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2. Importziekten

Author

van Thiel, P.P.A.M., Kager, P.A., Rigter, I., van Everdingen, J.J.E., editor, Schobben, A.F.A.M., editor, and Wiersma, Tj., editor

Published
2014
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4. Control of malaria: a successful experience from Viet Nam

Author

Hung Le Q., Vries Peter J.de, Giao Phan T., Nam Nguyen V., Binh Tran Q., Chong M.T., Quoc N.T.T.A., Thanh T.N., Hung L.N., and Kager P.A.

Subjects
Malaria, Falciparum/prevention and control, Malaria, Falciparum/diagnosis, Malaria, Falciparum/drug therapy, Malaria, Vivax/prevention and control, Malaria, Vivax/diagnosis, Malaria, Vivax/drug therapy, Sesquiterpenes/therapeutic use, Chloroquine/therapeutic use, Primaquine/therapeutic use, Pyrethrins/Bedding and linens, Pyrethrins/utilization, Knowledge, attitudes, practice, Health education, Ethnic groups, Prospective studies, Viet Nam, Public aspects of medicine, RA1-1270
Abstract

OBJECTIVE: To follow malaria prospectively in an ethnic minority commune in the south of Viet Nam with high malaria transmission and seasonal fluctuation, during malaria control interventions using insecticide-treated bednets (ITBNs) and early diagnosis and treatment (EDT) of symptomatic patients. METHODS: From 1994 onwards the following interventions were used: distribution of ITBNs to all households with biannual reimpregnation; construction of a health post and appointment of staff trained in microscopic diagnosis and treatment of malaria; regular supply of materials and drugs; annual cross-sectional malaria surveys with treatment of all parasitaemic subjects, and a programme of community involvement and health education. Surveys were held yearly at the end of the rainy season. During the surveys, demographic data were updated. Diagnosis and treatment of malaria were free of charge. Plasmodium falciparum infection was treated with artesunate and P. vivax infection with chloroquine plus primaquine. FINDINGS: The baseline survey in 1994 recorded 716inhabitants. Of the children under 2years of age, 37% were parasitaemic; 56% of children aged 2-10 years, and 35% of the remaining population were parasitaemic. P. falciparum accounted for 73-79% of these infections. The respective splenomegaly rates for the above-mentioned age groups were 20%, 56%, and 32%. In 1999, the proportion of parasitaemic subjects was 4%, 7% and 1%, respectively, of which P.falciparum contributed 56%. The splenomegaly rate was 0%, 5% and 2%, respectively. CONCLUSIONS: A combination of ITBNs and EDT, provided free of charge, complemented by annual diagnosis and treatment during malaria surveys and community involvement with health education successfully brought malaria under control. This approach could be applied to other regions in the south of Viet Nam and provides a sound basis for further studies in other areas with different epidemiological patterns of malaria.

Published
2002

5. Miltefosine treatment of Leishmania major infectioin: an observational study involving Dutch military personnel returning from Northern Afghanistan

Author

van Thiel, P.P.A.M., Leenstra, T., Kager, P.A., de Vries, H.J., van Vugt, M., van der Meide, W.F., Bart, A., Zeegelaar, J.E., van der Sluis, A., Schallig, H.D.F.H., van Gool, T., Faber, W.R., and de Vries, P.J.

Subjects
Leishmaniasis -- Care and treatment, Leishmaniasis -- Case studies, Military personnel -- Health aspects, Health, Health care industry
Published
2010

6. The effect of weekly iron and vitamin A supplementation on hemoglobin levels and iron status in adolescent schoolgirls in western Kenya

Author

Leenstra, T., Kariuki, S.K., Kurtis, J.D., Oloo, A.J., Kager, P.A., and Kuile, F.O. ter

Subjects
Iron deficiency anemia -- Care and treatment, Vitamin A -- Health aspects, Teenage pregnancy -- Health aspects, Iron in the body -- Health aspects, Teenage girls -- Health aspects
Abstract

Background/Objectives: Iron deficiency anemia is a major public health problem in developing countries and may affect school performance and physical work capacity in nonpregnant adolescents, and may increase the risk of anemia during subsequent teenage pregnancies. We assessed the effect of weekly iron (120 mg elemental iron) and vitamin A (25 000 IU) supplementation on hemoglobin, iron status and malaria and nonmalaria morbidity in adolescent schoolgirls. Subjects/Methods: A total of 279 schoolgirls aged 12-18 years from public primary schools in Kisumu, western Kenya. Double-blind randomized placebo-controlled trial using a factorial design. Results: Five months of iron supplementation was associated with a 0.52 g [dl.sup.-1] (0.21, 0.82) greater increase in hemoglobin relative to iron placebo. The effect was only observed in girls with iron deficiency on enrollment (1.34 g [dl.sup.-1] (0.79, 1.88)), but not in iron-replete girls (-0.20 g [d.sup.l-1] (-0.59, 0.18)). Similar differences in treatment effect were seen between menstruating and nonmenstruating girls. The effect of iron was independent of vitamin A. The baseline prevalence of vitamin A deficiency was low (6.7%) and no sustained increase in hemoglobin was seen with weekly vitamin A (-0.07 g [dl.sup.-1] (-0.38, 0.25)). Incidence of malaria parasitemia was higher in the iron than iron-placebo groups (Rate ratio 1.33 (0.94, 1.88)). Conclusions: Weekly iron supplementation results in substantial increases in hemoglobin concentration in adolescent schoolgirls in western Kenya, which may outweigh possible risks caused by malaria, but only in iron-deficient or menstruating girls and not in iron-replete and nonmenstruating girls. doi:10.1038/sj.ejcn.1602919; published online 10 October 2007 Keywords: iron; vitamin A; iron deficiency anemia; malaria; adolescents; schools, Introduction Anemia, including iron deficiency anemia, remains one of the most widespread public health problems in developing countries, with preschool children and pregnant women most severely affected (WHO, 2001). During [...]

Published
2009

8. FFAs are not involved in regulation of gluconeogenesis and glycogenolysis in adults with uncomplicated P. falciparum malaria

Author

van Thien, Huynh, Weverling, G.J., Ackermans, M.T., canh Hung, Nguyen, Endert, E., Kager, P.A., and Sauerwein, H.P.

Subjects
Gluconeogenesis -- Research, Biological sciences
Abstract

FFAs are not involved in regulation of gluconeogenesis and giycogenolysis in adults with uncomplicated P. falciparum malaria. Am J Physiol Endocrinol Metab 287: E609-E615, 2004. First published May 27, 2004; 10.1152/ajpendo.00026.2004.--In normal subjects, elevation of plasma free fatty acid (FFA) levels stimulates gluconeogenesis (GNG) and inhibits glycogenolysis (GLY). In adults with uncomplicated Plasmodium falciparum malaria, GNG is increased and GLY decreased. To test the hypothesis that FFAs are regulators of GNG and GLY in uncomplicated falciparum malaria, we investigated the effect of inhibition of lipolysis by acipimox in 12 patients with uncomplicated falciparum malaria. Six of them were given acipimox, and six served as controls. Also as controls, six matched healthy subjects were studied on two occasions with and without acipimox. After 16 h of fasting, glucose production and GNG were significantly higher in the malaria patients compared with the healthy controls (P = 0.003 and Plasmodium falciparum; free fatty acids

Published
2004

10. Control of malaria: a successful experience from Vietnam. (Research)

Author

Hung, Le Q., de Vries, Peter J., Giao, Phan T., Nam, Nguyen V., Binh, Tran Q., Chong, M.T., Quoc, N.T.T.A., Thanh, T.N., Hung, L.N., and Kager, P.A.

Subjects
Malaria -- Prevention, Mosquitoes -- Control
Abstract

Objective To follow malaria prospectively in an ethnic minority commune in the south of Viet Nam with high malaria transmission and seasonal fluctuation, during malaria control interventions using insecticide-treated bednets (ITBNs) and early diagnosis and treatment (EDT) of symptomatic patients. Methods From 1994 onwards the following interventions were used: distribution of ITBNs to all households with biannual reimpregnation; construction of a health post and appointment of staff trained in microscopic diagnosis and treatment of malaria; regular supply of materials and drugs; annual cross-sectional malaria surveys with treatment of all parasitaemic subjects, and a programme of community involvement and health education. Surveys were held yearly at the end of the rainy season. During the surveys, demographic data were updated. Diagnosis and treatment of malaria were free of charge. Plasmodium falciparum infection was treated with artesunate and P. vivax infection with chloroquine plus primaquine. Findings The baseline survey in 1994 recorded 716 inhabitants. Of the children under 2 years of age, 37% were parasitaemic; 56% of children aged 2-10 years, and 35% of the remaining population were parasitaemic. P. falciparum accounted for 73-79% of these infections. The respective splenomegaly rates for the above-mentioned age groups were 20%, 56%, and 32%. In 1999, the proportion of parasitaemic subjects was 4%, 7% and 1%, respectively, of which P. falciparum contributed 56%. The splenomegaly rate was 0%, 5% and 2%, respectively. Conclusions A combination of ITBNs and EDT, provided free of charge, complemented by annual diagnosis and treatment during malaria surveys and community involvement with health education successfully brought malaria under control. This approach could be applied to other regions in the south of Viet Nam and provides a sound basis for further studies in other areas with different epidemiological patterns of malaria. Keywords Malaria, Falciparum/prevention and control/diagnosis/drug therapy; Malaria, Vivax/prevention and control/diagnosis/drug therapy; Sesquiterpenes/therapeutic use; Chloroquine/therapeutic use; Primaquine/therapeutic use; Pyrethrins/Bedding and linens/ utilization; Knowledge, attitudes, practice; Health education; Ethnic groups; Prospective studies; Viet Nam (source: MeSH, NLM). Mots cles Paludisme plasmodium falciparum/prevention et controle/diagnostic/chimiotherapie; Paludisme plasmodium vivax/ prevention et controle/diagnostic/chimiotherapie; Sesquiterpenes/usage therapeutique; Chloroquine/usage therapeutique; Primaquine/usage therapeutique; Pyrethrine; Literie et linge/utilisation; Connaissance, attitude, pratique; Education sanitaire; Groupes ethniques; Etude prospective; Viet Nato (source: MESH, INSERM). Palabras clave Paludismo falciparum/prevencion y control/diagnostico/quimioterapia; Paludismo vivax/prevencion y control/ diagnostico/quimioterapia; Sesquiterpenos/uso terapeutico; Cloroquina/uso terapeutico; Primaquina/uso terapeutico; Piretrinas; Ropa de cama y ropa blanca/utilizacion; Conocimientos, actitudes y practica; Educacion en salud; Grupos etnicos; Estudios prospectivos; Viet Nam (fuente: DeCS, BIREME). Bulletin of the World Health Organization 2002;80:660-666., Voir page 665 le resume en francais. En la pagina 665 figura un resumen en espanol. Introduction Malaria remains a threat to almost 50% of the world's population. With 200 [...]

Published
2002

11. Percutaneous evacuation (PEVAC) of multivesicular echinococcal cysts with or without cystobiliary fistulas which contain non-drainable material: First results of a modified PAIR method. (Liver Disease)

Author

Schipper, H.G., Lameris, J.S., Delden, O.M. van, Rauws, E.A., and Kager, P.A.

Subjects
Cysts, Liver, Surgery, Health
Abstract

Background: Surgery is the treatment of choice in echinococcal cysts with cystobiliary fistulas. PAIR (puncture, aspiration, injection, and reaspiration of scolecidals) is contraindicated in these cases. Aim: To evaluate a [...]

Published
2002

16. Use of PCR on lymph-node samples as test of cure of visceral leishmaniasis

Author

Osman, O.F., Kager, P.A., Zijlstra, E.E., El-Hassan, A.M., Oskam, L., and Faculteit der Geneeskunde

Subjects
03 medical and health sciences, 0302 clinical medicine, Infectious Diseases, 030225 pediatrics, parasitic diseases, 030231 tropical medicine, Parasitology
Abstract

When the polymerase chain reaction (PCR) was used to test lymph-node aspirates from 35 patients from eastern Sudan, who had had visceral leishmaniasis but were believed cured, leishmanial DNA was detected in samples from 14 of the patients. There were no significant differences between the PCR-positives and -negatives in terms of age, sex, spleen size, malaria status or presence of anti-Leishmania antibodies. However, PCR was more often positive in the patients who tested negative by the leishmanin skin test (LST) than in those who gave positive skin tests. Moreover, patients with a positive PCR and a negative LST converted more often to LST positivity than those with a negative PCR and a negative LST. The most important finding was that, during follow-up, eight (57%) of the PCR-positives, but none of the 21 negatives, developed post-kala-azar dermal leishmaniasis (PKDL) In conclusion, PCR-based testing of lymph-node aspirates after treatment may be used as a prognostic marker for the future development of PKDL and may be useful in the follow-up of patients

Published
1997

18. Dengue as a cause of acute undifferentiated fever in Vietnam

Author

Phuong, H.L., de Vries, P.J., Nga, T.T.T., Giao, P.T., Hung, L.Q., Binh, T.Q., Nam, N.V., Nagelkerke, N., Kager, P.A., and Faculteit der Geneeskunde

Abstract

Background: Dengue is a common cause of fever in the tropics but its contribution to the total burden of febrile illnesses that is presented to primary health facilities in endemic regions such as Vietnam, is largely unknown. We aimed to report the frequency of dengue as a cause of fever in Binh Thuan Province, to describe the characteristics of dengue patients, and analyze the diagnostic accuracy of the health care workers and the determinants of the diagnostic process. Methods: All patients presenting with acute undifferentiated fever at twelve community health posts and one clinic at the provincial malaria station, Binh Thuan Province, a dengue endemic province in southern Vietnam, were included. Record forms were used to fill in patient and diseases characteristics, pre- referral treatment, signs and symptoms, provisional diagnosis and prescribed treatment, referral and final outcome. Serum samples were collected at first presentation and after 3 weeks for serologic diagnosis. Results: 2096 patients were included from April 2001 to March 2002. All 697 patients with paired serum samples were tested for dengue virus IgM and IgG. Acute dengue was found in 33.6% cases and past dengue virus infections were found in 57.1% cases. Acute primary infections were more common among children under 15 years old than among adults ( 7.7% vs. 3.5%, p value < 0.001). Younger age significantly predicted acute dengue ( RR per increasing year of age ( 95 % CI): 0.986 ( 0.975 - 0.997, p value = 0.014). 48.9% of cases with clinical diagnosis of acute dengue were serologically confirmed and 32.5% of cases without clinical diagnosis of acute dengue were positive by serology after all ( OR = 1.981, p value 0.025, 95% CI: 1.079 - 3.635). Tourniquet test was not a predictor for dengue diagnosis. Conclusion: Dengue is responsible for one third of the fevers presented to the public primary health services in Binh Thuan, southern Vietnam. It presents as a highly unspecific illness and is hardly recognized as a clinical entity by primary physicians

Published
2006

19. Opduikende pathogenen

Author

Meer, J.W.M. van der, Hoogkamp-Korstanje, J.A.A., Kager, P.A., and Overbeke, A.J.P.M.

Subjects
Optimalisering van het antibioticagebruik in het ziekenhuis, Towards optimal use of antibiotics in hospitals, GeneralLiterature_REFERENCE(e.g.,dictionaries,encyclopedias,glossaries)
Abstract

Contains fulltext : 22643___.PDF (Publisher’s version ) (Open Access)

Published
1996

22. Een patiënt met alveolaire echinokokkose (infectie met Echinococcus multilocularis)

Author

Raasveld, M.H.M., Ponsioen, C.Y., den Boer, S.S., Schipper, H.G., Kager, P.A., Other departments, and Faculteit der Geneeskunde

Abstract

In a 45-year-old Swiss male, who had been living in the Netherlands for 20 years, alveolar echinococcosis was diagnosed. He had probably been infected during his youth in Switzerland. His illness became symptomatic more than 20 years later. The diagnosis was reached by microscopic examination of material obtained from a necrotic mass in the liver. Imaging revealed that the disease had spread diffusely throughout the liver, spleen and abdomen. Curative resection was impossible. Percutaneous drainage of the hepatic necrotic mass was complicated by a bacterial infection for which he was treated with antibiotics. Treatment with high doses of albendazole resulted in considerable improvement. The patient represents the first case of Echinococcus multilocularis infection diagnosed in the Netherlands

Published
1997

23. De behandeling van malaria

Author

Kager, P.A., Zijlmans, C.W.R., Boele van Hensbroek, M., Wetsteyn, J.C.F.M., and Faculteit der Geneeskunde

Published
1997

26. Effect of food intake on pharmacokinetics of oral artemisinin in healthy Vietnamese subjects

Author

Dien, T.K., de Vries, P.J., Khanh, N.X., Koopmans, R-P., Binh, L.N., Duc, D.D., Kager, P.A., van Boxtel, C.J., Other departments, and Faculteit der Geneeskunde

Subjects
sense organs
Abstract

The influence of food intake on the pharmacokinetics of artemisinin was studied with six healthy Vietnamese male subjects. In a crossover study, artemisinin capsules (500 mg) were administered with and without food after an overnight fast. Plasma samples were obtained up to 24 h after intake of each drug. Measurement of artemisinin concentrations was performed by high-performance liquid chromatography with electrochemical detection. Tolerance was evaluated according to subjective and objective findings, including repeated physical examinations, routine blood investigations, and electrocardiograms. Pharmacokinetics were analyzed with a noncompartmental method and with a one-compartment model. This model had either zero-order or first-order input. No statistically significant differences were found between the results of the two experimental conditions. Specifically, there were no consistent differences in parameters most likely to be affected by food intake, including absorption profile, absorption rate, bioavailability (f) (as reflected in area under the concentration time curve [AUC]), and drug clearance. Some mean +/- standard deviation parameters after food were as follows: maximum concentration of drug in serum (Cmax), 443 +/- 224 microg x liter(-1); time to Cmax, 1.78 +/- 1.2 h; AUC, 2,092 +/- 1,441 ng x ml(-1) x h, apparent clearance/f, 321 +/- 167 liter x h(-1); mean residence time, 4.42 +/- 1.31 h; and time at which half of the terminal value was reached, 0.97 +/- 0.68 h. The total amount of artemisinin excreted in urine was less than 1% of the dose. We conclude that food intake has no major effect on artemisinin pharmacokinetics. In addition, we conclude tentatively that artemisinin is cleared by the liver, that this clearance does not depend on liver blood flow (i.e., that artemisinin is a so-called low-clearance drug), and that absorption of the drug is not affected by food intake

Published
1997

27. Enzyme-linked immunoassay for dengue virus IgM and IgG antibodies in serum and filter paper blood

Author

Tran, T.N.T. (Thanh Nga), Vries, P.J. (Peter) de, Hoang, L.P. (Lan Phuong), Phan, G.T. (Giao), Le, H.Q. (Hung), Tran, B.Q. (Binh), Vo, C.M.T. (Chi Mai), Nguyen, N.V. (Nam), Kager, P.A. (Piet), Nagelkerke, N.J.D. (Nico), Groen, J.M. (Jan), Tran, T.N.T. (Thanh Nga), Vries, P.J. (Peter) de, Hoang, L.P. (Lan Phuong), Phan, G.T. (Giao), Le, H.Q. (Hung), Tran, B.Q. (Binh), Vo, C.M.T. (Chi Mai), Nguyen, N.V. (Nam), Kager, P.A. (Piet), Nagelkerke, N.J.D. (Nico), and Groen, J.M. (Jan)

Abstract

Background: The reproducibilty of dengue IgM and IgG ELISA was studied in serum and filter paper blood spots from Vietnamese febrile patients. Methods: 781 pairs of acute (t0) and convalescent sera, obtained after three weeks (t3) and 161 corresponding pairs of filter paper blood spots were tested with ELISA for dengue IgG and IgM. 74 serum pairs were tested again in another laboratory with similar methods, after a mean of 252 days. Results: Cases were classified as no dengue (10 %), past dengue (55%) acute primary (7%) or secondary (28%) dengue. Significant differences between the two laboratories' results were found leading to different diagnostic classification (kappa 0.46, p < 0.001). Filter paper results correlated poorly to serum values, being more variable and lower with a mean (95% C1) difference of 0.82 (0.36 to 1.28) for IgMt3, 0.94 (0.51 to 1.37) for IgGt0 and 0.26 (-0.20 to 0.71) for IgGt3. This also led to differences in diagnostic classification (kappa value 0.44, p < 0.001) The duration of storage of frozen serum and dried filter papers, sealed in nylon bags in an air-conditioned room, had no significant effect on the ELISA results. Conclusion: Dengue virus IgG antibodies in serum and filter papers was not affected by duration of storage, but was subject to inter-laboratory variability. Dengue virus IgM antibodies measured in serum reconstituted from blood spots on filter papers were lower than in serum, in particular in the acute phase of disease. Therefore this method limits its value for diagnostic confirmation of individual patients with dengue virus infections. However the

Published
2006
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30. Splenomegaly in Baringo District, Kenya, an area endemic for visceral leishmaniasis and malaria

Author

Schaefer, K.U., Khan, B., Gachihi, G.S., Kager, P.A., Muller, A.S., Verhave, J.P., McNeill, K.M., and Other departments

Subjects
parasitic diseases, De biologische en epidemiologische betekenis van transmissie blokkade immuniteit en factoren die transmissie beïnvloeden op endemische malaria, The biological and epidemiological significance of transmission blocking immunity and transmission reducing factors in endemic falciparum malaria
Abstract

The relationship between splenomegaly and visceral leishmaniasis (VL) was investigated during a cross-sectional study in 2,941 individuals in Baringo District, Kenya, where both malaria and VL are endemic. Spleen size was correlated with presence of malaria parasites in thick blood films and with evidence of present or past Leishmania donovani infection as determined by serology and history. Marked splenomegaly (Hackett grade 3 or greater) significantly correlated with present or previous leishmanial infection (chi 2 = 53.5; p < 0.001) whereas moderate splenomegaly (Hackett grade 1 or 2) significantly correlated with malaria parasitaemia (chi 2 = 73.03; p < 0.001). The presence of antimalarial antibodies did not contribute to the differentiation of the cause of splenomegaly. The diagnostic significance of splenomegaly in this population is discussed

Published
1995

32. Incidence and risk factors of probable dengue virus infection among Dutch travelers to Asia.

Author

Cobelens, F.G.J. (Frank), Groen, J. (Jan), Osterhaus, A.D.M.E. (Albert), Leentvaar-Kuipers, A. (Anne), Wertheim-van Dillen, P.E.M. (Pauline), Kager, P.A. (Piet), Cobelens, F.G.J. (Frank), Groen, J. (Jan), Osterhaus, A.D.M.E. (Albert), Leentvaar-Kuipers, A. (Anne), Wertheim-van Dillen, P.E.M. (Pauline), and Kager, P.A. (Piet)

Abstract

We studied the incidence of dengue virus (DEN) infections in a cohort of Dutch short-term travellers to endemic areas in Asia during 1991-92. Sera were collected before and after travel. All post-travel sera were tested for DEN immunoglobulin M (IgM) [IgM capture (MAC)-enzyme-linked immunosorbent assay (ELISA)] and IgG (indirect ELISA). Probable DEN infection was defined as IgM seroconversion or a fourfold rise in IgG ratio in the absence of cross-reaction with antibody to Japanese encephalitis virus (JEV). Infections were considered clinically apparent in case of febrile illness (> 24 H) with headache, myalgia, arthralgia or rash. Probable DEN infection was found in 13 of 447 travellers (incidence rate 30/1000 person-months, 95% CI 17.4-51.6). One infection was considered secondary; no haemorrhagic fever occurred. The clinical-to-subclinical infection rate was 1:3.3. The risk of infection

Published
2002
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35. Late ziekten na verblijf in de tropen.

Author

Clerinx, J. and Kager, P.A.

Abstract

Copyright of Reizen en Ziekte is the property of Springer Nature / Books and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Published
2010
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36. Does Infection with Human Immunodeficiency Virus Affect the Antibody Responses to Plasmodium falciparum Antigenic Determinants in Asymptomatic Pregnant Women?

Author

Ayisi, J.G., primary, Branch, OraLee H., additional, Rafi-Janajreh, A., additional, van Eijk, A.M., additional, ter Kuile, F.O., additional, Rosen, D.H., additional, Kager, P.A., additional, Lanar, D.E., additional, Barbosa, A., additional, Kaslow, D., additional, Nahlen, B.L., additional, and Lal, A.A., additional

Published
2003
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39. Erratum

Author

Dondorp, A.M, primary, Kager, P.A, additional, Vreeken, J, additional, and White, N.J, additional

Published
2000
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