Tropical clinical epidemiology--'a new name for an old art'

Presidential addresses of the Royal Society of Tropical Medicine and Hygiene: 1907-2013

Presidents have been required to give an inaugural address on commencing office at the Royal Society of Tropical Medicine and Hygiene (RSTMH) since its foundation in 1907. All presidential addresses were identified, sourced and assembled into an annotated bibliography. The majority of presidential addresses have been published in Transactions of the Royal Society of Tropical Medicine and Hygiene. Unpublished and in some cases ‘lost’ contributions have now been sourced where possible and archived at the RSTMH. This unique, rich and rewarding archive provides a vista into the development of the RSTMH and the discipline of tropical medicine. The archive is freely available to all.

The effects of house spraying with DDT or lambda-cyhalothrin against Anopheles arabiensis on measures of malarial morbidity in children in Tanzania

The effects of house spraying of DDT and lambda-cyhalothrin against populations of Anopheles arabiensis were assessed in children aged between 1 and 10 years with regard to fever episodes and parasite prevalences. DDT and lambda-cyhalothrin treatment did not reduce the prevalence of malaria episodes as defined by fever (temperatures > or = 37.4 degrees C and/or fever reported) combined with high parasitaemia (> or = 100 parasites/200 leucocytes). However, the prevalence of malaria parasitaemia, of the episodes of fever with any level of malaria parasitaemia and of high parasitaemia alone were significantly reduced. Furthermore, the reduction in mean parasite densities was greater in children of the 1-2 years age group for both insecticides and also for children of 3-5 years age group with lambda-cyhalothrin. Measured and/or reported fever and high parasitaemia were correlated and the data indicated that most of the fevers in these children could be attributed to malaria. Using this criterion it is concluded that the population of An. arabiensis responded to both DDT and lambda-cyhalothrin house spraying which in turn also reduced malaria-related morbidity.

Malaria in Koraput district of Orissa

Incidence and prevalence of malaria was studied in the predominantly tribal district of Koraput, Orissa state. In the mass blood surveys in 61 malarious villages, a total of 12,122 persons were examined and 1,604 (13%) were found positive for malaria. Infant parasite rate was 23% and young children 2-4 years old were the worst affected (parasite rate 27.2%). P. falciparum, P. vivax, and P. malariae accounted for 80, 10 and 3% respectively of all infections. A sample of 2,554 children below 10 years of age were examined for splenomegaly. The spleen rate in 2-9 year old children was 22% and the average enlarged spleen (AES) was 2.06. There was no association between size of the spleen and species of parasite. Fever survey was done for a year in 22 villages and 5,511 blood samples were collected of which 24.8% were positive for malaria parasite. The annual parasite incidence (API) was 32.4 per 1000 infants and 89.5 per 1000 population. Children, 2-4 years old recorded the highest incidence (457/1000). The age pattern of prevalence and incidence indicate high level of acquired immunity in the population. Prevalence and incidence varied among different tribal communities. Prevalence of infection and splenomegaly was higher among children of Bonda, Kondh and Poroja tribes. The role of genetic factors in malaria is discussed.

Malaria--an overview

The epidemiology, clinical features, diagnosis, prognosis, management, chemotherapy and chemoprophylaxis of malaria are reviewed.