Curare: Curare, 22.1999

Curare, 22.1999

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Zeitschrift

Strukturtyp:: Zeitschrift

Werks-URN (URL):: https://digi.evifa.de/viewer/resolver?urn=urn:nbn:de:kobv:11-717458

URN:: urn:nbn:de:kobv:11-717458

Persistenter Identifier:: BV048470733

Titel:: Curare

Untertitel:: Zeitschrift für Medizinethnologie : journal of medical anthropology

Weitere Titel:: Zeitschrift für Medizinethnologie; Journal of medical anthropology; journal of medical anthropology and transcultural psychiatry

ISSN:: 0344-8622

Erscheinungsort:: Berlin

Verlag:: VWB, Verl. für Wiss. und Bildung

Erscheinungsjahr:: 1978

Signatur:: LA 1980

Lizenz:: Rechte vorbehalten - Freier Zugang

Sammlung:: Zeitschriften und Zeitungen > Zeitschriften zur Ethnologie

Wissensgebiet:: Sozial- und Kulturanthropologie > Allgemeines

Zeitschriftenband

Strukturtyp:: Zeitschriftenband

Werks-URN (URL):: https://digi.evifa.de/viewer/resolver?urn=urn:nbn:de:kobv:11-719160

URN:: urn:nbn:de:kobv:11-719160

Persistenter Identifier:: 1688646474515

Titel:: Curare, 22.1999

Untertitel:: Zeitschrift für Medizinethnologie : journal of medical anthropology

Weitere Titel:: Zeitschrift für Medizinethnologie; Journal of medical anthropology; journal of medical anthropology and transcultural psychiatry

Erscheinungsort:: Berlin

Verlag:: VWB, Verl. für Wiss. und Bildung

Erscheinungsjahr:: 1978

Zusätzliche Information:: Reproduktion

Signatur:: LA 1980

Sammlung:: Zeitschriften und Zeitungen > Zeitschriften zur Ethnologie

Zeitschriftenheft

Strukturtyp:: Zeitschriftenheft

Titel:: Vol. 22 (1999) 1: Trauma - Verletzung von Körper und Seele = Trauma - Injuring Body and Soul

Sonstige Person:: Schuler, Judith

Sammlung:: Zeitschriften und Zeitungen > Zeitschriften zur Ethnologie

Zeitschriftenartikel

Strukturtyp:: Zeitschriftenartikel

Titel:: Parasitic infestations in obstetrics and gynaecology

Sonstige Person:: Munjanja, Stephen P.

Sammlung:: Zeitschriften und Zeitungen > Zeitschriften zur Ethnologie

the drug of choice is piperazine 4g as a single dose given with the evening meal. Other drugs which may also be used are me- bendazole and praziquantel, Guardiasis This infestation is caused by an intestinal flagellate, Giardia lamblia. The organism normally inhabits the duodenum or caecum, where the trophozoites may cause damage to the wall of the intestine. With movement into the large bowel, encystation occurs and these are passed into faeces. The main infection route is waterborne and the organism survives chlo- rination. The main symptoms are dyspepsia and diarrhoea with steatorrhea. A malabsorption syndrome may occur. Diagnosis is by isolation of the cysts from the stool. Repeated stool examination may be necessary as the cysts are sometimes passed irregularly in faeces. Pregnancy does not alter the course of the in- fection. The malabsorption syndrome caused by the infestation may cause nutritional deficiences in pregnancy. treatment is by oral metronidazole 2g daily for 3 days. 54 Stephen P. Munjanja deficiencies and anaemia are more likely. Pregnancy may cause exacerbation of a latent infection and new attacks in pregnancy are more likely to be seri- ous. Rarely, vaginal, vulval or perineal lesions may be {ound in association with intestinal amoebiasis. An offensive serous or blood stained discharge is present which however is not very itchy or irritating. Lymphadenopathy may be present. Ulcers may be found in the vagina or cervix which can be mistaken for carcinoma. The diagnosis of amoebiasis is made by finding che trophozoites or cysts in the faeces or in the dis- charge or scrapings of ulcers in vulvo-vaginal infec- ions. Amoebiasis is treated with oral metronidazole 800 mg three times daily for 5 days. Tinidazole is also effective against amoebiasis and both drugs are safe in pregnancies. A ten day course of diloxanide furoate is recommended for asymptomic patients with cysts in the faeces, and is sometimes also used after a metronidazole or tinidazole course in acute dysentery. GYNAECOLOGY Amoebiasis The organism responsible for the disease, Entamoe- ba histolytica, has two stages in its life cycle, the tro- phozoite and the cyst. Ingestion of the cyst, through contaminated food and water, and hand-to-mouth contact are the modes of infection. Poor sanitation is âherefore a major contributory factor in its spread. Ingested cysts undergo excystation in the ileo- caecal region of the intestine and the trophoites mul tiply and invade the caecum and colon. Passage down to the rectum results in cyst forms which are found in the faeces. The organisms may penetrate the intestinal wall and travel through the portal veins to the liver and even to the lungs. The symptoms vary widely from the asymptom- atic carrier to severe dysentery. Hepatic amoebic ab- scess is a well known complication but other ab- scesses have been described in the lungs, brain, kid- neys and in the pericardium. The dysentery is caused by the damage to the wall of the intestine by the parasites and is frequent- ly bloody. In the acute phase, hypovolaemic shock may occur, whereas in chronic dysentery, nutritional Systemic infections Schisostomiasis Bilharzia is caused by the three types of Schistoso- ma, S.haematobium, S.mansoni and S.japonicum. S.haematobium causes urogenital bilharziasis, whereas S.mansoni and S.japonicum usually cause the gastrointestinal variety. Human beings are the definitive host of the para- site which passes through snails as an intermediate host, The infestation is borne by fresh water and is spread widely in sub-Saharan Africa. Rivers, lakes, canals and irrigation systems inhabited by the snails Bulinus bulinus and Bulinus physiopsis are sources of infection. Following asexual multiplication in the snail cercariae enter the skin of humans from the water and reach the liver through the bloodstream. Following maturation in the liver they migrate in the zase of S.mansoni to the inferior mensenteric veins and reach the recto-symoid area of the large bowel. In the case of S.haematobium, they migrate to the aurare 22(1999)1: 39-47

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