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PubMedDate not supplied

A neglected disease of humans: a new focus of visceral leishmaniasis in Bakool, Somalia.

Visceral leishmaniasis (VL) was observed in children in Bakool region, Somalia, an area where VL has not been reported before. We describe the extent of the problem in this war- and famine-stricken area. A retrospective analysis was done of all cases admitted to a VL treatment centre between July 2000 and August 2001. Patients with longstanding fever, splenomegaly and a positive direct agglutination test (DAT; titre > 1:3200) were treated as suspected VL cases. A rapid epidemiological and entomological assessment was performed in the area. Species identification was attempted from blood samples by polymerase chain reaction-restriction fragment length polymorphism analysis of cysteine proteinase B genes. In 1 year, 230 serologically-positive cases were diagnosed as VL, and response to therapy was good in 91.6% of the 225 treated with sodium stibogluconate. Parasitological confirmation was attempted and obtained in 2 cases. Parasites were found to be most similar to Sudanese and Ethiopian reference strains of the Leishmania donovani complex. In a serological survey of 161 healthy displaced persons, 15% were positive by the leishmanin skin test and 3 (2%) were positive by the DAT. The sandfly captures showed Phlebotomus martini and P. vansomerenae. VL seems to be a longstanding and serious health problem in Bakool region. Food insecurity might have contributed to the emergence and detection of VL in this area.

Adolescent↗
PubMed2001

Simultaneous storage and degradation of PHB and glycogen in activated sludge cultures.

Bacteria in activated sludge are subjected to periods of substrate availability and absence of external substrates. The response of bacteria to such dynamic conditions was studied in a 2 L sequencing batch reactor (SBR) by subjecting a mixed microbial population to successive periods of external substrate availability (feast period) and no external substrate availability (famine period). In previous studies, acetate or glucose was used as single substrate leading to the storage of polyhydroxybutyrate or glycogen, respectively. In this study, a mixture of acetate and glucose was used. It appeared that both substrates were consumed simultaneously. The relative contribution of growth and storage processes was in these experiments similar as in the systems fed with a single substrate only. The ratio of substrate uptake over substrate storage was 0.6 Cmol/Cmol for both substrates. The uptake rate of acetate was not influenced by the simultaneous uptake of glucose. The degradation kinetics and rates of the storage compounds were the same as for the systems in which only one compound was stored in the activated sludge. The global performance of the culture grown on mixed substrates could therefore be described as the sum of the conversions observed in cultures fed with the individual substrates.

Acetates↗
PubMed2002

Evolution of ageing.

Explaining why ageing occurs is a solution to the longstanding enigma of the role of senescence in nature. Even after half a century of progress, this solution continues to unfold. Evolution theory argues strongly against programmed ageing, suggesting instead that organisms are programmed for survival, not death. In the current view, ageing results from the twin principles that (i) the force of natural selection declines with age, and (ii) longevity requires investments in somatic maintenance and repair that must compete against investments in growth, reproduction and activities that might enhance fitness. In addition to explaining why ageing occurs, the evolutionary theory also provides insight into the mechanisms underlying the complex cellular and molecular changes that contribute to senescence, as well as an array of testable predictions. Some of the most interesting current problems are to understand how the genetic factors influencing ageing and longevity are predicted to respond to fluctuating environments, such as temporary periods of famine, as well as to other kinds of spatial and/or temporal heterogeneity. Rapid progress in human genomics raises the prospect of greatly increasing our knowledge of the determinants of human longevity. To make progress in understanding the role and evolution of genetic and non-genetic factors in human longevity, we need more detailed theoretical studies of how intra-population variables, such as socio-economic status, influence the selection forces that shape the life history.

Aged↗
PubMed2004

Mortality trends and setbacks: global convergence or divergence?

Health trends over much of the past century have been generally, and notably, positive throughout the world. In several regions, however, life expectancy has declined over the past 1-2 decades. This trend suggests that the expectation that emerged in the 1960s and 1970s of worldwide gains and convergence in population health status is not guaranteed by a general deterministic process. National populations can now be clearly grouped into those that have achieved rapid gains in life expectancy; those whose gains are slower or are perhaps plateauing; and those in which the trends have reversed. Over the past two centuries, outside times of war and famine, such reversals have been rare. Exploration of these varied population health trends elucidates better the close relation between population health and the processes of economic, social, and technological change. Such analysis has shown that the health status of human populations should be a guiding criterion in the debate on sustainable development.

Age Factors↗
PubMed1977

Starvation suppression and refeeding activation of infection. An ecological necessity?

The hypothesis is advanced that starvation suppresses and refeeding activates certain infections as an essential part of an ecological balance between man, his animals, and his environment. During famine, then, man fails to thrive, but his ultimate extinction is prevented in part by the parallel decline in fecundity of his "micropredators". In times of plenty the parallel increase in the same predators is a check against his excessive multiplication.

Adult↗
PubMed1982

Protein deficiency, energy deficiency, and the oedema of malnutrition.

The role of dietary protein deficiency in kwashiorkor is uncertain, although it has been shown not to be involved in the famine oedema of adults. A study of six different diets given to 103 children with oedematous malnutrition showed that the rate of loss of oedema was strongly correlated with the dietary energy intake (r = 0.75) but not with the protein intake (r = 0.03). 66 patients given a very-low protein diet (2.5% protein energy) lost oedema as fast as those given five times as much protein. The energy intake above which oedema resolved and below which oedema accumulated was 245-270 KJ/kg/day. Because energy deficiency is not invariably associated with oedema it cannot be the only factor involved, and the necessary dietary component(s) must therefore have been present in surfeit in all the therapeutic diets. This could be potassium together with factors necessary for its retention. The accessory ingredients must be low in foods associated with human and experimental nutritional oedema. It is suggested that protein deficiency is not the cause of the oedema of kwashiorkor and that there is no need to postulate a different pathogenesis for this oedema from starvation oedema of adults.

Adult↗
PubMed1987

Measures of nutritional status. Survey of young children in north-east Brazil.

In 738 children aged under 5 from three communities in north-east Brazil, nutritional status was assessed by four means-weight for age, height for age, weight for height, and middle upper arm circumference (MUAC). As judged by weight for age, 43% of children were adequately nourished and only 2% were severely malnourished. Stunting (less than 85% height for age) was seen in 8% and wasting (less than 70% weight for height) in 1%. There was poor agreement between MUAC (a measure of wasting) and weight for height when the conventional cut-off points for MUAC were applied. Although agreement improved with new MUAC cut-off points the probability of correct diagnosis of wasting (sensitivity) remained low. Although height for age and weight for height were the most useful measures of nutritional status, MUAC may be the best available in famine victims and refugees.

Age Factors↗
PubMed1999

Epidemic of neurolathyrism in Ethiopia.

After a drought and famine, overconsumption of the drought-tolerant grasspea triggered an epidemic of neurodegenerative neurolathyrism in Northeast Ethiopia. Environmental, nutritional, and medical factors seem to affect the susceptibility.

Adult↗
PubMed2003

Homocysteine metabolism and B-vitamins in schizophrenic patients: low plasma folate as a possible independent risk factor for schizophrenia.

Two apparently unrelated disorders, neural tube defects (NTD) and schizophrenia showed increased risks in birth cohorts exposed to famine during early gestation. NTD is associated with impaired folate metabolism. We investigated whether schizophrenia is also linked with a dysfunctional folate metabolism. In addition to the prevalence of the 677C-->T mutation in the 5,10-methylenetetrahydrofolate reductase (MTHFR) gene, we compared plasma and red blood cell (RBC) folate, vitamin B6, vitamin B12, and homocysteine (Hcy) concentrations of 35 schizophrenic patients with those of 104 unrelated controls. Schizophrenic patients had significantly lower plasma folate concentrations after adjustment for Hcy levels, and elevated RBC folate levels compared to controls. Vitamin B6, vitamin B12, and Hcy levels did not differ from control values. Plasma folate levels below the 10th percentile of controls were associated with an approximate 4-7-fold (before and after adjustment of folate levels for Hcy, respectively) risk of having schizophrenia. In addition, a significant dose-response relation between plasma folate concentrations and risk for schizophrenia suggested a protective effect by high plasma folate concentrations. Elevated Hcy levels and, in line with this finding, homozygosity for the 677C-->T mutation in the MTHFR gene were not associated with an increased risk for schizophrenia. Evidence is presented suggesting that folate metabolism is disturbed in schizophrenic patients, independently of Hcy.

Adult↗
PubMed1999

Prevalence of gestational diabetes mellitus in rural pregnant mothers in northern Ethiopia.

In a community based survey of gestational diabetes in 18 rural villages of the eastern zone of Tigray administrative region, northern Ethiopia, a total of 890 pregnant women with gestational age of 24 weeks and above were examined for gestational diabetes mellitus based on WHO criteria. A 75 gm oral glucose tolerance test was performed on each subject with measurement of glucose at 0 and 2 h. Blood glucose was determined by glucose oxidase method using capillary blood (Accutrend alpha, Boehringer Mannheim). The mean age of the mothers was 27.4 +/- 7.1 years. Forty four percent of the subjects were multiparas. The prevalence rate of gestational diabetes mellitus was found to be 3.7% (95% CI 2.5-4.9). The mean blood glucose 2 h after glucose load in those pregnant diagnosed to have gestational diabetes mellitus was 154.6 +/- 14.4 mg/dl (J.W. Rich-Edwards, G.A. Colditz, M.J. Stampfer, W.C. Willett, M.W. Gillman, C. Hennekens, F.E. Speizer, J.E. Manson, Birth weight and the risk for type 2 diabetes mellitus in adult women, Annu. Intern. Med. 130 (1999) 278-284). The prevalence of gestational diabetes mellitus in this region of the country is high as compared to other parts of Africa. The possible role and contribution of exposure of the general population in this area to chronic malnutrition as a result of prolonged famine, drought and war, to the high prevalence of gestational diabetes mellitus warrants further study.

Adult↗
PubMed1997

Protein-energy malnutrition: the nature and extent of the problem.

The paper begins by describing how the names 'protein malnutrition' and 'protein-energy malnutrition' (PEM) developed from the local name 'Kwashiorkor'. The central feature of severe PEM is oedema; the classical theory suggests that the cause is a deficiency of protein, but other factors are also involved. In the community mild-moderate PEM is defined by deficits in growth. A distinction has to be made between low weight for height (wasting) and low height for age (stunting), Stunting in particular affects some 50% of children worldwide. Its causes and consequences are briefly discussed. In adults, severe PEM has essentially the same features as in children and includes the condition'famine oedema' or 'hunger oedema'; there are again controversies about its cause. In the community, chronic malnutrition is assessed by the body mass index (BMI) (Wt/Ht(2)). Grades of deficiency have been defined and examples are given of functional consequences of a low BMI. Secondary malnutrition differs from primary PEM because of the role played by cytokines and other concomitants of illness or injury. The importance is emphasized of chronicity or duration in determining the clinical picture.

Journal Article↗
PubMed2003

Causes and health consequences of environmental degradation and social injustice.

Worldwide the greatest effects on the health of individuals and populations results from environmental degradation and social injustice, operating in consort. This paper describes the national and global causes and health consequences of these phenomena. Causes include overpopulation, pollution, deforestation, global warming, unsustainable agricultural and fishing practices, overconsumption, maldistribution of wealth, the rise of the corporation, the Third World debt crisis, and militarization and wars. Consequences include increased poverty, overcrowding, famine, weather extremes, species loss, acute and chronic medical illnesses, war and human rights abuses, and an increasingly unstable global situation that portends Malthusian chaos and disaster. Because of their scientific training, and due to their privileged socioeconomic status, physicians are in a unique position to recognize these phenomena and to act at all levels, from interactions with their patients, to volunteerism, to service and intervention in areas of great need, to direct political activism and involvement. Specific suggestions for action are discussed.

Capitalism↗
PubMed2000

Revisiting the concept of 'vulnerability'.

The terms 'vulnerable' and 'vulnerability' are used more and more frequently in the areas of both social science research into and prevention of HIV/AIDS, but certain difficulties arise when it comes to applying this concept to actual situations at the heart of which individuals or groups are more exposed to HIV. The concept of vulnerability must thus be clarified to reinforce its heuristic capacity and political and practical relevancy. The first part of this paper is devoted to presenting a heuristic matrix of vulnerability, used in previous research among people living with HIV/AIDS (PWHAs) and to extracting three levels of intelligibility, that is to say, first the social trajectory level, then the level on which two or more trajectories intersect, and finally that of the social context. Each of the elements belonging to these three levels must be described both objectively and subjectively. The identity construction processes are then proposed as particular observation and 'gelling' points for these various levels taken as a whole. In the second part of the paper, we have reviewed how the concept of 'vulnerability' has been defined and used in other fields, notably disaster, famine, and mental health, paying special attention to the crucial points in the debates that are raging in these fields. We have also shed light on a few concepts that are frequently associated with vulnerability, such as victimization, insecurity, and risk. In the third part, we have summarized our approach to vulnerability as a relevant concept for elucidating risk-taking processes and designing intervention programmes. The importance of analysing the inter-individual differences, the variability in time and the relational dimension of all social vulnerability has been stressed.

Crime↗
PubMed2003

Combined slurry and solid-phase bioremediation of diesel contaminated soils.

This work investigates, at a laboratory and pilot-scale, the influence of various operating parameters on the combined slurry and solid-phase bioremediation technique for a diesel contaminated soil. For slurry-phase bioreactors (SPB), it has been found that, as far as famine conditions are attained at the end of the react cycle, a low hydraulic retention time and a low slurry recycle ratio allows for a better utilization of the reactor volume. A 7-day slurry-phase bioreactor treatment has been shown to provide enough contaminant removal allowing the soil drawn from the slurry-phase bioreactors to be fed effectively to the solid-phase bioreactors (SoPB) for completing the soil cleanup. However, an important improvement of the solid-phase bioreactor performance has been found using soil additives, namely sand and surfactants. While the first soil additive improves pile porosity and consequently oxygen diffusion, the latter increases contaminant bioavailability.

Biodegradation, Environmental↗
PubMed1998

The evolution of aging: a new approach to an old problem of biology.

Most gerontologists believe aging did not evolve, is accidental, and is unrelated to development. The opposite viewpoint is most likely correct. Genetic drift occurs in finite populations and leads to homozygosity in multiple-alleled traits. Episodic selection events will alter random drift towards homozygosity in alleles that increase fitness with respect to the selection event. Aging increases population turnover, which accelerates the benefit of genetic drift. This advantage of aging led to the evolution of aging systems (ASs). Periodic predation was the most prevalent episodic selection pressure in evolution. Effective defenses to predation that allow exceptionally long lifespans to evolve are shells, extreme intelligence, isolation, and flight. Without episodic predation, aging provides no advantage and aging systems will be deactivated to increase reproductive potential in unrestricted environments. The periodic advantage of aging led to the periodic evolution of aging systems. Newer aging systems co-opted and added to prior aging systems. Aging organisms should have one dominant, aging system that co-opts vestiges of earlier-evolved systems as well as vestiges of prior systems. In human evolution, aging systems chronologically emerged as follows: telomere shortening, mitochondrial aging, mutation accumulation, senescent gene expression (AS#4), targeted somatic tissue apoptotic-atrophy (AS#5), and female reproductive tissue apoptotic-atrophy (AS#6). During famine or drought, to avoid extinction, reproduction is curtailed and aging is slowed or somewhat reversed to postpone or reverse reproductive senescence. AS#4-AS#6 are gradual and reversible aging systems. The life-extending/rejuvenating effects of caloric restriction support the idea of aging reversibility. Development and aging are timed by the gradual loss of cytosine methylation in the genome. Methylated cytosines (5mC) inhibit gene transcription, and deoxyribonucleic acid (DNA) cleavage by restriction enzymes. Cleavage inhibition prevents apoptosis, which requires DNA fragmentation. Free radicals catalyze the demethylation of 5mC while antioxidants catalyze the remethylation of cytosine by altering the activity of DNA methyltransferases. Hormones act as either surrogate free radicals by stimulating the cyclic adenosine monophosphate (cAMP) pathway or as surrogate antioxidants through cyclic guanosine monophosphate (cGMP) pathway stimulation. Access to DNA containing 5mC inhibited developmental and aging genes and restriction sites is allowed by DNA helicase strand separation. Tightly wound DNA does not allow this access. The DNA helicase generates free radicals during strand separation; hormones either amplify or counteract this effect. Caloric restriction slows or reverses the aging process by increasing melatonin levels, which suppresses reproductive and free radical hormones, while increasing antioxidant hormone levels. Cell apoptosis during CR leads to somatic wasting and a release of DNA, which increases bioavailable cGMP. The rapid aging diseases of progeria, the three diseases: (xeroderma pigmentosum (XP), Cockayne syndrome(CS), and ataxia telangiectasia (AT)), and Werner's syndrome are related to or caused by defects in three separate DNA helicases. The rapid aging diseases caused by mitochondrial malfunctions mirror those seen in XP, CS, and AT. Comparing these diseases allows for assignment of the different symptoms of aging to their respective aging systems. Follicle-stimulating hormone (FSH) demethylates the genes of AS#4, luteinizing hormone (LH) of AS#5, and estrogen of AS#6 while cortisol may act cooperatively with FSH and LH, and 5-alpha dihydrotestosterone (DHT) with FSH in these role. The Werner's DNA helicase links timing of the age of puberty, menopause, and maximum lifespan in one mechanism. Telomerase is under hormonal control. Most cancers likely result from malfunctions in the programmed apoptosis of AS#5 and AS#6. The Hayflick limit is reached primarily through loss of cytosine methylation of genes that inhibit replication. Men suffer the diseases of AS#4 at a higher rate than women who suffer from AS#5 more often. Adult mammal cloning suggests aging-related cellular demethylation, and thus aging, is reversible. This theory suggests that the protective effect of smoking and ibuprofen for Alzheimer's disease is caused through LH suppression.

Aging↗
PubMed2001

[Plant fungi: the first pathogenic agents recognized in the history of science].

The eighteenth century is the beginning of the scientific emergence of plant pathology. Naturalists disproved spontaneous generation, meteorological and supernatural origins of plant diseases. It is necessary to explain plant alterations and to find possibilities of control to reduce significant losses of yield and to limit famine. In 1728, the words 'plant parasite', 'plant disease', and 'epidemics' were used for the first time. In 1755, the first seed treatment and, in 1805 the first description of a whole cycle of plant disease were proposed. In the nineteenth century much work on bunt and rusts of wheat, potato downy mildew, and grape vine powdery mildew established the scientific status of plant pathology. A retrospective analysis of these early developments shows a very good concordance with Koch's postulate published one century later.

Fungi↗
PubMed2004

The history of epidemic typhus.

Few infectious diseases have influenced human civilization to the same degree as louse-transmitted typhus. Rickettsia prowazekii continues to strikes tens to hundreds of thousands of persons who live with war, famine, crowding, and in squalid conditions associated with social unrest, with mortality rates in excess of 10% to 15%. Historical documents confirm that such devastation has been a continuous feature of human existence to the extent that typhus has been a major determinant in the outcome of many wars, altering human history in its wake-despite incomplete knowledge of its precise origin. In the twenty-first century, circumstances are still conductive for outbreak; the emerging threat of bioterrorism raises justifiable concerns that typhus could affect civilization just as greatly in the future as it has in the past.

Disease Outbreaks↗
PubMed1999

Hypothesis: is low prenatal vitamin D a risk-modifying factor for schizophrenia?

The central nervous system is increasingly being recognised as a target organ for vitamin D via its wide-ranging steroid hormonal effects and via the induction of various proteins such as nerve growth factor. This paper proposes that low maternal vitamin D may impact adversely on the developing foetal brain, leaving the affected offspring at increased risk of adult-onset schizophrenia. The hypothesis can parsimoniously explain diverse epidemiological features of schizophrenia, such as the excess of winter births, increased rates of schizophrenia in dark-skinned migrants to cold climates, the increased rate of schizophrenia births in urban versus rural setting, and the association between prenatal famine and schizophrenia. Studies that will allow rejection of the hypothesis are proposed.

Adult↗