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Cross-sectional prevalence and pattern of non-anaemia severe malaria among 2-10 year olds in Sokoto in Northwestern Nigeria. Front Med 2022; 16:969-974. [PMID: 36245046 DOI: 10.1007/s11684-021-0912-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 11/25/2021] [Indexed: 01/19/2023]
Abstract
Malaria is highly prevalent in Nigeria and accounts for approximately 40% of global malaria mortality. However, most reports on severe malaria in Nigeria are from hospital-based studies without accurate information from communities; thus, malaria-related deaths in the community are left untracked. This study aimed to describe the prevalence and pattern of severe malaria in a community in Northwestern Nigeria. A cross-sectional study was conducted among 2-10-year-old children in Sokoto, in August and December 2016, to determine the endemicity of malaria based on Plasmodium falciparum prevalence rate (PfPR2-10) and to describe the disease pattern. Severe malaria was diagnosed according to the World Health Organisation criteria. Data were described using Stata version 15. The prevalence of non-anaemia severe malaria was higher than expected (2.6%), considering the endemicity pattern which was mesoendemic based on a PfPR2-10 of 34.8%. The mean age of children with severe malaria was 3.73 years, and the male-female ratio was 2:1. However, 54.0% of the patients had hyperparasitaemia. A relatively high prevalence of non-anaemia severe malaria was found in Wamakko. This finding suggests the need to identify and treat cases in the community using modifications of current strategies, particularly seasonal malaria chemoprophylaxis.
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Vasse C, Faye A, Naudin J, Titomanlio L, Angoulvant A, Pham LL, Carbajal R, de Suremain N. Severe imported malaria involving hyperparasitemia (≥ 10%) in non-immune children: Assessment of French practices. Arch Pediatr 2022; 29:300-306. [DOI: 10.1016/j.arcped.2022.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 12/27/2021] [Accepted: 01/13/2022] [Indexed: 11/28/2022]
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Kumatia EK, Ayertey F, Appiah-Opong R, Bagyour GK, Asare KO, Mbatcho VC, Dabo J. Intervention of standardized ethanol leaf extract of Annickia polycarpa, (DC.) Setten and Maas ex I.M. Turner. (Annonaceae), in Plasmodium berghei infested mice produced anti-malaria action and normalized gross hematological indices. JOURNAL OF ETHNOPHARMACOLOGY 2021; 267:113449. [PMID: 33129949 DOI: 10.1016/j.jep.2020.113449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/27/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Malaria is a global public health burden due to large number of annual infections and casualties caused by its hematological complications. The bark of Annickia polycarpa is an effective anti-malaria agent in African traditional medicine. However, there is no standardization parameters for A. polycarpa. The anti-malaria properties of its leaf are also not known. AIM OF THE STUDY To standardize the ethanol leaf extract of A. polycarpa (APLE) and investigate its anti-malaria properties and the effect of its treatment on hematological indices in Plasmodium berghei infected mice in the Rane's test. MATERIALS AND METHODS Malaria was induced by inoculating female ICR mice with 1.0 × 107P. berghei-infected RBCs in 0.2 mL (i.p.) of blood. Treatment was commenced 3 days later with APLE 50, 200, 400 mg/kg p.o., Quinine 30 mg/kg i.m. (Standard drug) or sterile water (Negative control) once daily per group for 4 successive days. Anti-malarial activity and gross malaria indices such as hyperparasitemia, mean change in body weight and mean survival time (MST) were determined for each group. Changes in white blood cells (WBCs), red blood cells (RBCs), platelets (PLT) counts, hemoglobin (HGB) concentration, hematocrit (HCT) and mean corpuscular volume (MCV) were also measured in the healthy mice before infection as baseline and on day 3 and 8 after inoculation using complete blood count. Standardization was achieved by UHPLC-MS chemical fingerprint analysis and quantitative phytochemical tests. RESULTS APLE, standardized to its total alkaloids, phenolics and saponin contents, produced significant (P < 0.05) dose-dependent clearance of mean hyperparasitemia of 22.78 ± 0.93% with the minimum parasitemia level of 2.01 ± 0.25% achieved at 400 mg/kg p.o. on day 8. Quinine 30 mg/kg i.m. achieved a minimum parasitemia level of 6.15 ± 0.92%. Moreover, APLE (50-400 mg/kg p.o.) evoked very significant anti-malaria activity of 89.22-95.50%. Anti-malaria activity of Quinine 30 mg/kg i.m. was 86.22%. APLE also inverse dose-dependently promotes weight gain with the effect being significant (P < 0.05) at 50 mg/kg p.o. Moreover, APLE dose-dependently increased the MST of malaria infested mice with 100% survival at 400 mg/kg p.o. Quinine 30 mg/kg i.m. also produce 100% survival rate but did not promote (P > 0.05) weight gain. Hematological studies revealed the development of leukocytopenia, erythrocytosis, microcytic anemia and thrombocytopenia in the malaria infected mice which were reverted with the treatment of APLE 50-400 mg/kg p.o. or Quinine 30 mg/kg i.m. but persisted in the negative control. The UHPLC-MS fingerprint analysis of APLE led to identification of one oxoaporphine and two aporphine alkaloids (1-3). Alkaloids 1 and 3 are being reported in this plant for the first time. CONCLUSION These results indicate that APLE possessed significant anti-malaria, immunomodulatory, erythropoietic and hematinic actions against malaria infection. APLE also has the ability to revoke deleterious physiological alteration produced by malaria and hence, promote clinical cure. These properties of APLE are due to its constituents especially, aporphine and oxoaporphine alkaloids.
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Affiliation(s)
- Emmanuel Kofi Kumatia
- Phytochemistry Department, Centre for Plant Medicine Research, Mampong-Akwapim, Ghana.
| | - Frederick Ayertey
- Phytochemistry Department, Centre for Plant Medicine Research, Mampong-Akwapim, Ghana
| | - Regina Appiah-Opong
- Chemical Pathology Department, Noguchi Memorial Institute for Medical Research, Legon, Accra, Ghana
| | - Godfrey Kyaakyile Bagyour
- Chemistry and Applied Biochemistry Department, University of Development Studies, Navrongo-Campus, Tamale, Ghana
| | - Kenneth Opare Asare
- Clinical Resaerch Department, Centre for Plant Medicine Research, Mampong-Akwapim, Ghana
| | - Valentine Chi Mbatcho
- Chemistry and Applied Biochemistry Department, University of Development Studies, Navrongo-Campus, Tamale, Ghana
| | - Jonathan Dabo
- Biodiversity Conservation and Ecoservices Division, Forestry Research Institute of Ghana, Kumasi, Ghana
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Birhanu Z, Yihdego YYE, Emana D, Feyissa D, Kenate S, Kebede E, Getahun K, Yewhalaw D. Relationship between exposure to malaria and haemoglobin level of children 2-9 years old in low malaria transmission settings. Acta Trop 2017; 173:1-10. [PMID: 28522274 DOI: 10.1016/j.actatropica.2017.05.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Revised: 05/12/2017] [Accepted: 05/14/2017] [Indexed: 11/29/2022]
Abstract
In the context of reduced transmission of malaria, it is essential to examine the association between exposure to malaria and haemoglobin level. This study measured the Haemoglobin level of children 2-9 years of age and examined its association with malariometric indices. A cross sectional study was conducted, during June 2016, on 763 children 2-9 years old, recruited from ten sites representing different malaria transmission settings in Ethiopia. Haemoglobin concentration was determined using HemoCue analyzer. Malariometric indices (splenomegaly rate, parasite rate and serological marker) were measured. The overall prevalence of anaemia was 17.3% (95% CI: 14.6-19.9) in the study population. Mild, moderate and severe anaemia accounted for 7.3%, 7.2% and 2.8% respectively. Of the children with anaemia (132), only 7 (5.3%) had malaria parasitaemia. The prevalence of malaria parasitaemia was 3.6% (2/56), 9.1% (5/55) and 0.0% (0/21) among children with mild, moderate and severe anaemia, respectively. Malaria reactive antibody and anaemia co-occurred in 3.13% (21/672) of the samples. Seroprevalence and parasitaemia did not have significant association with anaemia (p>0.05). However, splenomegaly was significantly associated with increased risk of anaemia (AOR=14.93; p=0.001). Anaemia was significantly higher among children 2-4 years old (22.2%), and children living in households without any insecticide treated bed net (34.0%). The prevalence of anaemia was lower by 55.0% among children living in households with at least one net (AOR=0.45, 95% CI: 0.21-0.96). Repeated exposure to malaria infections (seropositive) and parasitaemia was less likely to contribute to development of anaemia among children 2-9 years in this study setting. Thus, in low malaria endemic settings, anaemia prevention and control program required to reconsider the historical evidence that suggests malaria is one of the major risk factor for anaemia.
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Affiliation(s)
- Zewdie Birhanu
- Department of Health Education and Behavioral Sciences, Institute of Health, Jimma University, P.O. Box 378, Ethiopia.
| | | | - Daniel Emana
- Department of Medical Laboratory Sciences and Pathology, Institute of Health, Jimma University, Ethiopia.
| | - Damtew Feyissa
- Oromia Regional Health Bureau, Jimma Zone Health Department, Jimma, Ethiopia.
| | - Silashi Kenate
- Oromia Regional Health Bureau, Jimma Zone Health Department, Jimma, Ethiopia.
| | - Estifanos Kebede
- Department of Medical Laboratory Sciences and Pathology, Institute of Health, Jimma University, Ethiopia.
| | - Kefelegn Getahun
- College of Social Sciences and Humanities, Jimma University, Ethiopia.
| | - Delenasaw Yewhalaw
- Tropical and Infectious Diseases Research Center, Jimma University, Jimma, Ethiopia.
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Mornand P, Verret C, Minodier P, Faye A, Thellier M, Imbert P. Severe imported malaria in children in France. A national retrospective study from 1996 to 2005. PLoS One 2017; 12:e0180758. [PMID: 28749962 PMCID: PMC5531540 DOI: 10.1371/journal.pone.0180758] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/21/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUNDS Malaria is a leading cause of imported febrile illnesses in pediatric travelers, but few studies have addressed severe imported pediatric malaria. We aimed to determine the risk factors and the features of imported pediatric severe malaria. METHODS We conducted a retrospective, descriptive study using the French National Reference Center for Imported Malaria database, in children aged 0-15 years who were hospitalized with a falciparum malaria from January 1st 1996 to December 31th 2005. Uncomplicated and severe cases of falciparum malaria were compared to identify risk factors for severe cases. In the hospitals that reported more than five severe cases during the study period, we evaluated severe cases for prognostic factors and assessed the accuracy WHO criteria for predicting severity. Given the rarity of deaths, adverse outcomes were defined as requiring major therapeutic procedures (MTPs)-e.g., sedation, mechanical ventilation, nasal oxygen therapy, blood transfusions, hemodialysis, fluid resuscitation-or pediatric intensive care unit (PICU) admission. RESULTS Of 4150 pediatric malaria cases included in the study, 3299 were uncomplicated and 851 (20.5%) were severe. Only one death was recorded during this period. Predictors for severe falciparum malaria were: age <2 years (OR = 3.2, 95% CI = 2.5-4.0, p <0.0001) and a travel in the Sahelian region (OR = 1.7, 95% CI = 1.3-2.0, p = 0.0001). Of 422 severe malaria cases, a stay in a Sahelian region, lack of chemoprophylaxis, age <2 years or thrombocytopenia <100 x 10^3/mm^3 predicted adverse outcomes. Except for the hyperparasitemia threshold of 4%, the main WHO 2000 criteria for severe malaria reliably predicted adverse outcomes. In our study, the threshold of parasitemia most predictive of a poor outcome was 8%. CONCLUSION In imported pediatric malaria, children younger than 2 years deserve particular attention. The main WHO 2000 criteria for severity are accurate, except for the threshold of hyperparasitemia, which should be revised.
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Affiliation(s)
- Pierre Mornand
- Service de pédiatrie générale, Hôpital d’enfants A. Trousseau, 26 avenue du Dr Arnold Netter, 75571 Paris cedex 12, France
| | - Catherine Verret
- Institut de Recherche Biomédicale des Armées. BP 73, Brétigny Sur Orge Cedex, France
| | - Philippe Minodier
- Urgences pédiatriques, CHU Nord, Chemin des Bourrely, Marseille, France
| | - Albert Faye
- Assistance Publique des Hôpitaux de Paris, Service de Pédiatrie Générale, Hôpital Robert Debré, Paris, France
- INSERM 1123, Université Paris Diderot, Paris Sorbonne Cité, Paris, France
| | - Marc Thellier
- AP-HP, Service de Parasitologie-Mycologie, Centre National de Référence du paludisme, Hôpital Pitié-Salpêtrière, Paris, France
- INSERM, Centre d’Immunologie et des Maladies Infectieuses de Paris, CIMI-PARIS, U 1135 INSERM/UPMC, Paris, France
| | - Patrick Imbert
- Centre de vaccinations internationales, Hôpital d’instruction des armées Bégin, Saint-Mandé, France
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Iwalokun BA, Iwalokun SO, Udoh BE, Balogun M. Assessment of co-segregated TLR4 genotypes among Nigerian children with asymptomatic and clinical malaria. Asian Pac J Trop Biomed 2017. [DOI: 10.1016/j.apjtb.2016.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Severe malaria in children leads to a significant impairment of transitory otoacoustic emissions--a prospective multicenter cohort study. BMC Med 2015; 13:125. [PMID: 26021376 PMCID: PMC4457990 DOI: 10.1186/s12916-015-0366-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2014] [Accepted: 05/13/2015] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Severe malaria may influence inner ear function, although this possibility has not been examined prospectively. In a retrospective analysis, hearing impairment was found in 9 of 23 patients with cerebral malaria. An objective method to quickly evaluate the function of the inner ear are the otoacoustic emissions. Negative transient otoacoustic emissions are associated with a threshold shift of 20 dB and above. METHODS This prospective multicenter study analyses otoacoustic emissions in patients with severe malaria up to the age of 10 years. In three study sites (Ghana, Gabon, Kenya) 144 patients with severe malaria and 108 control children were included. All malaria patients were treated with parental artesunate. RESULTS In the control group, 92.6 % (n = 108, 95 % confidence interval 86.19-6.2 %) passed otoacoustic emission screening. In malaria patients, 58.5 % (n = 94, malaria vs controls p < 0.001, 95 % confidence interval 48.4-67.9 %) passed otoacoustic emission screening at the baseline measurement. The value increased to 65.2 % (n = 66, p < 0.001, 95 % confidence interval 53.1-75.5 %) at follow up 14-28 days after diagnosis of malaria. The study population was divided into severe non-cerebral malaria and severe malaria with neurological symptoms (cerebral malaria). Whereas otoacoustic emissions in severe malaria improved to a passing percentage of 72.9 % (n = 48, 95 % confidence interval 59-83.4 %) at follow-up, the patients with cerebral malaria showed a drop in the passing percentage to 33 % (n = 18) 3-7 days after diagnosis. This shows a significant impairment in the cerebral malaria group (p = 0.012 at days 3-7, 95 % confidence interval 16.3-56.3 %; p = 0.031 at day 14-28, 95 % confidence interval 24.5-66.3 %). CONCLUSION The presented data show that 40 % of children have involvement of the inner ear early in severe malaria. In children, audiological screening after severe malaria infection is not currently recommended, but is worth investigating in larger studies.
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Ossou-Nguiet PM, Okoko AR, Ekouya Bowassa G, Oko AP, Mabiala-Babela JR, Ndjobo Mamadoud IC, Moyen G. [Determinants of cerebral malaria in Congolese children]. Rev Neurol (Paris) 2013; 169:510-4. [PMID: 23394850 DOI: 10.1016/j.neurol.2012.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2012] [Revised: 11/01/2012] [Accepted: 11/07/2012] [Indexed: 10/27/2022]
Abstract
Malaria still constitutes a worrying problem of public health. It remains an important cause of infant mortality. To determine the determinants of severe malaria a case control study was carried out from July to December 2011 in the pediatric intensive care department of the university hospital of Brazzaville. The group included 230 children hospitalised for severe malaria, and the control group consisted of children followed up for non-severe malaria. Cases and controls were compared using statistical tests for matched group. The young age of the mother (OR=4.13), her poor education level (OR=2.36), the low socioeconomic level of parents (OR=5.90), the malnutrition (OR=2.67), the delay of consultation (OR=13.69) and parasitemia were associated with significantly higher risk of severe malaria. The importance of identified determinants imposes the implementation of primary prevention measures, which pass through the amelioration of socioeconomic and cultural conditions of populations, the reinforcement of sanitary education, and also a secondary prevention consisting of an early and accurate management of ordinary malaria.
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Affiliation(s)
- P M Ossou-Nguiet
- Service de neurologie, université de Brazzaville, CHU de Brazzaville, 13, boulevard Maréchal-Lyautey, BP 32, Brazzaville, Congo.
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