million women living in malaria-endemic areas become pregnant

each year. For these women, malaria is a threat both to themselves and to their

babies, with up to 200 000 newborn deaths each year as a result of malaria in

pregnancy.

>

>Date: Fri, 25 Apr 2003 17:16:38 -0000

>From: " sidharthur " <sidharthur@...>

>Subject: AFRICA MALARIA REPORT 2003

>

>http://www.rbm.who.int/amd2003/amr2003/ch1.htm

>

>AFRICA MALARIA REPORT 2003

>Contents

>

>----------------------------------------------------------------------

>----------

>1. The burden of malaria in Africa

>

>----------------------------------------------------------------------

>----------

>

>About 90% of all malaria deaths in the world today occur in Africa

>south of the Sahara. This is because the majority of infections in

>Africa are caused by Plasmodium falciparum, the most dangerous of the

>four human malaria parasites. It is also because the most effective

>malaria vector - the mosquito Anopheles gambiae - is the most

>widespread in Africa and the most difficult to control. An estimated

>one million people in Africa die from malaria each year and most of

>these are children under 5 years old (1).

>

>Malaria affects the lives of almost all people living in the area of

>Africa defined by the southern fringes of the Sahara Desert in the

>north, and a latitude of about 28° in the south. Most people at risk

>of the disease live in areas of relatively stable malaria

>transmission - infection is common and occurs with sufficient

>frequency that some level of immunity develops. A smaller proportion

>of people live in areas where risk of malaria is more seasonal and

>less predictable, because of either altitude or rainfall patterns.

>People living in the peripheral areas north or south of the main

>endemic area (Figure 1.1) or bordering highland areas are vulnerable

>to highly seasonal transmission and to malaria epidemics.

>

>In areas of stable malaria transmission, very young children and

>pregnant women are the population groups at highest risk for malaria

>morbidity and mortality. Most children experience their first malaria

>infections during the first year or two of life, when they have not

>yet acquired adequate clinical immunity - which makes these early

>years particularly dangerous. Ninety percent of all malaria deaths in

>Africa occur in young children. Adult women in areas of stable

>transmission have a high level of immunity, but this is impaired

>especially in the first pregnancy, with the result that risk of

>infection increases.

>

>Malaria has been well controlled or eliminated in the five

>northernmost African countries, Algeria, Egypt, Libyan Arab

>Jamahiriya, Morocco, and Tunisia. In these countries the disease was

>caused predominantly by Plasmodium vivax and transmitted by

>mosquitoes that were much easier to control than those in Africa

>south of the Sahara. Surveillance efforts continue in most of these

>countries in order to prevent both a reintroduction of malaria

>parasites to local mosquito populations, and the introduction of

>other mosquito species that could transmit malaria more efficiently

>(a particular risk in southern Egypt). The malaria situation in these

>countries is not considered further in this report.

>

>Malaria is endemic in some of the offshore islands to the west of

>mainland Africa - Sao Tome and Principe and São Tiago Island of Cape

>Verde. In the east, malaria is endemic in Madagascar, in the Comoro

>islands (both the Islamic Federal Republic of the Comoros and the

>French Territorial Collectivity of Mayotte), and on Pemba and

>Zanzibar, but has been eliminated from the island of Reunion. In

>Mauritius, malaria has been well controlled since the 1950s, but

>occasional outbreaks of vivax malaria occur, the last in association

>with a cyclone in 1982. Since that year there has been a steady

>decrease in cases and risk is now extremely low. Seychelles has been

>free of malaria since 1930, and malaria vectors are believed to no

>longer exist there.

>

>1.1 Burden of malaria on health in Africa

>

>Mortality

>

>There are three principal ways in which malaria can contribute to

>death in young children (Figure 1.2). First, an overwhelming acute

>infection, which frequently presents as seizures or coma (cerebral

>malaria), may kill a child directly and quickly. Second, repeated

>malaria infections contribute to the development of severe anaemia,

>which substantially increases the risk of death. Third, low birth

>weight - frequently the consequence of malaria infection in pregnant

>women - is the major risk factor for death in the first month of life

>(3). In addition, repeated malaria infections make young children

>more susceptible to other common childhood illnesses, such as

>diarrhoea and respiratory infections, and thus contribute indirectly

>to mortality (4).

>

>The consensus view of recent studies and reviews is that malaria

>causes at least 20% of all deaths in children under 5 years of age in

>Africa (Figures 1.3 and 1.4). Although respiratory disease caused by

>a variety of infectious agents results in a similar proportion of

>deaths, P. falciparum is the most important single infectious agent

>causing death among young children.

>

>Morbidity and long-term disability

>

>Children who survive malaria may suffer long-term consequences of the

>infection. Repeated episodes of fever and illness reduce appetite and

>restrict play, social interaction, and educational opportunities,

>thereby contributing to poor development. An estimated 2% of children

>who recover from malaria infections affecting the brain (cerebral

>malaria) suffer from learning impairments and disabilities due to

>brain damage, including epilepsy and spasticity (5).

>

>1.2 Burden of malaria on African health systems

>

>In all malaria-endemic countries in Africa, 25-40% (average 30%) of

>all outpatient clinic visits are for malaria (with most diagnosis

>made clinically). In these same countries, between 20% and 50% of all

>hospital admissions are a consequence of malaria (see country

>profiles for details).

>

>With high case-fatality rates due to late presentation, inadequate

>management, and unavailability or stock-outs of effective drugs,

>malaria is also a major contributor to deaths among hospital

>inpatients (Figure 1.5).

>

>This high burden may in fact be partly a result of misdiagnoses,

>since many facilities lack laboratory capacity and it is often

>difficult clinically to distinguish malaria from other infectious

>diseases. Nonetheless, malaria is responsible for a high proportion

>of public health expenditure on curative treatment, and substantial

>reductions in malaria incidence would free up available health

>resources and facilities and health workers' time, to tackle other

>health problems.

>

>1.3 Burden of malaria on the poor

>

>Poor people are at increased risk both of becoming infected with

>malaria and of becoming infected more frequently. Child mortality

>rates are known to be higher in poorer households and malaria is

>responsible for a substantial proportion of these deaths. In a

>demographic surveillance system in rural areas of the United Republic

>of Tanzania, under-5 mortality following acute fever (much of which

>would be expected to be due to malaria) was 39% higher in the poorest

>socioeconomic group than in the richest (6).

>

>A survey in Zambia also found a substantially higher prevalence of

>malaria infection among the poorest population groups (7) (Figure

>1.6). Poor families live in dwellings that offer little protection

>against mosquitoes and are less able to afford insecticide-treated

>nets. Poor people are also less likely to be able to pay either for

>effective malaria treatment or for transportation to a health

>facility capable of treating the disease.

>

>Both direct and indirect costs associated with a malaria episode

>represent a substantial burden on the poorer households. A study in

>northern Ghana found that, while the cost of malaria care was just 1%

>of the income of the rich, it was 34% of the income of poor

>households (8).

>

>1.4 Recent trends in the burden of malaria

>

>Routine case detection and reporting

>

>Data from health facilities are potentially useful for monitoring

>time trends in the number of malaria cases and deaths but have severe

>limitations (Figure 1.7). In Africa, most cases of malaria are

>diagnosed on the basis of clinical symptoms and treatment is

>presumptive, rather than based on laboratory confirmation. Moreover,

>malaria parasitaemia is common among clinic attendees in many endemic

>areas, so that a positive laboratory result does not necessarily mean

>that the patient is ill with malaria. The main clinical symptoms of

>malaria - fever and general weakness - are nonspecific and may well

>be due to other common infections.

>

>Reporting from facilities to districts and from districts to the

>ministry of health varies in its completeness and timeliness from

>country to country and often does not include nongovernment

>facilities. Thus, routine reports of the number of malaria cases and

>deaths have limited value for comparisons of the malaria burden

>between countries. Demographic and health surveys (DHS) and other

>sources (9) indicate that less than 40% of malaria morbidity and

>mortality is seen in formal health facilities - a small fraction of

>the total burden. However, routinely collected data are often the

>only information available over a prolonged period and over a wide

>geographical area. While these data are of use for local programme

>planning, major investment in improving both the quality of health

>information systems and access to health services would be required

>before their utility for monitoring changes in malaria disease trends

>could be assessed.

>

>At present, the most reliable data available on trends in malaria

>deaths in children under 5 years of age is obtained from demographic

>surveillance systems (DSS), which measure deaths and possible causes

>prospectively over time in populations of known size and composition.

>The number of DSS sites is increasing: 24 sites in 13 African

>countries are collaborating under the INDEPTH network (International

>Network of field sites with continuous Demographic Evaluation of

>Populations and Their Health) (10). Most of these sites are in

>eastern and southern Africa; there are a few sites in the west of the

>continent but none in central Africa.

>

>Recently, data from 1982-1998 were analysed across 28 DSS sites,

>adjusting for the specificity and sensitivity of verbal autopsies

>that were used to attribute deaths to malaria (11). Malaria mortality

>in under-5s almost doubled in eastern and southern Africa over the

>period 1990-1998 compared with 1982-1989. It is known that the

>prevalence of malaria infections caused by chloroquine-resistant

>parasites increased substantially from the late 1980s in these same

>areas (Figure 1.8). Thus, although the methodology cannot prove cause

>and effect, it is very likely that some of this increase in child

>mortality was related to some extent to the spread of chloroquine-

>resistant malaria. In west Africa the mortality rate remained the

>same; here too, however, malaria became proportionally more important

>(11). Analysis of mortality data being collected from INDEPTH using

>standardized verbal autopsy questionnaires since 2000 should soon

>provide further insight into more recent disease trends.

>

>Throughout Africa south of the Sahara, the decrease in all-cause

>under-5 mortality that was apparent during the 1970s and 1980s

>levelled off in the 1990s (Figure 1.9), perhaps partially as a result

>of increased malaria mortality. Some of the important factors that

>may have contributed to the increasing malaria burden in these

>African settings include:

>

>drug resistance (12)

>more frequent exposure of non-immune populations

>emergence of HIV/AIDS (13, 14)

>climate and environmental change (15)

>breakdown of control programmes (16).

>

>1.5 Future prospects

>

>>From the time trends shown, it appears that RBM is acting against a

>background of increasing malaria burden. With the typical 2-3-year

>delay in national-level data becoming available, it is still too

>early to evaluate the extent to which RBM has achieved a levelling-

>off or reversal of the rising trend in the malaria burden. The very

>low level of coverage with ITNs and untreated nets documented in 2000

>and 2001 falls far below the coverage levels in the ITN trials that

>demonstrated substantial health benefits. It should therefore come as

>no surprise that significant reductions in child mortality have yet

>to be observed. The impact of treatment coverage levels is more

>difficult to estimate, given both a lack of information on promptness

>and dosage, and varying levels of drug effectiveness. Coverage levels

>approaching the Abuja target of 60% will probably be required before

>the full effect of ITNs and effective treatment on child health will

>become apparent.

>

>References

>

>1. The World Health Report 2002: reducing risks, promoting healthy

>life. Geneva, World Health Organization, 2002.

>

>2. MARA/ARMA collaboration (Mapping Malaria Risk in Africa), July

>2002. www.mara.org.za.

>

>3. Steketee RW et al. The burden of malaria in pregnancy in malaria-

>endemic areas. American Journal of Tropical Medicine and Hygiene,

>2001, 64(1,2 S):28-35.

>

>4. Molineaux L. Malaria and mortality: some epidemiological

>considerations. ls of Tropical Medicine and Parasitology, 1997, 91

>(7):811-825.

>

>5. SC, Breman JG. Gaps in the childhood malaria burden in

>Africa: cerebral malaria, neurological sequelae, anemia, respiratory

>distress, hypoglycemia, and complications of pregnancy. American

>Journal of Tropical Medicine and Hygiene, 2001, 64(1,2 S):57-67.

>

>6. Mwageni E et al. Household wealth ranking and risks of malaria

>mortality in rural Tanzania. In: Third MIM Pan-African Conference on

>Malaria, Arusha, Tanzania, 17-22 November 2002. Bethesda, MD,

>Multilateral Initiative on Malaria: abstract 12.

>

>7. Report on the Zambia Roll Back Malaria baseline study undertaken

>in 10 sentinel districts, July to August 2001. Zambia, RBM National

>Secretariat, 2001.

>

>8. Akazili J. Costs to households of seeking malaria care in the

>Kassena-Nankana District of Northern Ghana. In: Third MIM Pan-African

>Conference on Malaria, Arusha, Tanzania, 17-22 November 2002.

>Bethesda, MD, Multilateral Initiative on Malaria: abstract 473.

>

>9. Breman JG. The ears of the hippopotamus: manifestations,

>determinants, and estimates of the malaria burden. American Journal

>of Tropical Medicine and Hygiene, 2001, 64(1,2 S):1-11.

>

>10. Population and health in developing countries. Vol. 1.

>Population, health and survival at INDEPTH sites. Ottawa,

>International Development Research Centre, 2002.

>

>11. Korenromp EL et al. Measuring trends in childhood malaria

>mortality in Africa: a new assessment of progress toward targets

>based on verbal autopsy. [Lancet Infectious Diseases, conditionally

>accepted, March 2003].

>

>12. Trape J-F. The public health impact of chloroquine resistance in

>Africa. American Journal of Tropical Medicine and Hygiene, 2001, 64

>(1,2 S):12-17.

>

>13. Grimwade K et al. HIV-infection in adults increases rates of

>severe and fatal falciparum malaria in regions of unstable

>transmission. In: XIVth International AIDS conference 2002,

>Barcelona, Spain: abstract ThPeC7604.

>

>14. Nwanyanwu OC et al. Malaria and human immunodeficiency virus

>infection among male employees of a sugar estate in Malawi.

>Transactions of the Royal Society of Tropical Medicine and Hygiene,

>1997, 91(5):567-569.

>

>15. Mouchet J et al. Evolution of malaria in Africa for the past 40

>years: impact of climatic and human factors. Journal of the American

>Mosquito Control Association, 1998, 14(2):121-130.

>

>16. Sharp B et al. Malaria control by residual insecticide spraying

>in Chingola and Chililabombwe, Copperbelt Province, Zambia. Tropical

>Medicine and International Health, 2002, 7(9):732-736.

>

>17. The World Health Report 2001. Mental health: new understanding,

>new hope. Geneva, World Health Organization, 2001.

>

>----------------------------------------------------------------------

>----------

> Contents AFRICA MALARIA REPORT 2003

>

>----------------------------------------------------------------------

>----------

>

>________________________________________________________________________

>

>Message: 7

> Date: Fri, 25 Apr 2003 17:15:51 -0000

> From: " sidharthur " <sidharthur@...>