1
|
Souleiman Y, Ismail L, Eftimie R. Modeling and investigating malaria P. Falciparum and P. Vivax infections: Application to Djibouti data. Infect Dis Model 2024; 9:1095-1116. [PMID: 39006106 PMCID: PMC11245922 DOI: 10.1016/j.idm.2024.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 06/03/2024] [Accepted: 06/14/2024] [Indexed: 07/16/2024] Open
Abstract
Malaria is an infectious and communicable disease, caused by one or more species of Plasmodium parasites. There are five species of parasites responsible for malaria in humans, of which two, Plasmodium Falciparum and Plasmodium Vivax, are the most dangerous. In Djibouti, the two species of Plasmodium are present in different proportions in the infected population: 77% of P. Falciparum and 33% of P. Vivax. In this study we present a new mathematical model describing the temporal dynamics of Plasmodium Falciparum and Plasmodium Vivax co-infection. We focus briefly on the well posedness of this model and on the calculation of the basic reproductive numbers for the infections with each Plasmodium species that help us understand the long-term dynamics of this model (i.e., existence and stability of various eqiuilibria). Then we use computational approaches to: (a) identify model parameters using real data on malaria infections in Djibouti; (b) illustrate the influence of different estimated parameters on the basic reproduction numbers; (c) perform global sensitivity and uncertainty analysis for the impact of various model parameters on the transient dynamics of infectious mosquitoes and infected humans, for infections with each of the Plasmodium species. The originality of this research stems from employing the FAST method and the LHS method to identify the key factors influencing the progression of the disease within the population of Djibouti. In addition, sensitivity analysis identified the most influential parameter for Falciparium and Vivax reproduction rates. Finally, the uncertainty analysis enabled us to understand the variability of certain parameters on the infected compartments.
Collapse
Affiliation(s)
- Yahyeh Souleiman
- Centre de Recherche en Mathématiques et Numérique (CRMN), University of the Djibouti, Campus Balbala, Djibouti
| | - Liban Ismail
- Centre de Recherche en Mathématiques et Numérique (CRMN), University of the Djibouti, Campus Balbala, Djibouti
| | - Raluca Eftimie
- Laboratoire Mathématiques de Besançon (LMB), University of Bourgogne Franche-Comté, Besançon, France
| |
Collapse
|
2
|
Moffitt CA, Olupot-Olupot P, Wamulugwa J, Abeso J, Muszynski JA, O'Brien N. Improving adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: assessment of a quality improvement initiative. Malar J 2024; 23:245. [PMID: 39148059 PMCID: PMC11328489 DOI: 10.1186/s12936-024-05076-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 08/11/2024] [Indexed: 08/17/2024] Open
Abstract
BACKGROUND Malaria is the leading cause of hospitalizations and death in Uganda, particularly in children under the age of five. Studies have shown that adherence to the World Health Organization (WHO) guidelines for the management of severe malaria reduces mortality in hospitalized children. This study aimed to determine the impact of targeted interventions on adherence to the WHO severe malaria treatment guidelines in children at a Ugandan hospital as part of a quality improvement initiative. METHODS Interventions included workflow changes, such as obtaining patient blood samples for diagnostic testing by the admitting healthcare provider as well as utilizing patient caregivers to assist nursing staff in timing medications. An additional intervention was the use of an admission checklist sticker. The post-intervention sample was compared to the baseline assessment. The primary outcome was the proportion of patients receiving care consistent with all aspects of the WHO guidelines. Secondary outcomes included the proportion of patients receiving malaria diagnostic testing, those receiving at least 3 doses of artesunate, the timely administration of artesunate, and adherence to other guideline components. Statistical analyses were conducted using GraphPad PRISM 9.0. Comparisons between groups were analysed using Chi-square or Fisher's exact test for categorical variables and Mann-Whitney test for continuous variables. RESULTS The post-intervention group included 230 patients with a median age of 5 years [4-8], and 58% of patients were male. Adherence to all aspects of the WHO guidelines was achieved in 10% of patients in the post-intervention group compared to 3% of patients in the baseline (P = 0.007). Appropriate malaria diagnostic testing was performed in 85% of patients post-intervention compared to 66% of patients in the baseline (P < 0.0001). Patients in the post-intervention group were more likely to receive the minimum 3 doses of artesunate (86%) than in the baseline (74%) (P = 0.008). Patients in the post-intervention group were more likely to receive artesunate doses on time than in the baseline (dose 2 P = 0.02, dose 3 P = 0.003). CONCLUSIONS Targeted, low-cost interventions led to improvement in adherence to severe malaria treatment guidelines. The most notable changes were in malaria diagnostic testing and antimalarial administration.
Collapse
Affiliation(s)
- Cynthia A Moffitt
- Division of Pediatric Critical Care, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA.
| | - Peter Olupot-Olupot
- Mbale Regional Referral Hospital, Busitema University Faculty of Health Sciences, Mbale, Uganda
- Mbale Clinical Research Institute, Mbale, Uganda
| | | | | | - Jennifer A Muszynski
- Division of Pediatric Critical Care, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| | - Nicole O'Brien
- Division of Pediatric Critical Care, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, 43205, USA
| |
Collapse
|
3
|
MacAulay S, Masud N, Cable J. Analysis of bamboo fibres and their associated dye on a freshwater fish host-parasite system. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:51025-51036. [PMID: 39138730 PMCID: PMC11364605 DOI: 10.1007/s11356-024-34626-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 08/01/2024] [Indexed: 08/15/2024]
Abstract
With the growth of the fashion and textile industries into the twenty-first century, associated pollution has become pervasive. Fibre-based microplastics are the most common types of plastics recovered from aquatic ecosystems encouraging the move towards organic fibre usage. Often marketed as biodegradable and 'environmentally friendly', organic textile fibres are seen as less harmful, but their impacts are understudied. Here, we assess the health effects of reconstituted bamboo-viscose fibres, processed bamboo-elastane fibres (both at 700 fibres/L) and their associated dye (Reactive Black-5, at 1 mg/L) on fish, with an emphasis on disease resistance utilising an established host-parasite system: the freshwater guppy host (Poecilia reticulata) and Gyrodactylus turnbulli (monogenean ectoparasite). Following 3 weeks exposure to the bamboo fibres and associated dye, half the experimental fish were infected with G. turnbulli, after which individual parasite trajectories were monitored for a further 17 days. Overall, exposures to reconstituted bamboo-viscose fibres, processed bamboo-elastane fibres or dye were not associated with any change in host mortality nor any significant changes in parasite infection burdens. When analysing the routine metabolic rate (RMR) of fish, uninfected fish had, on average, significantly impacted RMR when exposed to processed bamboo-elastane (increased RMR) and reconstituted bamboo-viscose (decreased RMR). Hosts exposed to reconstituted bamboo-viscose and the associated dye treatment showed significant changes in RMR pre- and post-infection. This study bolsters the growing and needed assessment of the potential environmental impacts of alternative non-plastic fibres; nevertheless, more research is needed in this field to prevent potential greenwashing.
Collapse
Affiliation(s)
- Scott MacAulay
- School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK.
| | - Numair Masud
- School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK
| | - Jo Cable
- School of Biosciences, Cardiff University, Cardiff, CF10 3AX, UK
| |
Collapse
|
4
|
Nkahe DL, Kopya E, Ngangue Siewe NI, Ndjeunia Mbiakop P, Kala Chouakeu NA, Mimpfoundi R, Kekeunou S, Awono-Ambene P, Antonio-Nkondjio C. Durability of PBO nets (Olyset Plus®), 12 months after their distribution in Bertoua, Cameroon. Parasite Epidemiol Control 2024; 26:e00373. [PMID: 39228793 PMCID: PMC11369369 DOI: 10.1016/j.parepi.2024.e00373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 05/06/2024] [Accepted: 07/28/2024] [Indexed: 09/05/2024] Open
Abstract
Background The rapid spread of pyrethroid resistance has led to a change in strategy, going from pyrethroid-based nets to PBO + pyrethroid-treated nets. Although these new nets may significantly improve the control of pyrethroid-resistant mosquitoes, their durability in the field remain not yet well documented. This study investigates the durability and washing resistance of Olyset-Plus nets in the city centre and rural areas of Bertoua, Cameroon. In each site, a semi-structured questionnaire was administered to at least 190 households with an Olyset-Plus net. Factors such as net use, physical integrity and bioefficacy were recorded. Bioassays were conducted on the collected nets to assess their bioefficacy and resistance to washing. They were tested against wild Anopheles gambiae sensus lato (s.l.). Unused nets and the Kisumu strain were used as controls. Washing and cone testing of the nets was carried out according to standard WHO protocols. Results A high rate of net use by children was recorded in the urban area (89.1% (106/119)) compared to the rural area (39.7% (118/297)). The majority of Olyset-Plus nets inspected 82.2% (162/197) in the rural area and 88% (206/234) in the urban centre were in good condition (Hole Index<64). Only 5.6% and 6.8% of nets were badly torn in rural and urban sites respectively. Nets were washed more regularly in the urban centre. 88.1% of urban dwellers reported having washed their nets at least once compared to only 62% of rural dwellers. Bioefficacy tests with nets indicated a mortality rate ranging from 66% for unwashed nets to 86.7% for nets washed at least once. Bioefficacy varied significantly in the city of Bertoua according to net washing frequency, soaking time, soap type and drying location, whereas in the rural village, only washing(washed or unwashed) and soaking status (soaked or unsoaked) significantly influenced the bioefficacy of Olyset-Plus nets. Conclusions This study revealed different handling practices of bed nets in rural and urban settings which could significantly affect Olyset-Plus nets bio-efficacy and durability. Routine monitoring and sensitization of communities to best practices concerning bed nets usage and handling during mass distribution might enhance the net durability in the community.
Collapse
Affiliation(s)
- Diane Leslie Nkahe
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Physiology and Biology, Faculty of Science, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Edmond Kopya
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Physiology and Biology, Faculty of Science, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Nasser Idriss Ngangue Siewe
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Physiology and Biology, Faculty of Science, University of Douala, B.P. 24157, Cameroon
| | - Paulette Ndjeunia Mbiakop
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Department of Animal Physiology and Biology, Faculty of Science, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Nelly Armanda Kala Chouakeu
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Vector-Borne Diseases Laboratory of the Research Unit of Biology and Applied Ecology (VBID-RUBAE), Department of Animal Biology, Faculty of Science, University of Dschang, Dschang, Cameroon
| | - Rémy Mimpfoundi
- Department of Animal Physiology and Biology, Faculty of Science, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Sévilor Kekeunou
- Department of Animal Physiology and Biology, Faculty of Science, University of Yaoundé I, P.O. Box 337, Yaoundé, Cameroon
| | - Parfait Awono-Ambene
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
| | - Christophe Antonio-Nkondjio
- Institut de Recherche de Yaoundé (IRY), Organisation de Coordination Pour la Lutte Contre les Endémies en Afrique Centrale (OCEAC), P.O. Box 288, Yaoundé, Cameroon
- Vector Biology Liverpool School of Tropical Medicine Pembroke Place, Liverpool L3 5QA, UK
| |
Collapse
|
5
|
Rozi IE, Permana DH, Syahrani L, Asih PBS, Zubaidah S, Risandi R, Wangsamuda S, Dewayanti FK, Demetouw MR, Mabui S, Robaha MMF, Sumiwi ME, Bangs MJ, Lobo NF, Hawley WA, Syafruddin D. Rapid entomological assessment in eight high malaria endemic regencies in Papua Province revealed the presence of indoor and outdoor malaria transmissions. Sci Rep 2024; 14:14603. [PMID: 38918533 PMCID: PMC11199675 DOI: 10.1038/s41598-024-64958-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 06/14/2024] [Indexed: 06/27/2024] Open
Abstract
Malaria in eastern Indonesia remains high despite significant reduction and elimination in other parts of the country. A rapid entomological assessment was conducted in eight high malaria endemic regencies of Papua Province, Indonesia, to expedite malaria elimination efforts in this region. This study aims to characterize specific, actionable endpoints toward understanding where and when malaria transmission is happening, where interventions may function best, and identify gaps in protection that result in continued transmission. The entomological assessment included identifying potential vectors through human landing catch (HLC), indoor morning and night resting collections, identification of larval sites through surveillance of water bodies, and vector incrimination toward understanding exposure to malaria transmission. Human landing catches (HLCs) and larval collections identified 10 Anopheles species, namely Anopheles koliensis, Anopheles punctulatus, Anopheles farauti, Anopheles hinesorum, Anopheles longirostris, Anopheles peditaeniatus, Anopheles tesselatus, Anopheles vagus, Anopheles subpictus and Anopheles kochi. The most common and abundant species found overall were An. koliensis and An. punctulatus, while An. farauti was found in large numbers in the coastal areas of Mimika and Sarmi Regencies. Vector incrimination on Anopheles collected from HLCs and night indoor resting demonstrated that An. koliensis and An. punctulatus carried Plasmodium in Keerom, Jayapura, and Sarmi Regencies. Analysis of HLCs for the most common species revealed that the An. koliensis and An. punctulatus, bite indoors and outdoors at equal rates, while An. farauti predominantly bite outdoors. Larval surveillance demonstrated that most water bodies in and surrounding residential areas contained Anopheles larvae. This study demonstrated indoor and outdoor exposure to mosquito bites and gaps in protection, enabling exposure to infectious bites in all regencies. This explains why current malaria control efforts focusing on indoor protection have failed to substantially reduce malaria incidence in the region. Optimization of insecticide-treated bed nets (ITNs), as well as installment of mosquito screens in houses, may further reduce indoor transmission. For outdoor transmission, the use of community-centric approaches to reduce or eliminate larval sources within and surrounding the village through the guidance of locally stationed entomologists, along with Social and Behavior Change mediated health education towards the local adoption of mosquito protection tools during outdoor activities, may reduce malaria transmission.
Collapse
Affiliation(s)
- Ismail E Rozi
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
- Doctoral Program in Faculty of Medicine, Hasanuddin University, Makassar, Indonesia
| | - Dendi H Permana
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
- Doctoral Program in Biomedical Sciences Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Lepa Syahrani
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
- Doctoral Program in Faculty of Mathematics and Natural Sciences, University of Indonesia, Depok, Indonesia
| | - Puji B S Asih
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
| | - Siti Zubaidah
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
| | - Rifqi Risandi
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
| | - Suradi Wangsamuda
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
| | - Farahana K Dewayanti
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia
| | | | - Silas Mabui
- Papua Province Health Office, Jayapura, Papua, Indonesia
| | | | - Maria E Sumiwi
- United Nations International Children's Emergency Fund (UNICEF), Jakarta, Indonesia
| | - Michael J Bangs
- PT Freeport Indonesia, International SOS, Freeport Medical Services, Kuala Kencana, Papua, Indonesia
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| | - Neil F Lobo
- Eck Institute for Global Health, University of Notre Dame, Indiana, USA
| | - William A Hawley
- United Nations International Children's Emergency Fund (UNICEF), Jakarta, Indonesia
| | - Din Syafruddin
- Eijkman Research Center for Molecular Biology, National Research and Innovation Agency (BRIN), Cibinong, Indonesia.
- Department of Parasitology, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
- Hasanuddin University Medical Research Center (HUMRC), Makassar, Indonesia.
| |
Collapse
|
6
|
Orbán Á, Schumacher JJ, Mucza S, Strinic A, Molnár P, Babai R, Halbritter A, Vértessy BG, Karl S, Krohns S, Kézsmárki I. Magneto-optical assessment of Plasmodium parasite growth via hemozoin crystal size. Sci Rep 2024; 14:14318. [PMID: 38906910 PMCID: PMC11192761 DOI: 10.1038/s41598-024-60988-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 04/30/2024] [Indexed: 06/23/2024] Open
Abstract
Hemozoin is a natural biomarker formed during the hemoglobin metabolism of Plasmodium parasites, the causative agents of malaria. The rotating-crystal magneto-optical detection (RMOD) has been developed for its rapid and sensitive detection both in cell cultures and patient samples. In the current article we demonstrate that, besides quantifying the overall concentration of hemozoin produced by the parasites, RMOD can also track the size distribution of the hemozoin crystals. We establish the relations between the magneto-optical signal, the mean parasite age and the median crystal size throughout one erythrocytic cycle of Plasmodium falciparum parasites, where the latter two are determined by optical and scanning electron microscopy, respectively. The significant correlation between the magneto-optical signal and the stage distribution of the parasites indicates that the RMOD method can be utilized for species-specific malaria diagnosis and for the quick assessment of drug efficacy.
Collapse
Affiliation(s)
- Ágnes Orbán
- Department of Physics, BME Budapest University of Technology and Economics, Budapest, 1111, Hungary.
| | - Jan-Jonas Schumacher
- Experimental Physics 5, Center for Electronic Correlations and Magnetism, Institute of Physics, University of Augsburg, 86159, Augsburg, Germany
| | - Szilvia Mucza
- Department of Physics, BME Budapest University of Technology and Economics, Budapest, 1111, Hungary
| | - Ana Strinic
- Experimental Physics 5, Center for Electronic Correlations and Magnetism, Institute of Physics, University of Augsburg, 86159, Augsburg, Germany
| | - Petra Molnár
- Malaria Research Laboratory, Institute of Enzymology, Research Centre for Natural Sciences, Budapest, 1117, Hungary
| | - Réka Babai
- Malaria Research Laboratory, Institute of Enzymology, Research Centre for Natural Sciences, Budapest, 1117, Hungary
- Department of Applied Biotechnology and Food Sciences, BME Budapest University of Technology and Economics, Budapest, 1111, Hungary
| | - András Halbritter
- Department of Physics, BME Budapest University of Technology and Economics, Budapest, 1111, Hungary
| | - Beáta G Vértessy
- Malaria Research Laboratory, Institute of Enzymology, Research Centre for Natural Sciences, Budapest, 1117, Hungary
- Department of Applied Biotechnology and Food Sciences, BME Budapest University of Technology and Economics, Budapest, 1111, Hungary
| | - Stephan Karl
- Vector-Borne Diseases Unit, PNG Institute of Medical Research, Madang, Madang Province, 511, Papua New Guinea
- Australian Institute of Tropical Health and Medicine, James Cook University, Smithfield, QLS, Australia
| | - Stephan Krohns
- Experimental Physics 5, Center for Electronic Correlations and Magnetism, Institute of Physics, University of Augsburg, 86159, Augsburg, Germany
| | - István Kézsmárki
- Experimental Physics 5, Center for Electronic Correlations and Magnetism, Institute of Physics, University of Augsburg, 86159, Augsburg, Germany.
| |
Collapse
|
7
|
Todarwal MA, Sancheti RS, Nikume SR, Patel HM, Bendre RS. Anti-Malarial and Multi-Bioactive Co (II), Cu (II) and Ni (II) Salen Complexes: Synthesis, Characterization and Computational Studies. Chem Biodivers 2024:e202400715. [PMID: 38825566 DOI: 10.1002/cbdv.202400715] [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: 03/20/2024] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024]
Abstract
Herein, we report the anti-malarial, anti-bacterial and anti-inflammatory activities of the N2O2 donor tetradentate salen type ligand and its CoL, NiL, and CuL metal complexes. The synthesized compounds were characterized by various spectroscopic analytical methods. The in-vitro anti-malarial investigations revealed that the complex CuL exhibited equipotency with quinine drug having IC50 value 0.25 μg/mL. The compound L showed significant inhibition of bacterial spp. viz. E. Coli, P. Aeruginosa, and S. Aureus (MIC=12.5-50 μg/mL), while the compound CoL (MIC=12.5 μg/mL) exhibited potency against gram-positive bacteria. In the in-vitro anti-inflammatory study, the compound CuL displayed moderate activity than other tested compounds. The compound CuL showed the highest anti-malarial docking score with enzyme pLDH at -8.12 Kcal/mol. The DFT study also gives authentication of higher antimalarial activity of CuL due to high dipole moment. None of the potent compounds was found cytotoxic towards vero cell lines.
Collapse
Affiliation(s)
- Minakshee A Todarwal
- Department of Chemistry, SNJB's KKHA Arts, SMGL Commerce and SPHJ Science College, Chandwad, 423101, India
- School of Chemical Sciences, KBC, North Maharashtra University, Jalgaon, 425001, India
| | - Rakesh S Sancheti
- Department of Chemistry, SNJB's KKHA Arts, SMGL Commerce and SPHJ Science College, Chandwad, 423101, India
| | - Sumit R Nikume
- School of Chemical Sciences, KBC, North Maharashtra University, Jalgaon, 425001, India
| | - Harun M Patel
- Department of Pharmaceutical Chemistry, R. C. Institute of Pharmaceutical Education and Research, Shirpur, 425405, India
| | - Ratnamala S Bendre
- School of Chemical Sciences, KBC, North Maharashtra University, Jalgaon, 425001, India
| |
Collapse
|
8
|
Bertran-Cobo C, Dumont E, Noordin NR, Lai MY, Stone W, Tetteh KK, Drakeley C, Krishna S, Lau YL, Wassmer SC. Plasmodium knowlesi infection is associated with elevated circulating biomarkers of brain injury and endothelial activation. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.04.25.24306382. [PMID: 38712121 PMCID: PMC11071568 DOI: 10.1101/2024.04.25.24306382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Introduction Malaria remains a major public health concern with substantial morbidity and mortality worldwide. In Malaysia, the emergence of Plasmodium knowlesi has led to a surge in zoonotic malaria cases and deaths in recent years. Signs of cerebral involvement have been observed in a non-comatose, fatal case of severe knowlesi infection, but the potential impact of this malaria species on the brain remains underexplored. To address this gap, we investigated circulating levels of brain injury, inflammation, and vascular biomarkers in a cohort of knowlesi-infected patients and controls. Methods Archived plasma samples from 19 patients with confirmed symptomatic knowlesi infection and 19 healthy, age-matched controls from Peninsular Malaysia were analysed. A total of 52 plasma biomarkers of brain injury, inflammation, and vascular activation were measured using Luminex and SIMOA assays. Wilcoxon tests were used to examine group differences, and biomarker profiles were explored through hierarchical clustering heatmap analysis. Results Bonferroni-corrected analyses revealed significantly elevated brain injury biomarker levels in knowlesi-infected patients, including S100B (p<0.0001), Tau (p=0.0007), UCH-L1 (p<0.0001), αSyn (p<0.0001), Park7 (p=0.0006), NRGN (p=0.0022), and TDP-43 (p=0.005). Compared to controls, levels were lower in the infected group for BDNF (p<0.0001), CaBD (p<0.0001), CNTN1 (p<0.0001), NCAM-1 (p<0.0001), GFAP (p=0.0013), and KLK6 (p=0.0126). Hierarchical clustering revealed distinct group profiles for circulating levels of brain injury and vascular activation biomarkers. Conclusions Our findings highlight for the first time the impact of Plasmodium knowlesi infection on the brain, with distinct alterations in cerebral injury and endothelial activation biomarker profiles compared to healthy controls. Further studies are warranted to investigate the pathophysiology and clinical significance of these altered surrogate markers, through both neuroimaging and long-term neurocognitive assessments.
Collapse
|
9
|
Boonyuan W, Panthawong A, Thannarin T, Kongratarporn T, Khamvarn V, Chareonviriyaphap T, Nararak J. Irritant and repellent behaviors of sterile male Aedes aegypti (L.) (Diptera: Culicidae) mosquitoes are crucial in the development of disease control strategies applying sterile insect technique. PeerJ 2024; 12:e17038. [PMID: 38529314 PMCID: PMC10962334 DOI: 10.7717/peerj.17038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024] Open
Abstract
The mosquito Aedes aegypti, known to transmit important arboviral diseases, including dengue, chikungunya, Zika and yellow fever. Given the importance of this disease vector, a number of control programs have been proposed involving the use of the sterile insect technique (SIT). However, the success of this technique hinges on having a good understanding of the biology and behavior of the male mosquito. Behavioral responses of Ae. aegypti male populations developed for SIT technology were tested under laboratory conditions against chemical and natural irritants and repellents using an excito-repellency (ER) chamber. The results showed that there were no significant behavioral escape responses in any of the radiation-sterilized male Ae. aegypti test populations when exposed to citronella, DEET, transfluthrin, and deltamethrin, suggesting that SIT did not suppress the expected irritancy and repellency (avoidance) behaviors. The type of information reported in the current study is vital in defining the effects of SIT on vector behavior and understanding how such behavior may influence the success of SIT technology with regard to other vector control interventions.
Collapse
Affiliation(s)
- Wasana Boonyuan
- Nuclear Technology Research and Development Center, Thailand Institute of Nuclear Technology (Public Organization), Nakhon Nayok, Thailand
| | - Amonrat Panthawong
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| | - Thodsapon Thannarin
- Nuclear Technology Research and Development Center, Thailand Institute of Nuclear Technology (Public Organization), Nakhon Nayok, Thailand
| | - Titima Kongratarporn
- Nuclear Technology Research and Development Center, Thailand Institute of Nuclear Technology (Public Organization), Nakhon Nayok, Thailand
| | - Vararas Khamvarn
- Nuclear Technology Research and Development Center, Thailand Institute of Nuclear Technology (Public Organization), Nakhon Nayok, Thailand
| | | | - Jirod Nararak
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok, Thailand
| |
Collapse
|
10
|
Witbooi PJ, Abiodun GJ, Maharaj R. Modeling the effect of imported malaria on the elimination programme in KwaZulu-Natal province of South Africa. Pan Afr Med J 2024; 47:80. [PMID: 38708136 PMCID: PMC11068472 DOI: 10.11604/pamj.2024.47.80.35882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Accepted: 02/19/2024] [Indexed: 05/07/2024] Open
Abstract
Introduction with imported malaria cases in a given population, the question arises as to what extent the local cases are a consequence of the imports or not. We perform a modeling analysis for a specific area, in a region aspiring for malaria-free status. Methods data on malaria cases over ten years is subjected to a compartmental model which is assumed to be operating close to the equilibrium state. Two of the parameters of the model are fitted to the decadal data. The other parameters in the model are sourced from the literature. The model is utilized to simulate the malaria prevalence with or without imported cases. Results in any given year the annual average of 460 imported cases, resulted in an end-of-year season malaria prevalence of 257 local active infectious cases, whereas without the imports the malaria prevalence at the end of the season would have been fewer than 10 active infectious cases. We calculate the numerical value of the basic reproduction number for the model, which reveals the extent to which the disease is being eliminated from the population or not. Conclusion without the imported cases, over the ten seasons of malaria, 2008-2018, the KwaZulu-Natal province would have been malaria-free over at least the last 7 years of the decade indicated. This simple methodology works well even in situations where data is limited.
Collapse
Affiliation(s)
- Peter Joseph Witbooi
- Department of Mathematics and Applied Mathematics, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
| | - Gbenga Jacob Abiodun
- Department of Mathematics and Applied Mathematics, University of the Western Cape, Private Bag X17, Bellville 7535, South Africa
- Department of Mathematics, Southern Methodist University, Dallas, TX 75275, USA
| | - Rajendra Maharaj
- Office of Malaria Research, South African Medical Research Council, Durban, South Africa
- School of Life Sciences, College of Agriculture, Engineering and Sciences, University of KwaZulu-Natal, South Africa
| |
Collapse
|
11
|
Arich S, Assaid N, Weill M, Tmimi FZ, Taki H, Sarih M, Labbé P. Human activities and densities shape insecticide resistance distribution and dynamics in the virus-vector Culex pipiens mosquitoes from Morocco. Parasit Vectors 2024; 17:72. [PMID: 38374110 PMCID: PMC10877764 DOI: 10.1186/s13071-024-06164-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 01/25/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Mosquitoes of the Culex pipiens complex are widely distributed vectors for several arboviruses affecting humans. Consequently, their populations have long been controlled using insecticides, in response to which different resistance mechanisms have been selected. Moreover, their ecological preferences and broad adaptability allow C. pipiens mosquitoes to breed in highly polluted water bodies where they are exposed to many residuals from anthropogenic activities. It has been observed for several mosquito species that anthropization (in particular urbanization and agricultural lands) can lead to increased exposure to insecticides and thus to increased resistance. The main objective of the present study was to investigate whether and how urbanization and/or agricultural lands had a similar impact on C. pipiens resistance to insecticides in Morocco. METHODS Breeding sites were sampled along several transects in four regions around major Moroccan cities, following gradients of decreasing anthropization. The imprint of anthropogenic activities was evaluated around each site as the percentage of areas classified in three categories: urban, agricultural and natural. We then assessed the frequencies of four known resistance alleles in these samples and followed their dynamics in five urban breeding sites over 4 years. RESULTS The distribution of resistance alleles revealed a strong impact of anthropization, in both agricultural and urbanized lands, although different between resistance mutations and between Moroccan regions; we did not find any clear trend in the dynamics of these resistance alleles during the survey. CONCLUSIONS Our study provides further evidence for the role of anthropic activities in the selection and maintenance of mutations selected for resistance to insecticides in mosquitoes. The consequences are worrying as this could decrease vector control capacities and thus result in epizootic and epidemic outbreaks. Consequently, concerted and integrated disease control strategies must be designed that include better management regarding the consequences of our activities.
Collapse
Affiliation(s)
- Soukaina Arich
- Institut des Sciences de l'Évolution de Montpellier, UMR 5554, CNRS-UM-IRD- EPHE), Université de Montpellier, Cedex 5, Montpellier, France
- Laboratory of Biology and Health, Faculty of Sciences Ben M'Sik, URAC34, Hassan II University of Casablanca, Casablanca, Morocco
- Laboratoire des Maladies Vectorielles (LMV), Institut Pasteur du Maroc, Casablanca, Morocco
| | - Najlaa Assaid
- Laboratoire des Maladies Vectorielles (LMV), Institut Pasteur du Maroc, Casablanca, Morocco
| | - Mylène Weill
- Institut des Sciences de l'Évolution de Montpellier, UMR 5554, CNRS-UM-IRD- EPHE), Université de Montpellier, Cedex 5, Montpellier, France
| | - Fatim-Zohra Tmimi
- Laboratoire des Maladies Vectorielles (LMV), Institut Pasteur du Maroc, Casablanca, Morocco
| | - Hassan Taki
- Laboratory of Biology and Health, Faculty of Sciences Ben M'Sik, URAC34, Hassan II University of Casablanca, Casablanca, Morocco
| | - M'hammed Sarih
- Laboratoire des Maladies Vectorielles (LMV), Institut Pasteur du Maroc, Casablanca, Morocco
| | - Pierrick Labbé
- Institut des Sciences de l'Évolution de Montpellier, UMR 5554, CNRS-UM-IRD- EPHE), Université de Montpellier, Cedex 5, Montpellier, France.
- Institut Universitaire de France, 1 rue Descartes, 75231, Cedex 05 Paris, France.
| |
Collapse
|
12
|
Champer SE, Chae B, Haller BC, Champer J, Messer PW. Resource-explicit interactions in spatial population models. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.01.13.575512. [PMID: 38293045 PMCID: PMC10827080 DOI: 10.1101/2024.01.13.575512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
Continuous-space population models can yield significantly different results from their panmictic counterparts when assessing evolutionary, ecological, or population-genetic processes. However, the computational burden of spatial models is typically much greater than that of panmictic models due to the overhead of determining which individuals interact with one another and how strongly they interact. Though these calculations are necessary to model local competition that regulates the population density, they can lead to prohibitively long runtimes. Here, we present a novel modeling method in which the resources available to a population are abstractly represented as an additional layer of the simulation. Instead of interacting directly with one another, individuals interact indirectly via this resource layer. We find that this method closely matches other spatial models, yet can dramatically increase the speed of the model, allowing the simulation of much larger populations. Additionally, models structured in this manner exhibit other desirable characteristics, including more realistic spatial dynamics near the edge of the simulated area, and an efficient route for modeling more complex heterogeneous landscapes.
Collapse
Affiliation(s)
- Samuel E. Champer
- Department of Computational Biology, Cornell University, Ithaca, NY 14853
| | - Bryan Chae
- Department of Computational Biology, Cornell University, Ithaca, NY 14853
| | - Benjamin C. Haller
- Department of Computational Biology, Cornell University, Ithaca, NY 14853
| | - Jackson Champer
- Center for Bioinformatics, School of Life Sciences, Center for Life Sciences, Peking University, Beijing, China 100871
| | - Philipp W. Messer
- Department of Computational Biology, Cornell University, Ithaca, NY 14853
| |
Collapse
|
13
|
Woolley SD, Grigg MJ, Marquart L, Gower J, Piera K, Nair AS, Amante FM, Rajahram GS, William T, Frazer DM, Chalon S, McCarthy JS, Anstey NM, Barber BE. Longitudinal changes in iron homeostasis in human experimental and clinical malaria. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.12.19.23300265. [PMID: 38196596 PMCID: PMC10775340 DOI: 10.1101/2023.12.19.23300265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Abstract
Background The interaction between iron deficiency and malaria is incompletely understood. We evaluated longitudinal changes in iron homeostasis in volunteers enrolled in malaria volunteer infection studies (VIS) and in Malaysian patients with falciparum and vivax malaria. Methods We retrieved samples and associated data from 55 participants enrolled in malaria VIS, and 171 malaria patients and 30 healthy controls enrolled in clinical studies in Malaysia. Ferritin, hepcidin, erythropoietin, and soluble transferrin receptor (sTfR) were measured by ELISA. Results In the VIS, participants' parasitaemia was correlated with baseline mean corpuscular volume (MCV), but not iron status (ferritin, hepcidin or sTfR). Ferritin, hepcidin and sTfR all increased during the VIS. Ferritin and hepcidin normalised by day 28, while sTfR remained elevated. In VIS participants, baseline iron status (ferritin) was associated with post-treatment increases in liver transaminase levels. In Malaysian malaria patients, hepcidin and ferritin were elevated on admission compared to healthy controls, while sTfR increased following admission. Hepcidin normalised by day 28; however, ferritin and sTfR both remained elevated 4 weeks following admission. Conclusion Our findings demonstrate that parasitaemia is associated with an individual's MCV rather than iron status. The persistent elevation in sTfR 4 weeks post-infection in both malaria VIS and clinical malaria may reflect a causal link between malaria and iron deficiency.
Collapse
Affiliation(s)
- Stephen D Woolley
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Clinical Sciences Department, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
- Academic Department of Military Medicine, Royal Centre for Defence Medicine, Birmingham, United Kingdom
| | - Matthew J Grigg
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Louise Marquart
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- School of Public Health, University of Queensland, Brisbane, Australia
| | - Jeremy Gower
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Kim Piera
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
| | - Arya Sheela Nair
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Fiona M Amante
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Giri S Rajahram
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Department of Medicine, Queen Elizabeth II Hospital, Kota Kinabalu, Malaysia
- Clinical Research Centre, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
| | - Timothy William
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Department of Medicine, Queen Elizabeth II Hospital, Kota Kinabalu, Malaysia
- Subang Jaya Medical Centre, Subang Jaya, Malaysia
| | - David M Frazer
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | | | - James S McCarthy
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Victorian Infectious Diseases Institute, Peter Doherty Institute, University of Melbourne, Melbourne, Australia
| | - Nicholas M Anstey
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
| | - Bridget E Barber
- Infection and Inflammation Program, QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Global and Tropical Health Division, Menzies School of Health Research, Charles Darwin University, Darwin, Australia
- Infectious Diseases Society Kota Kinabalu Sabah-Menzies School of Health Research Clinical Research Unit, Kota Kinabalu, Malaysia
- Infectious Diseases Department, Royal Brisbane and Women's Hospital, Brisbane, Australia
| |
Collapse
|
14
|
Nsengimana A, Biracyaza E, Isimbi J, Uwambajimana C, Hategekimana JC, Kagisha V, Asingizwe D, Nyandwi JB. Request for Antimalarial Medicines and Their Dispensing Without a Prescription in Community Pharmacies in Rwanda. INTEGRATED PHARMACY RESEARCH AND PRACTICE 2023; 12:195-212. [PMID: 37928945 PMCID: PMC10625414 DOI: 10.2147/iprp.s428105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Accepted: 10/20/2023] [Indexed: 11/07/2023] Open
Abstract
Purpose This study aimed to explore the request and dispensing of antimalarial medicines without a prescription in community pharmacies in Rwanda, as well as factors associated. Methods We employed an embedded mixed-methods design that involved a convenience sample of 235 licensed community pharmacists between February and April 2022. To simultaneously collect qualitative and quantitative data, we used a self-administered questionnaire containing a combination of close and open-ended questions. Bivariate and multivariate regression analyses were performed to examine the relationship between dispensing antimalarial medicines without a prescription and the selected independent variables. Statistical significance was set at p<0.05, and a 95% confidence interval was applied. The factors influencing the dispensing of antimalarial medicines without a prescription were analyzed using thematic content analysis as a qualitative analysis approach. Results Most respondents (88.5%) were asked to dispense antimalarial medicines by clients without a prescription. More than half of them (54%) agreed, but 34.5% refused; instead, they referred clients to malaria diagnostic testing facilities. Those who had rapid diagnostic tests for malaria in stock (OR=2.08, 95% CI:1.1-3.94), and thought that antimalarials were over-the-counter medicines (OR=7.03, 95% CI:2.01-24.5) were more likely to dispense antimalarial medicines without prescriptions. The primary reasons reported by community pharmacists for dispensing antimalarial medicines without prescriptions included their prior knowledge of malaria diagnosis, client pressure, and fear of losing clients. However, non-adherence to negative results obtained from formal health facilities and long queues at these institutions have also been cited as additional factors driving clients to seek antimalarial medicines without prescriptions. Conclusion Dispensing antimalarial medicines without prescriptions is a common practice in community pharmacies in Rwanda. The main factors contributing to this practice include lack of awareness regarding the classification of antimalarials as prescription medicines, the availability of malaria diagnostic tests, client pressure, and fear of losing clients.
Collapse
Affiliation(s)
- Amon Nsengimana
- US Agency for International Development Global Health Supply Chain Program, Procurement and Supply Chain Management, Kigali, Rwanda
| | - Emmanuel Biracyaza
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, Québec, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - Joyce Isimbi
- Department of Pharmacy, University of Rwanda, Kigali, Rwanda
| | | | | | - Vedaste Kagisha
- Department of Pharmacy, University of Rwanda, Kigali, Rwanda
| | - Domina Asingizwe
- Department of Physiotherapy; University of Rwanda, Kigali, Rwanda
- East African Community Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, University of Rwanda, Kigali, Rwanda
| | - Jean Baptiste Nyandwi
- Department of Pharmacy, University of Rwanda, Kigali, Rwanda
- East African Community Regional Centre of Excellence for Vaccines, Immunization and Health Supply Chain Management, University of Rwanda, Kigali, Rwanda
| |
Collapse
|
15
|
Ochora DO, Mogire RM, Masai RJ, Yeda RA, Mwakio EW, Amwoma JG, Wakoli DM, Yenesew A, Akala HM. Ex vivo and In vitro antiplasmodial activities of approved drugs predicted to have antimalarial activities using chemogenomics and drug repositioning approach. Heliyon 2023; 9:e18863. [PMID: 37583763 PMCID: PMC10424068 DOI: 10.1016/j.heliyon.2023.e18863] [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: 05/05/2023] [Revised: 07/31/2023] [Accepted: 07/31/2023] [Indexed: 08/17/2023] Open
Abstract
High malaria mortality coupled with increased emergence of resistant multi-drug resistant strains of Plasmodium parasite, warrants the development of new and effective antimalarial drugs. However, drug design and discovery are costly and time-consuming with many active antimalarial compounds failing to get approved due to safety reasons. To address these challenges, the current study aimed at testing the antiplasmodial activities of approved drugs that were predicted using a target-similarity approach. This approach is based on the fact that if an approved drug used to treat another disease targets a protein similar to Plasmodium falciparum protein, then the drug will have a comparable effect on P. falciparum. In a previous study, in vitro antiplasmodial activities of 10 approved drugs was reported of the total 28 approved drugs. In this study, six out of 18 drugs that were previously not tested, namely epirubicin, irinotecan, venlafaxine, palbociclib, pelitinib, and PD153035 were tested for antiplasmodial activity. The drug susceptibility in vitro assays against five P. falciparum reference strains (D6, 3D7, W2, DD2, and F32 ART) and ex vivo assays against fresh clinical isolates were done using the malaria SYBR Green I assay. Standard antimalarial drugs were included as controls. Epirubicin and irinotecan showed excellent antiplasmodial ex vivo activity against field isolates with mean IC50 values of 0.044 ± 0.033 μM and 0.085 ± 0.055 μM, respectively. Similar activity was observed against W2 strain where epirubicin had an IC50 value of 0.004 ± 0.0009 μM, palbociclib 0.056 ± 0.006 μM, and pelinitib 0.057 ± 0.013 μM. For the DD2 strain, epirubicin, irinotecan and PD 153035 displayed potent antiplasmodial activity (IC50 < 1 μM). Epirubicin and irinotecan showed potent antiplasmodial activities (IC50 < 1 μM) against DD2, D6, 3D7, and F32 ART strains and field isolates. This shows the potential use of these drugs as antimalarials. All the tested drugs showed antiplasmodial activities with IC50 values below 20 μM, which suggests that our target similarity-based strategy is successful at predicting antiplasmodial activity of compounds thereby circumventing challenges in antimalarial drug discovery.
Collapse
Affiliation(s)
- Douglas O. Ochora
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, P.O. Box 408-40200, Kisii, Kenya
- DSI/NWU, Preclinical Drug Development Platform, Faculty of Health Sciences, North-West University, Private Bag X6001, 2520, Potchefstroom, South Africa
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| | - Reagan M. Mogire
- Kenya Medical Research Institute (KEMRI) – Kemri-Wellcome Trust Research Programme, P.O. Box 230-80108, Kilifi, Kenya
| | - Rael J. Masai
- Department of Biological Sciences, School of Pure and Applied Sciences, Kisii University, P.O. Box 408-40200, Kisii, Kenya
| | - Redemptah A. Yeda
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| | - Edwin W. Mwakio
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| | - Joseph G. Amwoma
- Department of Biological Sciences, University of Embu P. O. Box 6-60100, Embu, Kenya
| | - Dancan M. Wakoli
- Department of Biochemistry and Molecular Biology, Egerton University, P.O. Box 536-20115, Egerton-Njoro, Kenya
| | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, P.O. Box 30197-00100, Nairobi, Kenya
| | - Hoseah M. Akala
- United States Army Medical Research Directorate-Africa (USAMRD-A), Kenya Medical Research Institute (KEMRI)—Walter Reed Project, P.O. Box 54-40100, Kisumu, Kenya
| |
Collapse
|
16
|
Sharma B, Agarwal A, Awasthi SK. Is structural hybridization invoking new dimensions for antimalarial drug discovery research? RSC Med Chem 2023; 14:1227-1253. [PMID: 37484560 PMCID: PMC10357931 DOI: 10.1039/d3md00083d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 05/01/2023] [Indexed: 07/25/2023] Open
Abstract
Despite effective prevention methods, malaria is a devastating, persistent infection caused by protozoal parasites that result in nearly half a million fatalities annually. Any progress made thus far in the eradication of the disease is jeopardized by the expansion of malaria parasites that have evolved to become resistant to a wide range of drugs, including first-line therapy. To surmount this significant obstacle, it is necessary to develop newly synthesized drugs with multiple modes of action that may have a novel target in various stages of Plasmodium parasite development and this is made possible by the hybridization concept. Hybridization is the combination of at least two diverse pharmacophore units with some linkers bringing about a single molecule with a diverse mode of action. It intensifies a drug's physiological and chemical characteristics, such as absorption, cellular target contact, metabolism, excretion, distribution, and toxicity. This review article outlines the currently published most potent hybrid drugs against the Plasmodium species.
Collapse
Affiliation(s)
- Bhawana Sharma
- Chemical Biology Laboratory, Department of Chemistry, University of Delhi Delhi-110007 India
| | - Alka Agarwal
- Department of Medicinal Chemistry, Institute of Medical Sciences, Banaras Hindu University Varanasi-221005 Uttar Pradesh India
| | - Satish Kumar Awasthi
- Chemical Biology Laboratory, Department of Chemistry, University of Delhi Delhi-110007 India
| |
Collapse
|
17
|
Mzilahowa T, Gowelo S, Chiphwanya J, Bauleni A, Mukaka M. Anopheles funestus sensu stricto Giles (Diptera:Culicidae) bites after sunrise at two rural villages in northern Malawi and its implications for malaria vector control. Malawi Med J 2023; 35:80-88. [PMID: 38264168 PMCID: PMC10731528 DOI: 10.4314/mmj.v35i2.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2024] Open
Abstract
Introduction Malawi has scaled up distribution and use of LLINs but their effectiveness depends on vector behaviour. This study reports information on where and when peak biting takes place by Anopheles vectors at two study sites in northern Malawi. Methods The study was carried out at a single village each in Nkhata Bay and Karonga districts, northern Malawi. Monthly, three teams of four people each sampled mosquitoes using Human Landing Collections (HLCs) from 6.00 pm to 6.00 am. Mosquitoes were counted and identified by PCR. Plasmodium falciparum sporozoites were detected by ELISA and an entomological inoculation rate was estimated. Results A total of 4,668 and 2,079 mosquitoes were sampled in Nkhata Bay and Karonga districts respectively. An. funestus s.s was common (91.3%; n = 2,611) in Nkhata Bay while An. arabiensis was common (96.9%; n = 706) in Karonga. Pf sporozoite rates varied from 0.8% (4/484) to 3.3% (51/1558). Individuals in Nkhata Bay received more bites (approx. 200 bites/ person/ night) compared to Karonga (approx. 50 bites/ person/ night). An. funestus was more likely to bite indoors (p=0.002) while An. arabiensis was (p=0.05) more likely to bite outdoors. Furthermore, An. funestus peak biting was in the early morning hours from 4:00 am (approx. 331 and 177 bites/ person/ night indoors and outdoors respectively) and remained high till 6:00 am. An. arabiensis peak biting (approx. 63 and 62 bites/ person/ night indoors and outdoors respectively) was around mid-night (12:00). An EIR of 108.4 infective bites/ person/ year was estimated for Nkhata Bay compared to 9.1 infective bites/ person/ year for Karonga. Conclusion An. funestus s.s. had a considerable Pf sporozite infection rate and EIR. The shift in biting behaviour shown by this species poses a challenge to malaria control. Further studies are required to understand the biting behaviour of Anopheles vectors in Malawi.
Collapse
Affiliation(s)
- Themba Mzilahowa
- MAC Communicable Diseases Action Centre, Kamuzu University of Health Sciences, Malawi
| | - Steven Gowelo
- MAC Communicable Diseases Action Centre, Kamuzu University of Health Sciences, Malawi
| | | | - Andrew Bauleni
- MAC Communicable Diseases Action Centre, Kamuzu University of Health Sciences, Malawi
| | - Mavuto Mukaka
- Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine, Nuffield Department of Medicine, University of Oxford, UK
| |
Collapse
|
18
|
Ghosh AK, Panda SK, Luyten W. Immunomodulatory activity of plants against white spot syndrome virus (WSSV) in shrimp culture: a review. AQUACULTURE INTERNATIONAL 2023; 31:1743-1774. [DOI: 10.1007/s10499-023-01051-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 01/04/2023] [Indexed: 07/15/2023]
|
19
|
Nair MS, Huang Y, Wang M, Weathers PJ. SARS-CoV-2 omicron variants are susceptible in vitro to Artemisia annua hot water extracts. JOURNAL OF ETHNOPHARMACOLOGY 2023; 308:116291. [PMID: 36804200 PMCID: PMC9937997 DOI: 10.1016/j.jep.2023.116291] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Revised: 02/12/2023] [Accepted: 02/15/2023] [Indexed: 06/05/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Artemisia annua L. has >2000 yr of history in treating fever a symptom common to many infectious diseases including viruses. The plant is widely used as a tea infusion in many areas of the globe to thwart many infectious diseases. AIM OF THE STUDY The SARS-CoV-2 (COVID-19) virus continues to infect millions while rapidly evolving new variants that are more transmissible and evade vaccine-elicited antibodies, e.g., omicron and its subvariants. Having shown potency against all previously tested variants, A. annua L. extracts were further tested against highly infectious omicron and its recent subvariants. MATERIALS AND METHODS Using Vero E6 cells, we measured the in vitro efficacy (IC50) of stored (frozen) dried-leaf hot-water A. annua L. extracts of four cultivars (A3, BUR, MED, and SAM) against SARS-CoV-2 variants: original WA1 (WT), BA.1 (omicron), BA.2, BA.2.12.1, and BA.4. End point virus titers of infectivity in cv. BUR-treated human lung A459 cells overexpressing hu-ACE2 were determined for both WA1 and BA.4 viruses. RESULTS When normalized to the artemisinin (ART) or leaf dry weight (DW) equivalent of the extract, the IC50 values ranged from 0.5 to 16.5 μM ART and from 20 to 106 μg DW. IC50 values were within limits of assay variation of our earlier studies. End-point titers confirmed a dose-response inhibition in ACE2 overexpressing human lung cells to the BUR cultivar. Cell viability losses were not measurable at leaf dry weights ≤50 μg for any cultivar extract. CONCLUSIONS A. annua hot-water extracts (tea infusions) continue to show efficacy against SARS-CoV-2 and its rapidly evolving variants and deserve greater attention as a possible cost-effective therapeutic.
Collapse
Affiliation(s)
- M S Nair
- Aaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - Y Huang
- Aaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - M Wang
- Aaron Diamond AIDS Research Center, Columbia University Irving Medical Center, New York, NY, USA.
| | - P J Weathers
- Department of Biology and Biotechnology, Worcester Polytechnic Institute, Worcester, MA, 01609, USA.
| |
Collapse
|
20
|
Akinbobola JS, Okaiyeto SO, Sackey AK, Allam L, Mohammed B, Dinga JN, Chukwuemeka PC, Cunningham L. Comparative performance evaluation of blood film microscopy for the diagnosis of bovine trypanosomosis by some laboratories in North-central Nigeria. Open Vet J 2023; 13:599-603. [PMID: 37304603 PMCID: PMC10257452 DOI: 10.5455/ovj.2023.v13.i5.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 04/12/2023] [Indexed: 06/13/2023] Open
Abstract
Background Due to its affordability in disease-affected communities and suitability for field application, microscopy has historically been considered the gold standard for field diagnosis of trypanosomosis in rural settings. Aim This works aims to compare the performance of microscopists on bovine trypanosome microscopy by organizing the first comparative assessment on a correct reading of slides by laboratory professionals using the read slide results and a structured interviewer-administered questionnaire in North-central Nigeria. Methods Ten participants were addressed, as they were sent a panel of two slides (Slide 1: No Trypanosome present; Slide 2: Trypanosome present) and a questionnaire. Results All participants greater than 41 years old reported correctly the presence and absence of parasites on slides. Only 3/8 of microscopists from routine diagnostic laboratories reported correctly the presence of the parasite. Conclusion Our study confirmed errors in reading slides. Therefore, training of microscopists besides a nationwide quality assessment is recommended.
Collapse
Affiliation(s)
- Jones Soladoye Akinbobola
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | | | | | - Lushaikyaa Allam
- Veterinary Teaching Hospital, Ahmadu Bello University, Zaria, Nigeria
| | - Bisalla Mohammed
- Department of Veterinary Pathology, Ahmadu Bello University, Zaria, Nigeria
| | - Jerome Nyhalah Dinga
- Michael Gahnyam Gbeugvat Foundation, Buea, Cameroon
- Biotechnology Unit, Faculty of Science, University of Buea, Buea, Cameroon
| | - Prosper C. Chukwuemeka
- Department of Veterinary Medicine, Faculty of Veterinary Medicine, University of Abuja, Abuja, Nigeria
| | - Lucas Cunningham
- Department of Tropical Disease Biology, Biological Sciences, Liverpool School of Tropical Medicine, Liverpool, UK
| |
Collapse
|
21
|
Mogaka S, Molu H, Kagasi E, Ogila K, Waihenya R, Onditi F, Ozwara H. Senna occidentalis (L.) Link root extract inhibits Plasmodium growth in vitro and in mice. BMC Complement Med Ther 2023; 23:71. [PMID: 36879244 PMCID: PMC9987147 DOI: 10.1186/s12906-023-03854-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 01/20/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND Senna occidentalis (L.) Link has been used worldwide in traditional treatment of many diseases and conditions including snakebite. In Kenya, a decoction from the plant roots taken orally, is used as a cure for malaria. Several studies have demonstrated that extracts from the plant possess antiplasmodial activity, in vitro. However, the safety and curative potency of the plant root against established malaria infection is yet to be scientifically validated, in vivo. On the other hand, there are reports on variation in bioactivity of extracts obtained from this plant species, depending on the plant part used and place of origin among other factors. In this study, we demonstrated the antiplasmodial activity of Senna occidentalis roots extract in vitro, and in mice. METHODS Methanol, ethyl acetate, chloroform, hexane and water extracts of S. occidentalis root were tested for in vitro antiplasmodial activity against Plasmodium falciparum, strain 3D7. Cytotoxicity of the most active solvent extracts was determined using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and the curative potency in Plasmodium berghei infected mice evaluated by Rane's test. RESULTS All of the solvent extracts tested in this study inhibited the propagation of P. falciparum, strain 3D7, in vitro, with polar extracts being more active than non-polar ones. Methanolic extracts had the highest activity (IC50 = 1.76) while hexane extract displayed the lowest activity (IC50 = 18.47). At the tested concentrations, methanolic and aqueous extracts exhibited high selectivity index against P. falciparum strain 3D7 (SI > 10) in the cytotoxicity assay. Further, the extracts significantly suppressed the propagation of P. berghei parasites (P < 0.05) in vivo and increased the survival time of the infected mice (P < 0.0001). CONCLUSIONS Senna occidentalis (L.) Link root extract inhibits the propagation of malaria parasites in vitro and in BALB/c mice.
Collapse
Affiliation(s)
- Simeon Mogaka
- Department of Tropical and Infectious Diseases, Institute of Primate Research, P.O Box 24481, Karen, Nairobi, 00502, Kenya.
- Department of Zoology, Jomo Kenyatta University of Agriculture and Technology, P.O Box 62000-00200, Nairobi, Kenya.
| | - Halkano Molu
- Department of Tropical and Infectious Diseases, Institute of Primate Research, P.O Box 24481, Karen, Nairobi, 00502, Kenya
| | - Esther Kagasi
- Department of Tropical and Infectious Diseases, Institute of Primate Research, P.O Box 24481, Karen, Nairobi, 00502, Kenya
| | - Kenneth Ogila
- Department of Zoology, Jomo Kenyatta University of Agriculture and Technology, P.O Box 62000-00200, Nairobi, Kenya
| | - Rebeccah Waihenya
- Department of Zoology, Jomo Kenyatta University of Agriculture and Technology, P.O Box 62000-00200, Nairobi, Kenya
| | - Faith Onditi
- Department of Tropical and Infectious Diseases, Institute of Primate Research, P.O Box 24481, Karen, Nairobi, 00502, Kenya
- Laboratory of Malaria Immunology and Vaccinology, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, MD, USA
| | - Hastings Ozwara
- Department of Tropical and Infectious Diseases, Institute of Primate Research, P.O Box 24481, Karen, Nairobi, 00502, Kenya
| |
Collapse
|
22
|
Moffitt CA, Olupot-Olupot P, Onen JW, O’Brien N. Adherence to severe malaria treatment guidelines in children at a Ugandan regional hospital: a baseline assessment for a malaria treatment quality improvement project. Malar J 2023; 22:67. [PMID: 36841756 PMCID: PMC9960713 DOI: 10.1186/s12936-023-04507-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 02/20/2023] [Indexed: 02/27/2023] Open
Abstract
BACKGROUND Malaria is one of the most common causes of hospital admission and death in children under the age of five. The World Health Organization (WHO) has issued guidelines for the identification and treatment of severe malaria. Evidence has shown that adherence to standardized malaria treatment protocols improves outcomes. As a baseline assessment in preparation for a malaria treatment quality improvement project, this study aimed to determine adherence to the WHO severe malaria treatment guidelines in children at a Ugandan Regional Referral Hospital. METHODS A retrospective review was performed on a convenience sample of children discharged between June 2021 and March 2022 from the Mbale Regional Referral Hospital Paediatrics Ward with a diagnosis of severe malaria. Data were collected using a standardized case report form. Demographics, presenting symptoms, laboratory results, treatments, length of stay, and mortality were extracted. Comparison of treatments received to items recommended in the WHO guidelines was undertaken to determine adherence. RESULTS 147 patients were included. The median age was 5 years (IQR 2-7 years), and 55% were male. The most common features of severe malaria were haemoglobinuria (49%), haemoglobin < 5 mg/dL (34%), and altered mentation (24%). Median hospital length of stay was 3 days (IQR 2-4 days), and the mortality rate was 27% (n = 40). Overall adherence to all aspects of the WHO severe malaria guidelines was achieved in 3% (n = 4) of patients. The most common areas of deficiency were not testing to confirm malaria diagnosis (34%) and inadequate administration of artesunate (82%). Fewer than the three recommended doses of artesunate occurred in 22% of patients. Additionally, a delay in the administration of the second dose occurred in 67% (n = 78) and in the third dose in 77% (n = 71) of patients. While the recommended time between doses is 12 h, the median interval between dose one and dose two was 15 h (12-20) and the median interval from dose two to dose three was 17 h (14-25). CONCLUSIONS Current adherence to severe malaria treatment guidelines in children at this Ugandan regional referral hospital is poor, but this study has identified target areas for improvement.
Collapse
Affiliation(s)
- Cynthia A. Moffitt
- grid.240344.50000 0004 0392 3476Division of Pediatric Critical Care, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205 USA
| | - Peter Olupot-Olupot
- grid.461221.20000 0004 0512 5005Faculty of Health Sciences, Busitema University, Mbale Regional Referral Hospital, Mbale, Uganda
| | - Joan Wamulugwa Onen
- grid.461221.20000 0004 0512 5005Mbale Regional Referral Hospital, Mbale, Uganda
| | - Nicole O’Brien
- grid.240344.50000 0004 0392 3476Division of Pediatric Critical Care, Nationwide Children’s Hospital, 700 Children’s Drive, Columbus, OH 43205 USA
| |
Collapse
|
23
|
Nyagumbo E, Pote W, Shopo B, Nyirenda T, Chagonda I, Mapaya RJ, Maunganidze F, Mavengere WN, Mawere C, Mutasa I, Kademeteme E, Maroyi A, Taderera T, Bhebhe M. Medicinal plants used for the management of respiratory diseases in Zimbabwe: Review and perspectives potential management of COVID-19. PHYSICS AND CHEMISTRY OF THE EARTH (2002) 2022; 128:103232. [PMID: 36161239 PMCID: PMC9489988 DOI: 10.1016/j.pce.2022.103232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 08/17/2022] [Accepted: 08/23/2022] [Indexed: 06/16/2023]
Abstract
Respiratory diseases have in the recent past become a health concern globally. More than 523 million cases of coronavirus disease (COVID19), a recent respiratory diseases have been reported, leaving more than 6 million deaths worldwide since the start of the pandemic. In Zimbabwe, respiratory infections have largely been managed using traditional (herbal) medicines, due to their low cost and ease of accessibility. This review highlights the plants' toxicological and pharmacological evaluation studies explored. It seeks to document plants that have been traditionally used in Zimbabwe to treat respiratory ailments within and beyond the past four decades. Extensive literature review based on published papers and abstracts retrieved from the online bibliographic databases, books, book chapters, scientific reports and theses available at Universities in Zimbabwe, were used in this study. From the study, there were at least 58 plant families comprising 160 medicinal plants widely distributed throughout the country. The Fabaceae family had the highest number of medicinal plant species, with a total of 21 species. A total of 12 respiratory ailments were reportedly treatable using the identified plants. From a total of 160 plants, colds were reportedly treatable with 56, pneumonia 53, coughs 34, chest pain and related conditions 29, asthma 25, tuberculosis and spots in lungs 22, unspecified respiratory conditions 20, influenza 13, bronchial problems 12, dyspnoea 7, sore throat and infections 5 and sinus clearing 1 plant. The study identified potential medicinal plants that can be utilised in future to manage respiratory infections.
Collapse
Affiliation(s)
- Elliot Nyagumbo
- Department of Biochemistry, Faculty of Medicine and Health Sciences, Midlands State University, Gweru, Zimbabwe
| | - William Pote
- Ethnobiology-based Drug discovery, Research and Development Trust, Gweru, Zimbabwe
- Department of Physiology, School of Medicine and Health Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Bridgett Shopo
- Department of Applied Bioscience and Biotechnology, Faculty of Science and Technology, Midlands State University, Gweru, Zimbabwe
- Ethnobiology-based Drug discovery, Research and Development Trust, Gweru, Zimbabwe
| | - Trust Nyirenda
- Department of Physiology, Faculty of Medicine and Health Sciences, Midlands State University, Gweru, Zimbabwe
- Department of Anatomy and Physiology, Faculty of Medicine, National University of Science and Technology, Bulawayo, Zimbabwe
| | - Ignatius Chagonda
- Department of Agriculture Practice, Faculty of Agriculture, Midlands State University, Gweru, Zimbabwe
| | - Ruvimbo J Mapaya
- Department of Applied Bioscience and Biotechnology, Faculty of Science and Technology, Midlands State University, Gweru, Zimbabwe
| | - Fabian Maunganidze
- Ethnobiology-based Drug discovery, Research and Development Trust, Gweru, Zimbabwe
- Department of Physiology, Faculty of Medicine and Health Sciences, Midlands State University, Gweru, Zimbabwe
| | - William N Mavengere
- Ethnobiology-based Drug discovery, Research and Development Trust, Gweru, Zimbabwe
- Department of Biotechnology, School of Industrial Sciences and Technology, Harare Institute of Technology, Harare, Zimbabwe
| | - Cephas Mawere
- Department of Biotechnology, School of Industrial Sciences and Technology, Harare Institute of Technology, Harare, Zimbabwe
| | - Ian Mutasa
- Ethnobiology-based Drug discovery, Research and Development Trust, Gweru, Zimbabwe
- Department of Physiology, School of Medicine and Health Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Emmanuel Kademeteme
- Department of Physiology, School of Medicine and Health Sciences, Great Zimbabwe University, Masvingo, Zimbabwe
| | - Alfred Maroyi
- Department of Botany, University of Fort Hare, Alice, South Africa
| | - Tafadzwa Taderera
- Department of Biomedical Sciences, Physiology Unit, University of Zimbabwe, P.O. Box MP167, Mt Pleasant, Harare, Zimbabwe
| | - Michael Bhebhe
- Department of Biochemistry, Faculty of Medicine and Health Sciences, Midlands State University, Gweru, Zimbabwe
- Ethnobiology-based Drug discovery, Research and Development Trust, Gweru, Zimbabwe
| |
Collapse
|
24
|
Rahi M, Sharma A. India could harness public-private partnerships to achieve malaria elimination. THE LANCET REGIONAL HEALTH. SOUTHEAST ASIA 2022; 5:100059. [PMID: 37383669 PMCID: PMC10305908 DOI: 10.1016/j.lansea.2022.100059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Public-private partnerships (PPP) have been beneficial in different sectors like infrastructure development and service sector across the world, including in India. Such partnerships in the healthcare sector have also been successful in providing access to affordable medical attention to all sections of society. These partnerships between public and private entities have proven to be beneficial in controlling malaria in high burden districts of India and taking these areas to the brink of elimination, thus setting examples to follow. The two successful ones are the Comprehensive Case Management Project (CCMP) in Odisha which is now adopted by the state, and the Malaria Elimination Demonstration Project (MEDP) which has nearly eliminated malaria from the highly endemic district of Mandla in Madhya Pradesh. Here we propose that non-government and semi-government actors may be given vital roles in the malaria elimination efforts till 2030 and beyond. These partners will add value to the national programme and may have the potential to develop and test different models of malaria elimination in real-life settings that the government programme can absorb sustainably.
Collapse
Affiliation(s)
- Manju Rahi
- Division of Epidemiology and Communicable Diseases, Indian Council of Medical Research (ICMR), New Delhi, India
- Academy of Scientific and Innovative Research, Ghaziabad, India
| | - Amit Sharma
- Academy of Scientific and Innovative Research, Ghaziabad, India
- ICMR-National Institute of Malaria Research, New Delhi, India
- Molecular Medicine, International Centre for Genetic Engineering and Biotechnology, New Delhi, India
| |
Collapse
|
25
|
Gindola Y, Getahun D, Sugerman D, Tongren E, Tokarz R, Wossen M, Demissie K, Zemelak E, Okugn A, Wendimu J, Hailu G, Tegistu M, Begna D. Adherence to national malaria clinical management and testing guidelines in selected private clinics of Gambela Town, Gambela Region, Ethiopia: a mixed method study. Malar J 2022; 21:164. [PMID: 35658968 PMCID: PMC9166442 DOI: 10.1186/s12936-022-04206-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 05/27/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The World Health Organization World Malaria Report of 2019 indicated an estimated 228 million cases of malaria occurred worldwide in 2018. More than 75% of the total area of Ethiopia is malarious, making malaria a leading public health problem in Ethiopia. Adherence to clinical guidelines improves the quality of care received by patients, thus improving patient outcomes. This study investigates healthcare workers' adherence to malaria testing and treatment guidelines in selected private clinics of Gambela Town, Ethiopia. METHODS A mixed study design involving a retrospective review of 425 patient files and 20 healthcare worker interviews in private clinics was implemented. Data were collected using pre-tested data collection forms. The collected data were then cleaned and entered into statistical software for analysis, with a level of significance set at < 0.05. A qualitative analysis was also conducted using healthcare worker interviews to identify the existing barriers to guideline adherence. RESULTS Among the 430 cases of suspected malaria, only 65% were tested for malaria. Of those tested, 75% tested positive and 25% tested negative. The most common co-morbidity in patients treated for malaria was anaemia (30%), followed by gastroenteritis (10%). Patients with co-morbidities were more likely to receive appropriate treatment (p = 0.03) compared to those without co-morbidities. All healthcare workers interviewed were aware of the existence of the malaria treatment guidelines. However, many were not aware of the contents of the guidelines and only 40% had been trained to understand the guidelines. Overall, 85% of the workers claimed to adhere to guidelines, with 15% claiming non-adherence. CONCLUSION The gap between knowledge of the malaria treatment guidelines and their application by healthcare workers remains wide. The level of knowledge of these guidelines was also low. Continuous training, follow-up, supportive supervision, and improved adherence to the malaria guidelines are therefore recommended.
Collapse
Affiliation(s)
- Yamlak Gindola
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia.
| | | | - David Sugerman
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Eric Tongren
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Ryan Tokarz
- Centers for Disease Control and Prevention, Atlanta, USA
| | - Mesfin Wossen
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | | | | | - Akuma Okugn
- Gambela Regional Health Bureau, Gambela, Gambela Regional, Ethiopia
| | - Jimmawork Wendimu
- Department of Public Health, St'Paul Hospital Millennium Medical College, Addis Ababa, Ethiopia
| | - Girmay Hailu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Tegistu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| | - Dumesa Begna
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
| |
Collapse
|
26
|
de Haan F, Boon WPC, Amaratunga C, Dondorp AM. Expert perspectives on the introduction of Triple Artemisinin-based Combination Therapies (TACTs) in Southeast Asia: a Delphi study. BMC Public Health 2022; 22:864. [PMID: 35490212 PMCID: PMC9055751 DOI: 10.1186/s12889-022-13212-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 04/07/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Triple Artemisinin-based Combination Therapies (TACTs) are being developed as a response to artemisinin and partner drug resistance in Southeast Asia. However, the desirability, timing and practical feasibility of introducing TACTs in Southeast Asia is subject to debate. This study systematically assesses perspectives of malaria experts towards the introduction of TACTs as first-line treatment for uncomplicated falciparum malaria in Southeast Asia. METHODS A two-round Delphi study was conducted. In the first round, 53 malaria experts answered open-ended questions on what they consider the most important advantages, disadvantages, and implementation barriers for introducing TACTs in Southeast Asia. In the second round, the expert panel rated the relevance of each statement on a 5-point Likert scale. RESULTS Malaria experts identified 15 advantages, 15 disadvantages and 13 implementation barriers for introducing TACTs in Southeast Asia in the first round of data collection. In the second round, consensus was reached on 13 advantages (8 perceived as relevant, 5 as not-relevant), 12 disadvantages (10 relevant, 2 not-relevant), and 13 implementation barriers (all relevant). Advantages attributed highest relevance related to the clinical and epidemiological rationale of introducing TACTs. Disadvantages attributed highest relevance related to increased side-effects, unavailability of fixed-dose TACTs, and potential cost increases. Implementation barriers attributed highest relevance related to obtaining timely regulatory approval, timely availability of fixed-dose TACTs, and generating global policy support for introducing TACTs. CONCLUSIONS The study provides a structured oversight of malaria experts' perceptions on the major advantages, disadvantages and implementation challenges for introducing TACTs in Southeast Asia, over current practices of rotating ACTs when treatment failure is observed. The findings can benefit strategic decision making in the battle against drug-resistant malaria.
Collapse
Affiliation(s)
- Freek de Haan
- Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, 3484 CB, Utrecht, the Netherlands.
| | - Wouter P C Boon
- Copernicus Institute of Sustainable Development, Utrecht University, Princetonlaan 8a, 3484 CB, Utrecht, the Netherlands
| | - Chanaki Amaratunga
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Ratchathewi DistrictBangkok, 10400, Thailand
| | - Arjen M Dondorp
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Ratchathewi DistrictBangkok, 10400, Thailand
| |
Collapse
|
27
|
Heger T, Zatloukal M, Kubala M, Strnad M, Gruz J. Procyanidin C1 from Viola odorata L. inhibits Na +,K +-ATPase. Sci Rep 2022; 12:7011. [PMID: 35487935 PMCID: PMC9055044 DOI: 10.1038/s41598-022-11086-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 04/13/2022] [Indexed: 01/30/2023] Open
Abstract
Members of the Viola genus play important roles in traditional Asian herbal medicine. This study investigates the ability of Viola odorata L. extracts to inhibit Na+,K+-ATPase, an essential animal enzyme responsible for membrane potential maintenance. The root extract of V. odorata strongly inhibited Na+,K+-ATPase, while leaf and seeds extracts were basically inactive. A UHPLC-QTOF-MS/MS metabolomic approach was used to identify the chemical principle of the root extract’s activity, resulting in the detection of 35,292 features. Candidate active compounds were selected by correlating feature area with inhibitory activity in 14 isolated fractions. This yielded a set of 15 candidate compounds, of which 14 were preliminarily identified as procyanidins. Commercially available procyanidins (B1, B2, B3 and C1) were therefore purchased and their ability to inhibit Na+,K+-ATPase was investigated. Dimeric procyanidins B1, B2 and B3 were found to be inactive, but the trimeric procyanidin C1 strongly inhibited Na+,K+-ATPase with an IC50 of 4.5 µM. This newly discovered inhibitor was docked into crystal structures mimicking the Na3E1∼P·ADP and K2E2·Pi states to identify potential interaction sites within Na+,K+-ATPase. Possible binding mechanisms and the principle responsible for the observed root extract activity are discussed.
Collapse
Affiliation(s)
- Tomas Heger
- Department of Experimental Biology, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Marek Zatloukal
- Department of Chemical Biology, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Martin Kubala
- Department of Experimental Physics, Faculty of Science, Palacky University, Olomouc, Czech Republic
| | - Miroslav Strnad
- Laboratory of Growth Regulators, Institute of Experimental Botany of the Czech Academy of Sciences, Palacky University, Olomouc, Czech Republic
| | - Jiri Gruz
- Department of Experimental Biology, Faculty of Science, Palacky University, Olomouc, Czech Republic.
| |
Collapse
|
28
|
Otambo WO, Olumeh JO, Ochwedo KO, Magomere EO, Debrah I, Ouma C, Onyango P, Atieli H, Mukabana WR, Wang C, Lee MC, Githeko AK, Zhou G, Githure J, Kazura J, Yan G. Health care provider practices in diagnosis and treatment of malaria in rural communities in Kisumu County, Kenya. Malar J 2022; 21:129. [PMID: 35459178 PMCID: PMC9034626 DOI: 10.1186/s12936-022-04156-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 04/07/2022] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Accurate malaria diagnosis and appropriate treatment at local health facilities are critical to reducing morbidity and human reservoir of infectious gametocytes. The current study assessed the accuracy of malaria diagnosis and treatment practices in three health care facilities in rural western Kenya. METHODS The accuracy of malaria detection and treatment recommended compliance was monitored in two public and one private hospital from November 2019 through March 2020. Blood smears from febrile patients were examined by hospital laboratory technicians and re-examined by an expert microscopists thereafter subjected to real-time polymerase chain reaction (RT-PCR) for quality assurance. In addition, blood smears from patients diagnosed with malaria rapid diagnostic tests (RDT) and presumptively treated with anti-malarial were re-examined by an expert microscopist. RESULTS A total of 1131 febrile outpatients were assessed for slide positivity (936), RDT (126) and presumptive diagnosis (69). The overall positivity rate for Plasmodium falciparum was 28% (257/936). The odds of slide positivity was higher in public hospitals, 30% (186/624, OR:1.44, 95% CI = 1.05-1.98, p < 0.05) than the private hospital 23% (71/312, OR:0.69, 95% CI = 0.51-0.95, p < 0.05). Anti-malarial treatment was dispensed more at public hospitals (95.2%, 177/186) than the private hospital (78.9%, 56/71, p < 0.0001). Inappropriate anti-malarial treatment, i.e. artemether-lumefantrine given to blood smear negative patients was higher at public hospitals (14.6%, 64/438) than the private hospital (7.1%, 17/241) (p = 0.004). RDT was the most sensitive (73.8%, 95% CI = 39.5-57.4) and specific (89.2%, 95% CI = 78.5-95.2) followed by hospital microscopy (sensitivity 47.6%, 95% CI = 38.2-57.1) and specificity (86.7%, 95% CI = 80.8-91.0). Presumptive diagnosis had the lowest sensitivity (25.7%, 95% CI = 13.1-43.6) and specificity (75.0%, 95% CI = 50.6-90.4). RDT had the highest non-treatment of negatives [98.3% (57/58)] while hospital microscopy had the lowest [77.3% (116/150)]. Health facilities misdiagnosis was at 27.9% (77/276). PCR confirmed 5.2% (4/23) of the 77 misdiagnosed cases as false positive and 68.5% (37/54) as false negative. CONCLUSIONS The disparity in malaria diagnosis at health facilities with many slide positives reported as negatives and high presumptive treatment of slide negative cases, necessitates augmenting microscopic with RDTs and calls for Ministry of Health strengthening supportive infrastructure to be in compliance with treatment guidelines of Test, Treat, and Track to improve malaria case management.
Collapse
Affiliation(s)
- Wilfred Ouma Otambo
- grid.442486.80000 0001 0744 8172Department of Zoology, Maseno University, Kisumu, Kenya ,International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Julius O. Olumeh
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.10604.330000 0001 2019 0495Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Kevin O. Ochwedo
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.10604.330000 0001 2019 0495Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Edwin O. Magomere
- grid.8301.a0000 0001 0431 4443Department of Biochemistry and Molecular Biology, Egerton University, Njoro, Kenya
| | - Isaiah Debrah
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.8652.90000 0004 1937 1485West Africa Centre for Cell Biology of Infectious Pathogen, Department of Biochemistry, Cell and Molecular Biology, University of Ghana, Accra, Ghana
| | - Collins Ouma
- grid.442486.80000 0001 0744 8172Department of Biomedical Sciences and Technology, Maseno University, Kisumu, Kenya
| | - Patrick Onyango
- grid.442486.80000 0001 0744 8172Department of Zoology, Maseno University, Kisumu, Kenya
| | - Harrysone Atieli
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - Wolfgang R. Mukabana
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya ,grid.10604.330000 0001 2019 0495Department of Biology, Faculty of Science and Technology, University of Nairobi, Nairobi, Kenya
| | - Chloe Wang
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| | - Ming-Chieh Lee
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| | - Andrew K. Githeko
- grid.33058.3d0000 0001 0155 5938Centre for Global Health Research, Kenya Medical Research Institute, Kisumu, Kenya
| | - Guofa Zhou
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| | - John Githure
- International Centre of Excellence for Malaria Research, Tom Mboya University College of Maseno University, Homa Bay, Kenya
| | - James Kazura
- grid.67105.350000 0001 2164 3847Centre for Global Health and Diseases, Case Western University Reserve, Cleveland, OH USA
| | - Guiyun Yan
- grid.266093.80000 0001 0668 7243Depatment of Population Health and Disease Prevention, University of California, Irvine, CA USA
| |
Collapse
|
29
|
Pena GA, da Costa Lopes AS, de Morais SHS, do Nascimento LD, dos Santos FRR, da Costa KS, Alves CN, Lameira J. Host-Guest Inclusion Complexes of Natural Products and Nanosystems: Applications in the Development of Repellents. MOLECULES (BASEL, SWITZERLAND) 2022; 27:molecules27082519. [PMID: 35458718 PMCID: PMC9028570 DOI: 10.3390/molecules27082519] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/17/2022] [Accepted: 03/18/2022] [Indexed: 02/08/2023]
Abstract
Repellents are compounds that prevent direct contact between the hosts and the arthropods that are vectors of diseases. Several studies have described the repellent activities of natural compounds obtained from essential oils. In addition, these chemical constituents have been pointed out as alternatives to conventional synthetic repellents due to their interesting residual protection and low toxicity to the environment. However, these compounds have been reported with short shelf life, in part, due to their volatile nature. Nanoencapsulation provides protection, stability, conservation, and controlled release for several compounds. Here, we review the most commonly used polymeric/lipid nanosystems applied in the encapsulation of small organic molecules obtained from essential oils that possess repellent activity, and we also explore the theoretical aspects related to the intermolecular interactions, thermal stability, and controlled release of the nanoencapsulated bioactive compounds.
Collapse
Affiliation(s)
- Gueive Astur Pena
- Laboratório de Planejamento e Desenvolvimento de Fármacos, Federal University of Pará, Augusto Correa Street, w/n, Guamá, Belém 66075-110, Brazil; (G.A.P.); (C.N.A.)
| | - Anna Sylmara da Costa Lopes
- Laboratório de Catalálise e Oleoquímica, Federal University of Pará, Augusto Correa Street, w/n, Guamá, Belém 66075-110, Brazil;
| | - Sylvano Heleno Salgado de Morais
- Laboratório de Química Analítica e Ambiental, Federal University of Pará, Augusto Correa Street, w/n, Guamá, Belém 66075-110, Brazil;
| | - Lidiane Diniz do Nascimento
- Museu Paraense Emilio Goeldi, Laboratório Adolpho Ducke, Perimetral Avenue, Nuber 1901, Belém 66077-830, Brazil;
| | | | - Kauê Santana da Costa
- Laboratório de Simulação Computacional, Instituto de Biodiversidade, Universidade Federal do Oeste do Pará, Vera Paz Street, w/n Salé, Santarém 68040-255, Brazil
- Correspondence: (K.S.d.C.); (J.L.)
| | - Cláudio Nahum Alves
- Laboratório de Planejamento e Desenvolvimento de Fármacos, Federal University of Pará, Augusto Correa Street, w/n, Guamá, Belém 66075-110, Brazil; (G.A.P.); (C.N.A.)
| | - Jerônimo Lameira
- Laboratório de Planejamento e Desenvolvimento de Fármacos, Federal University of Pará, Augusto Correa Street, w/n, Guamá, Belém 66075-110, Brazil; (G.A.P.); (C.N.A.)
- Correspondence: (K.S.d.C.); (J.L.)
| |
Collapse
|
30
|
Shambhu S, Koundal D, Das P, Hoang VT, Tran-Trung K, Turabieh H. Computational Methods for Automated Analysis of Malaria Parasite Using Blood Smear Images: Recent Advances. COMPUTATIONAL INTELLIGENCE AND NEUROSCIENCE 2022; 2022:3626726. [PMID: 35449742 PMCID: PMC9017520 DOI: 10.1155/2022/3626726] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/26/2022] [Indexed: 11/18/2022]
Abstract
Malaria comes under one of the dangerous diseases in many countries. It is the primary reason for most of the causalities across the world. It is presently rated as a significant cause of the high mortality rate worldwide compared with other diseases that can be reduced significantly by its earlier detection. Therefore, to facilitate the early detection/diagnosis of malaria to reduce the mortality rate, an automated computational method is required with a high accuracy rate. This study is a solid starting point for researchers who want to look into automated blood smear analysis to detect malaria. In this paper, a comprehensive review of different computer-assisted techniques has been outlined as follows: (i) acquisition of image dataset, (ii) preprocessing, (iii) segmentation of RBC, and (iv) feature extraction and selection, and (v) classification for the detection of malaria parasites using blood smear images. This study will be helpful for: (i) researchers can inspect and improve the existing computational methods for early diagnosis of malaria with a high accuracy rate that may further reduce the interobserver and intra-observer variations; (ii) microbiologists to take the second opinion from the automated computational methods for effective diagnosis of malaria; and (iii) finally, several issues remain addressed, and future work has also been discussed in this work.
Collapse
Affiliation(s)
- Shankar Shambhu
- Chitkara University School of Computer Applications, Chitkara University, Himachal Pradesh, India
| | - Deepika Koundal
- School of Computer Science, University of Petroleum and Energy Studies, Dehradun, India
| | - Prasenjit Das
- Chitkara University School of Computer Applications, Chitkara University, Himachal Pradesh, India
| | - Vinh Truong Hoang
- Faculty of Computer Science, Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam
| | - Kiet Tran-Trung
- Faculty of Computer Science, Ho Chi Minh City Open University, Ho Chi Minh City, Vietnam
| | - Hamza Turabieh
- Department of Information Technology, College of Computing and Information Technology, Taif University, P.O. Box 11099, Taif 21944, Saudi Arabia
| |
Collapse
|
31
|
Llanos-Cuentas A, Manrrique P, Rosas-Aguirre A, Herrera S, Hsiang MS. Tafenoquine for the treatment of Plasmodium vivax malaria. Expert Opin Pharmacother 2022; 23:759-768. [PMID: 35379070 DOI: 10.1080/14656566.2022.2058394] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Plasmodium vivax malaria causes significant disease burden worldwide, especially in Latin America, Southeast Asia, and Oceania. P. vivax is characterized by the production of liver hypnozoites that cause clinical relapses upon periodic activation. Primaquine, an 8-aminoquinoline drug, has been the standard of care for decades to treat liver-stage P. vivax malaria; however, it requires long treatment regimens (one to two weeks) that lead to poor adherence and thus clinical relapses. Tafenoquine (TFQ), a newly available and efficacious single-dose 8-aminoquinoline, aims to address this challenge. Safe administration is possible when paired with the use of glucose-6-phosphate dehydrogenase (G6PD) diagnostics to prevent 8-aminoquinoline-induced hemolysis in patients with underlying G6PD deficiency (G6PDd). AREAS COVERED In this review, the authors present the recent literature regarding the pharmacology, efficacy, safety, and tolerability of TFQ and highlight regional differences in these areas. The authors also discuss the potential for TFQ, complemented with primaquine PQ and effective screening for G6PDd, to improve P. vivax clinical management and facilitate targeted mass drug administration in communities to decrease transmission. EXPERT OPINION Clinical studies show therapeutic efficacy of TFQ as well as a good performance in terms of safety and tolerability. Additional research regarding the effectiveness and safety TFQ in malaria elimination strategies such as targeted or mass drug administration are needed.
Collapse
Affiliation(s)
| | - Paulo Manrrique
- Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston, PA, USA
| | - Angel Rosas-Aguirre
- Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Sonia Herrera
- Department of Epidemiology, Division of Infectious Diseases and Global Health, Department of Pediatrics, Division of Pediatric Infectious Diseases, University of California San Francisco, San Francisco, CA, United States
| | - Michelle S Hsiang
- Department of Epidemiology, Division of Infectious Diseases and Global Health, Department of Pediatrics, Division of Pediatric Infectious Diseases, University of California San Francisco, San Francisco, CA, United States.,Department of Epidemiology and Biostatistics, University of California San Francisco (UCSF), San Francisco, CA, USA.,Department of PediatricsUniversity of California San Francisco (UCSF), San Francisco, CA, USA
| |
Collapse
|
32
|
Alene KA, Elagali A, Barth DD, Rumisha SF, Amratia P, Weiss DJ, Atalell KA, Erena AK, Gething PW, Clements ACA. Spatial codistribution of HIV, tuberculosis and malaria in Ethiopia. BMJ Glob Health 2022; 7:bmjgh-2021-007599. [PMID: 35217531 PMCID: PMC8867247 DOI: 10.1136/bmjgh-2021-007599] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 01/20/2022] [Indexed: 12/15/2022] Open
Abstract
Background HIV, tuberculosis (TB) and malaria are the three most important infectious diseases in Ethiopia, and sub-Saharan Africa. Understanding the spatial codistribution of these diseases is critical for designing geographically targeted and integrated disease control programmes. This study investigated the spatial overlap and drivers of HIV, TB and malaria prevalence in Ethiopia. Methods HIV, TB and malaria data were obtained from different nationwide prevalence surveys, and geospatial covariates were obtained from publicly available sources. A Bayesian model-based geostatistical framework was applied to each survey leveraging the strength of high-resolution spatial covariates to predict continuous disease-specific prevalence surfaces and their codistribution. Results The national prevalence was 1.54% (95% CI 1.40 to 1.70) for HIV, 0.39% (95% CI 0.34 to 0.45) for TB and 1.1% (95%CI 0.95 to 1.32) for malaria. Substantial subnational variation was predicted with the highest HIV prevalence estimated in Gambela (4.52%), Addis Ababa (3.52%) and Dire Dawa (2.67%) regions. TB prevalence was highest in Dire Dawa (0.96%) and Gambela (0.88%), while malaria was highest in Gambela (6.1%) and Benishangul-Gumuz (3.8%). Spatial overlap of their prevalence was observed in some parts of the country, mainly Gambela region. Spatial distribution of the diseases was significantly associated with healthcare access, demographic, and climatic factors. Conclusions The national distribution of HIV, TB and malaria was highly focal in Ethiopia, with substantial variation at subnational and local levels. Spatial distribution of the diseases was significantly associated with healthcare access, demographic and climatic factors. Spatial overlap of HIV, TB and malaria prevalence was observed in some parts of the country. Integrated control programmes for these diseases should be targeted to these areas with high levels of co-endemicity.
Collapse
Affiliation(s)
- Kefyalew Addis Alene
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia .,Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Ahmed Elagali
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Dylan D Barth
- University of Western Australia, Perth, Western Australia, Australia.,Wesfarmers Centre for Vaccines and Infectious Diseases, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Susan F Rumisha
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia.,National Institute for Medical Research, Dar es Salaam, Tanzania
| | - Punam Amratia
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia
| | - Daniel J Weiss
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Kendalem Asmare Atalell
- School of Nursing, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | | | - Peter W Gething
- Geospatial Health and Development, Telethon Kids Institute, Nedlands, Western Australia, Australia.,Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| | - Archie C A Clements
- Faculty of Health Sciences, Curtin University, Perth, Western Australia, Australia
| |
Collapse
|
33
|
Akampurira D, Akala HM, Derese S, Heydenreich M, Yenesew A. A new C-C linked benzophenathridine-2-quinoline dimer, and the antiplasmodial activity of alkaloids from Zanthoxylum holstzianum. Nat Prod Res 2022:1-11. [PMID: 35139708 DOI: 10.1080/14786419.2022.2034810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The CH2Cl2/MeOH (1:1) extract of Zanthoxylum holstzianum stem bark showed good antiplasmodial activity (IC50 2.5 ± 0.3 and 2.6 ± 0.3 µg/mL against the W2 and D6 strains of Plasmodium falciparum, respectively). From the extract five benzophenanthridine alkaloids [8-acetonyldihydrochelerythrine (1), nitidine (2), dihydrochelerythine (3), norchelerythrine (5), arnottianamide (8)]; a 2-quinolone alkaloid [N-methylflindersine (4)]; a lignan [4,4'-dihydroxy-3,3'-dimethoxylignan-9,9'-diyl diacetate (7)] and a dimer of a benzophenanthridine and 2-quinoline [holstzianoquinoline (6)] were isolated. The CH2Cl2/MeOH (1:1) extract of the root bark afforded 1, 3-6, 8, chelerythridimerine (9) and 9-demethyloxychelerythrine (10). Holstzianoquinoline (6) is new, and is the second dimer linked by a C-C bond of a benzophenanthridine and a 2-quinoline reported thus far. The compounds were identified based on spectroscopic evidence. Amongst five compounds (1-5) tested against two strains of P. falciparum, nitidine (IC50 0.11 ± 0.01 µg/mL against W2 and D6 strains) and norchelerythrine (IC50 value of 0.15 ± 0.01 µg/mL against D6 strain) were the most active.
Collapse
Affiliation(s)
- Denis Akampurira
- Department of Chemistry, University of Nairobi, Nairobi, Kenya.,Department of Chemistry, Kyambogo University, Kyambogo, Kampala, Uganda
| | - Hoseah M Akala
- Global Emerging Infections Surveillance (GEIS) Program, United States Army Medical Research Unit-Kenya (USAMRD-A/K), Kenya Medical Research Institute (KEMRI) - Walter Reed Project, Kisumu and Nairobi, Kenya
| | - Solomon Derese
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| | | | - Abiy Yenesew
- Department of Chemistry, University of Nairobi, Nairobi, Kenya
| |
Collapse
|
34
|
Marwa KJ, Konje ET, Kapesa A, Kamugisha E, Mwita S, Swedberg G. Artemether-lumefantrine and dihydroartemisinin-piperaquine treatment outcomes among children infected with uncomplicated Plasmodium falciparum malaria in Mwanza, Tanzania. Trop Med Health 2021; 49:94. [PMID: 34838151 PMCID: PMC8627025 DOI: 10.1186/s41182-021-00383-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/10/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Artemisinin based combination therapies (ACTs) have been a cornerstone in the treatment of malaria in the world. A rapid decline in dihydroartemisinin piperaquine (DHP) and artemether lumefantrine (ALU) efficacies has been reported in some parts of South East Asia, the historical epicenter for the antimalarial drug resistance. Prolonged drug use is associated with selection of resistant parasites due to exposure to inadequate drug levels hence effects on treatment outcomes in malaria. ALU and DHP are used as first line and alternative first line, respectively, in Tanzania. This study was carried in Igombe, Tanzania to assess the efficacies of ALU and DHP in routine treatment of uncomplicated malaria among children. METHODS This was a prospective study involving children up to 10 years and followed up for 28 and 35 days as per the WHO protocol, 2015 for monitoring antimalarial drug efficacy. The primary end points were crude and adjusted Adequate Clinical and Parasitological Response (ACPR), parasite clearance rate and reported adverse events. RESULTS A total of 205 children with uncomplicated malaria were enrolled. One hundred and sixteen participants were treated with ALU, while 89 participants were treated with DHP. Two participants in the ALU group were lost within the 24 h of follow-up. The PCR unadjusted ACPR was108 (94.7%) for ALU and 88 (98.9%) for DHP, while the PCR adjusted ACPR was 109(95.6%) and 88(98.9%) for ALU and DHP, respectively, at 28 day follow-up. No treatment failure was observed in both groups. Cumulative risk of recurrent parasitemia was similar in both groups (p = 0.32). Age and parasite density were strong predictors for persistent day 1 parasitemia (p = 0.034 and 0.026, respectively). Nausea and vomiting, abdominal pain and headache were the most clinical adverse events reported in both groups of patients. CONCLUSION The present study shows that ALU and DHP are still efficacious after more than a decade of use with PCR corrected efficacies greater than 95% implying a failure rate less than 5% which is below the WHO minimum threshold requirement for recommendation of a change in the treatment policy. Both drugs were well tolerated with no major adverse events reported.
Collapse
Affiliation(s)
- Karol J Marwa
- Department of Pharmacology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania.
| | - Eveline T Konje
- Department of Epidemiology, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Anthony Kapesa
- Department of Community Medicine, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Erasmus Kamugisha
- Department of Biochemistry, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Stanley Mwita
- School of Pharmacy, Catholic University of Health and Allied Sciences, Mwanza, Tanzania
| | - Göte Swedberg
- Institute of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| |
Collapse
|
35
|
Ajumobi O, Afolabi RF, Adewole A, Balogun MS, Nguku P, Ajayi IO. What do malaria program officers want to learn? A survey of perspectives on a proposed malaria short course in Nigeria. PLoS One 2021; 16:e0257890. [PMID: 34587210 PMCID: PMC8480891 DOI: 10.1371/journal.pone.0257890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 09/14/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In disease control, the program officers are vital to the successful implementation of control strategies. However, poor knowledge of the disease and its control, staff attrition, and lack of intentional training for new staff can lead to under-performance and ineffectiveness of interventions. Thus, the Nigeria Field Epidemiology and Laboratory Training Program, in collaboration with National Malaria Elimination Program, planned a malaria short course (MSC) to strengthen the capacity of current program managers and incoming staff. To guide the development of the curriculum for the MSC, we conducted a needs assessment survey to ascertain the perceived usefulness of the MSC, the priority rating of MSC thematic domains and associated factors. METHODS Overall, 384 purposively selected respondents across ten states and the Federal Capital Territory in Nigeria were interviewed. These comprised malaria and non-malaria control program staff at state, local government area (LGA) and ward levels. We administered a structured questionnaire to elicit information on socio-demographics, training needs, priority malaria thematic domains, perceived course usefulness and willingness of ministries/organizations to release staff to attend the MSC. Data were analyzed using descriptive and inferential statistics at p<0.05. RESULTS Mean age was 43.9 (standard deviation: 7.6 years), 172 (44.8%) were females. Of the 384 respondents, 181 (47.1%), 144 (37.5%) and 59 (15.4%) were at the ward, LGA and state levels, respectively. Seventy-two (18.8%) had never worked in malaria control program. Majority (98.7%, n = 379) reported the need for further training, 382 (99.5%) opined that the course would be useful, and all affirmed their employers' willingness towards their participation at the training. Respondents rated high the domains of basic malariology, malaria treatment, malaria prevention, surveillance/data management, use of computers, leadership skills, program management and basic statistics. Predictors of malaria topical domains' high rating were gender (odds ratio (OR) = 6.77; 95% CI:3.55-12.93) and educational qualifications (OR = 0.48; 95% CI:0.26-0.89). CONCLUSIONS A malaria short course is a necessity and appropriate for program officers at different levels of health administration in Nigeria to achieve malaria elimination, taking into consideration the challenges of human resource retention. The outcome of this study should inform the curriculum and the delivery of the MSC.
Collapse
Affiliation(s)
- Olufemi Ajumobi
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- School of Public Health, University of Nevada, Reno, Nevada, United States of America
| | - Rotimi Felix Afolabi
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
- Population and Health Research Entity, North-West University, Mmabatho, South Africa
| | - Adefisoye Adewole
- African Field Epidemiology Network Nigeria Country Office, Abuja, Nigeria
| | | | - Patrick Nguku
- African Field Epidemiology Network Nigeria Country Office, Abuja, Nigeria
| | - IkeOluwapo O. Ajayi
- Nigeria Field Epidemiology and Laboratory Training Program, Abuja, Nigeria
- Department of Epidemiology and Medical Statistics, College of Medicine, University of Ibadan, Ibadan, Nigeria
| |
Collapse
|
36
|
Omagha R, Idowu ET, Alimba CG, Otubanjo AO, Adeneye AK. Survey of ethnobotanical cocktails commonly used in the treatment of malaria in southwestern Nigeria. FUTURE JOURNAL OF PHARMACEUTICAL SCIENCES 2021. [DOI: 10.1186/s43094-021-00298-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Abstract
Background
Combination of different antimalarials has become the popular method of care for malaria morbidity in conventional and traditional treatment approaches due to the need to increase the efficacy and reduce the selection of drug resistance. A worrisome concern is the critical gaps with regards to the information available on antimalarial herbal cocktails. This study presents cocktail herbal remedies in ethnomedicinal approaches to malaria treatment in Oyo and Ogun states, South West Nigeria. Ethnobotanical information on indigenous antimalarials used in combination remedies was collected from herbal practitioners using a semi-structured questionnaire.
Results
Findings showed majority of respondents treat malaria with combination herbal remedies. They sighted their beliefs and customs, the efficacy, affordability and availability of these herbs as reasons for their adoption of herbal medicines as their preferred mode of treating malaria. Enquiry revealed 26 sets of cocktail antimalarials from a variety of plant species. The plants and ingredients are extracted and used as decoction, infusion or steam baths. Oral route was the most popular mode of administration. Respondents reported they drink one to two medium-sized cups of the recipe on an average of two times daily within a duration of about 10 days.
Conclusions
Herbal antimalarial remedies continue to be the popular treatments option in our localities. This study provides knowledge of the diverse ways respondents combine medicinal herbs and other local ingredients for malaria treatment. Pharmacological screening is urgently needed to validate their safety and efficacy in order to protect the health of our locals heavily relying on them to combat high burdens of malaria.
Collapse
|
37
|
Mutabazi T, Arinaitwe E, Ndyabakira A, Sendaula E, Kakeeto A, Okimat P, Orishaba P, Katongole SP, Mpimbaza A, Byakika-Kibwika P, Karamagi C, Kalyango JN, Kamya MR, Dorsey G, Nankabirwa JI. Assessment of the accuracy of malaria microscopy in private health facilities in Entebbe Municipality, Uganda: a cross-sectional study. Malar J 2021; 20:250. [PMID: 34090419 PMCID: PMC8180171 DOI: 10.1186/s12936-021-03787-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/27/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although microscopy remains the gold standard for malaria diagnosis, little is known about its accuracy in the private health facilities in Uganda. This study evaluated the accuracy of malaria microscopy, and factors associated with inaccurate smear results at private health facilities in Entebbe Municipality, Uganda. METHODS Between April and May 2018, all patients referred for a malaria smear in 16 private health facilities in Entebbe municipality were screened, and 321 patients were enrolled. A questionnaire was administered to collect demographic and clinical information, facility-based smear results were recorded from the participant's consultation notes, and a research slide was obtained for expert microscopy during exit interview. A health facility assessment was conducted, and information on experience in performing malaria microscopy was collected from all facility personnel reading smears and the data was linked to the participant's clinic visit. RESULTS The test positivity rate of malaria parasitaemia was 15.0% by expert microscopy. The sensitivity, specificity and negative predictive value of the facility-based microscopy were high (95.8%, 90.1 and 99.2%, respectively). However; the positive predictive value (PPV) was low with 27/73 (63%) patients diagnosed with malaria not having the disease. Majority of the inaccurate results were from 2 of the 23 laboratory personnel reading the smears. The factors associated with inaccurate smear readings included being read by a technician; (1) who had less than 5 years' experience in reading malaria smears (adjusted Odds Ratio [aOR] = 9.74, 95% confidence interval [CI] (1.06-89.5), p-value = 0.04), and (2) who was examining less than 5 smears a day (aOR = 38.8, 95% CI 9.65-156, p-value < 0.001). CONCLUSIONS The accuracy of malaria microscopy in this setting was high, although one third of the patients diagnosed with malaria did not have the disease. Majority of the errors in smear readings were made by two laboratory personnel, with the main factor associated with inaccurate smear results being low experience in malaria microscopy. In-service training may be sufficient to eliminate inaccurate smear results in this setting, and these private facilities would be ideal model facilities to improve the quality of malaria microscopy in Uganda especially in the public sector where accuracy is still poor.
Collapse
Affiliation(s)
- Tobius Mutabazi
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda.
- Directorate of Medical Services, Special Forces Command, Uganda People's Defence Forces, P.O. Box 11, Entebbe, Uganda.
| | - Emmanuel Arinaitwe
- Infectious Diseases Research Collaboration (IDRC), P.O. Box 7475, Kampala, Uganda
| | - Alex Ndyabakira
- Infectious Diseases Research Collaboration (IDRC), P.O. Box 7475, Kampala, Uganda
| | - Emmanuel Sendaula
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Alex Kakeeto
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Paul Okimat
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
- Institute of Public Health and Management, Clarke International University, P.O. Box 7782, Kampala, Uganda
| | - Philip Orishaba
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Simon Peter Katongole
- Faculty of Health Sciences, Uganda Martyrs University, P.O. Box 5498, Kampala, Uganda
| | - Arthur Mpimbaza
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Pauline Byakika-Kibwika
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Charles Karamagi
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Joan Nakayaga Kalyango
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
| | - Moses R Kamya
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
- Infectious Diseases Research Collaboration (IDRC), P.O. Box 7475, Kampala, Uganda
| | - Grant Dorsey
- Department of Medicine, University of California, San Francisco, San Francisco, USA
| | - Joaniter I Nankabirwa
- School of Medicine, Makerere University College of Health Sciences, P.O. Box 7072, Kampala, Uganda
- Infectious Diseases Research Collaboration (IDRC), P.O. Box 7475, Kampala, Uganda
| |
Collapse
|
38
|
Gram L, Desai S, Prost A. Classroom, club or collective? Three types of community-based group intervention and why they matter for health. BMJ Glob Health 2021; 5:bmjgh-2020-003302. [PMID: 33328198 PMCID: PMC7745328 DOI: 10.1136/bmjgh-2020-003302] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 10/06/2020] [Accepted: 10/08/2020] [Indexed: 12/12/2022] Open
Abstract
Interventions involving groups of laywomen, men and adolescents to promote health are increasingly popular, but past research has rarely distinguished between different types of intervention with groups. We introduce a simple typology that distinguishes three ideal types: classrooms, clubs and collectives. Classrooms treat groups as a platform for reaching a population with didactic behaviour change strategies. Clubs seek to build, strengthen and leverage relationships between group members to promote health. Collectives engage whole communities in assuming ownership over a health problem and taking action to address it. We argue that this distinction goes a long way towards explaining differences in achievable health outcomes using interventions with groups. First, classrooms and clubs are appropriate when policymakers primarily care about improving the health of group members, but collectives are better placed to achieve population-level impact. Second, classroom interventions implicitly assume bottleneck behaviours preventing a health outcome from being achieved can be reliably identified by experts, whereas collectives make use of local knowledge, skill and creativity to tackle complexity. Third, classroom interventions assume individual participants can address health issues largely on their own, while clubs and collectives are required to engender collective action in support of health. We invite public health researchers and policymakers to use our framework to align their own and communities’ ambitions with appropriate group-based interventions to test and implement for their context. We caution that our typology is meant to apply to groups of laypeople rather than professionalised groups such as whole civil society organisations.
Collapse
Affiliation(s)
- Lu Gram
- Institute for Global Health, Department of Population Health Sciences, University College London, London, UK
| | - Sapna Desai
- Population Council India, New Delhi, Delhi, India
| | - Audrey Prost
- Institute for Global Health, Department of Population Health Sciences, University College London, London, UK
| |
Collapse
|
39
|
Chen TT, Ljungqvist FC, Castenbrandt H, Hildebrandt F, Ingholt MM, Hesson JC, Ankarklev J, Seftigen K, Linderholm HW. The spatiotemporal distribution of historical malaria cases in Sweden: a climatic perspective. Malar J 2021; 20:212. [PMID: 33933085 PMCID: PMC8088552 DOI: 10.1186/s12936-021-03744-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 04/20/2021] [Indexed: 12/03/2022] Open
Abstract
Background Understanding of the impacts of climatic variability on human health remains poor despite a possibly increasing burden of vector-borne diseases under global warming. Numerous socioeconomic variables make such studies challenging during the modern period while studies of climate–disease relationships in historical times are constrained by a lack of long datasets. Previous studies have identified the occurrence of malaria vectors, and their dependence on climate variables, during historical times in northern Europe. Yet, malaria in Sweden in relation to climate variables is understudied and relationships have never been rigorously statistically established. This study seeks to examine the relationship between malaria and climate fluctuations, and to characterise the spatio-temporal variations at parish level during severe malaria years in Sweden 1749–1859. Methods Symptom-based annual malaria case/death data were obtained from nationwide parish records and military hospital records in Stockholm. Pearson (rp) and Spearman’s rank (rs) correlation analyses were conducted to evaluate inter-annual relationship between malaria data and long meteorological series. The climate response to larger malaria events was further explored by Superposed Epoch Analysis, and through Geographic Information Systems analysis to map spatial variations of malaria deaths. Results The number of malaria deaths showed the most significant positive relationship with warm-season temperature of the preceding year. The strongest correlation was found between malaria deaths and the mean temperature of the preceding June–August (rs = 0.57, p < 0.01) during the 1756–1820 period. Only non-linear patterns can be found in response to precipitation variations. Most malaria hot-spots, during severe malaria years, concentrated in areas around big inland lakes and southern-most Sweden. Conclusions Unusually warm and/or dry summers appear to have contributed to malaria epidemics due to both indoor winter transmission and the evidenced long incubation and relapse time of P. vivax, but the results also highlight the difficulties in modelling climate–malaria associations. The inter-annual spatial variation of malaria hot-spots further shows that malaria outbreaks were more pronounced in the southern-most region of Sweden in the first half of the nineteenth century compared to the second half of the eighteenth century.
Collapse
Affiliation(s)
- Tzu Tung Chen
- Regional Climate Group, Department of Earth Sciences, University of Gothenburg, 405 30, Gothenburg, Sweden.
| | - Fredrik Charpentier Ljungqvist
- Department of History, Stockholm University, 106 91, Stockholm, Sweden.,Bolin Centre for Climate Research, Stockholm University, 106 91, Stockholm, Sweden.,Swedish Collegium for Advanced Study, Linneanum, Thunbergsvägen 2, 752 38, Uppsala, Sweden
| | | | - Franziska Hildebrandt
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Mathias Mølbak Ingholt
- PandemiX Center, Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | - Jenny C Hesson
- Zoonosis Science Center, Department of Medical Biochemistry and Microbiology, Uppsala University, Uppsala, Sweden
| | - Johan Ankarklev
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Kristina Seftigen
- Regional Climate Group, Department of Earth Sciences, University of Gothenburg, 405 30, Gothenburg, Sweden.,Dendro Sciences Group, Swiss Federal Research Institute WSL, Birmensdorf, Switzerland
| | - Hans W Linderholm
- Regional Climate Group, Department of Earth Sciences, University of Gothenburg, 405 30, Gothenburg, Sweden
| |
Collapse
|
40
|
Sun M, Guo B, Xu M, Zhao M, Onakpa MM, Wu Z, Burdette JE, Che CT. (9βH)- and 17-Nor-Pimaranes from Icacina oliviformis. JOURNAL OF NATURAL PRODUCTS 2021; 84:949-955. [PMID: 33769037 PMCID: PMC8344086 DOI: 10.1021/acs.jnatprod.9b01131] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Eleven pimarane-type diterpenoids were isolated from the tubers of Icacina oliviformis, including three new compounds, icacinlactone M (9), icacinlactone H 2-O-β-d-glucopyranoside (10), and icacinlactone N 3-O-β-d-glucopyranoside (11), together with an artifact of acrenol (8). Among the known structures, icacinlactone A (2), icacinlactone B (3), icacinlactone H (4), 12-hydroxyicacinlactone A (5), 14α-methoxyhumirianthol (6), and annonalide (7) are reported from I. oliviformis for the first time, whereas icacinol (1) has previously been found in this plant. Icacinol, 14α-methoxyhumirianthol, and annonalide displayed moderate cytotoxic activity in a panel of human cancer cell lines.
Collapse
Affiliation(s)
- Meng Sun
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Brian Guo
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Mingming Xu
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Ming Zhao
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
- Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, College of Pharmacy, Nanjing University of Chinese Medicine, Nanjing 210023, People's Republic of China
| | - Monday M Onakpa
- Department of Veterinary Pharmacology and Toxicology, University of Abuja, Abuja 920001, Nigeria
| | - Zhenlong Wu
- Institute of Traditional Chinese Medicine and Natural Products, College of Pharmacy, Jinan University, Guangzhou 510632, People's Republic of China
| | - Joanna E Burdette
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| | - Chun-Tao Che
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Illinois at Chicago, Chicago, Illinois 60612, United States
| |
Collapse
|
41
|
Acquah FK, Donu D, Obboh EK, Bredu D, Mawuli B, Amponsah JA, Quartey J, Amoah LE. Diagnostic performance of an ultrasensitive HRP2-based malaria rapid diagnostic test kit used in surveys of afebrile people living in Southern Ghana. Malar J 2021; 20:125. [PMID: 33653356 PMCID: PMC7927401 DOI: 10.1186/s12936-021-03665-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/24/2021] [Indexed: 12/14/2022] Open
Abstract
Background The Alere™ Malaria Ag P.f Ultra-sensitive RDT (UsmRDT) kit is an HRP2-based malaria rapid diagnostic test (RDT) with enhanced sensitivity relative to the SD Bioline Malaria Ag P.f RDT (mRDT) kit. However, the diagnostic performance of the UsmRDT kit has not been evaluated in Ghana. Methods A total of 740 afebrile participants aged between 3 and 88 years old were recruited from the Central and Greater Accra Regions of Ghana during the off-peak malaria season. Axillary body temperature was measured, and a volume of 1 ml venous blood was drawn from each participant. Prior to separating the blood into plasma and packed cell pellets via centrifugation, the blood was spotted onto one UsmRDT and one mRDT kit and also used to prepare thick and thin blood smears as well as filter paper blood spots. Plasmodium falciparum specific polymerase chain reaction (PCR) was performed on gDNA extracted from 100 µl of the whole blood. Results The overall positivity rate for microscopy, PCR, UsmRDT and mRDT kit were 20.4%, 40.8%, 31.3% and 30.8%, respectively. Overall, the UsmRDT identified 9.3% (28/302) more PCR positive samples than the mRDT kits. All samples that were negative by the UsmRDT kit were also negative by the mRDT kit. Overall, the sensitivity and specificity of the UsmRDT was 73% (221/302) and 89% (388/436), respectively, while that for the mRDT kit was 58% and 90%, respectively. Conclusion Although the UsmRDT kit was not as sensitive as PCR at detecting asymptomatic P. falciparum carriage, it correctly identified P. falciparum in 9.3% of the study participants that were not captured by the mRDT kit. In malaria endemic settings, the UsmRDT would provide an added advantage by identifying more asymptomatic P. falciparum carriers than the mRDT kit for targeted treatment interventions.
Collapse
Affiliation(s)
- Festus K Acquah
- Immunology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana.,West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Dickson Donu
- Immunology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Evans K Obboh
- School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Dorcas Bredu
- Immunology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Bernice Mawuli
- West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana
| | - Jones A Amponsah
- Immunology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Joseph Quartey
- Parasitology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana
| | - Linda E Amoah
- Immunology Department, Noguchi Memorial Institute for Medical Research (NMIMR), University of Ghana, Accra, Ghana. .,West African Centre for Cell Biology of Infectious Pathogens (WACCBIP), University of Ghana, Accra, Ghana.
| |
Collapse
|
42
|
Tivura M, Afari-Asiedu S, Adjuik M, Baiden F, Owusu-Agyei S. Referral of sick children and levels of adherence by carers: implications on quality health care in the middle belt of Ghana. Ghana Med J 2021; 55:43-51. [PMID: 38322392 PMCID: PMC10665270 DOI: 10.4314/gmj.v55i1.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2024] Open
Abstract
Introduction Severely sick-children presenting at primary healthcare facilities need referral to higher level facilities for better care. Adherence to referrals and quality of care received by those referred could serve as critical steps towards their survival. Objective To describe experiences with severely sick children referred to higher-level health facilities for care and reasons for non-adherence to referral; to explore healthcare provider's perspectives to referral. Methods Referrals among 3046 young children were followed for adherence. Assessment of children referred from a PHC facility adhering to referral advice and reasons for non-adherence to referral was determined. Agreement on reported diagnoses at PHC centres and health-facilities receiving patients was assessed. Perspectives of healthcare providers were assessed. Results 212 children were referred from PHC centres to various hospitals with 14.2% non-adherence. Reasons given: 48.3% of carers adhering felt child's condition was severe; 43.3% complied with healthcare provider directive. The main reasons for non-adherence to referral were no money for transport (50%) and child condition not serious (30.0%). 69.0% of anaemia cases diagnosed at PHC facilities and hospitals. 65.7% fever diagnosed at a PHC centres were confirmed as malaria at the hospitals. Healthcare providers referred patients for severity, perceivedcomplication and non-response to treatment. Conclusion Adherence was generally good. The level of agreement in diagnosis of common diseases such as malaria and anaemia at PHC centres and district hospitals was high and low for rarer diseases. Capacity should be provided at PHC levels for adequate management of cases presented to reduce referrals carers have to make. Funding This study did not receive funding from any external sources.
Collapse
Affiliation(s)
- Mathilda Tivura
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | | | - Martin Adjuik
- School Of Public Health. University of Health and Allied Sciences, Ho, Ghana
| | - Frank Baiden
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
| | - Seth Owusu-Agyei
- Kintampo Health Research Centre, Ghana Health Service, Kintampo, Ghana
- Institute of Health Research. University of Health and Allied Sciences, Ho, Ghana
| |
Collapse
|
43
|
Blanco M, Suárez-Sanchez P, García B, Nzang J, Ncogo P, Riloha M, Berzosa P, Benito A, Romay-Barja M. Knowledge and practices regarding malaria and the National Treatment Guidelines among public health workers in Equatorial Guinea. Malar J 2021; 20:21. [PMID: 33413402 PMCID: PMC7789308 DOI: 10.1186/s12936-020-03528-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2020] [Accepted: 11/27/2020] [Indexed: 11/29/2022] Open
Abstract
Background In 2018, an estimated 228 million cases of malaria occurred worldwide. Countries are far from having achieved reasonable levels of national protocol compliance among health workers. Lack of awareness of treatment protocols and treatment resistance by prescribers threatens to undermine progress when it comes to reducing the prevalence of this disease. This study sought to evaluate the degree of knowledge and practices regarding malaria diagnosis and treatment amongst prescribers working at the public health facilities of Bata, Equatorial Guinea. Methods A cross-sectional survey was conducted in October-December 2017 amongst all public health professionals who attended patients under the age of 15 years, with suspected malaria in the Bata District of Equatorial Guinea. Practitioners were asked about their practices and knowledge of malaria and the National Malaria Treatment Guidelines. A bivariate analysis and a logistic regression model were used to determine factors associated with their knowledge. Results Among the 44 practitioners interviewed, 59.1% worked at a Health Centre and 40.9% at the District Hospital of Bata. Important differences in knowledge and practices between hospital and health centre workers were found. Clinical diagnosis was more frequently by practitioners at the health centres (p = 0.059), while microscopy confirmation was more frequent at regional hospital (100%). Intramuscular artemether was the anti-malarial most administrated at the health centres (50.0%), while artemether-lumefantrine was the treatment most used at the regional hospital (66.7%). Most practitioners working at public health facilities (63.6%) have a low level of knowledge regarding the National Malaria Treatment Guidelines. While knowledge regarding malaria, the National Malaria Treatment Guidelines and treatment resistances is low, it was higher amongst hospital workers than amongst practitioners at health centres. Conclusions It is essential to reinforce practitioners’ knowledge, treatment and diagnosis practices and use of the National Malaria Treatment Guidelines in order to improve malaria case management and disease control in the region. A specific malaria training programme ensuring ongoing updates training is necessary in order to ensure that greater experience does not entail obsolete knowledge and, consequently, inadequate diagnosis and treatment practices.
Collapse
Affiliation(s)
- Marta Blanco
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Medicina Preventiva, Hospital Virgen de la Salud, Toledo, Spain
| | - Pablo Suárez-Sanchez
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Servicio de Medicina Preventiva, Hospital Clínico San Carlos, Madrid, Spain
| | - Belén García
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Fundación Estatal, Salud, Infancia y Bienestar Social (FCSAI), Madrid, Spain
| | - Jesús Nzang
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Fundación Estatal, Salud, Infancia y Bienestar Social (FCSAI), Madrid, Spain
| | - Policarpo Ncogo
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Fundación Estatal, Salud, Infancia y Bienestar Social (FCSAI), Madrid, Spain
| | - Matilde Riloha
- Ministerio de Salud y Bienestar Social, Malabo, Equatorial Guinea
| | - Pedro Berzosa
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain
| | - Agustín Benito
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain.,Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain
| | - María Romay-Barja
- Centro Nacional de Medicina Tropical, Instituto de Salud Carlos III, Madrid, Spain. .,Red de Investigación Colaborativa en Enfermedades Tropicales, RICET, Madrid, Spain.
| |
Collapse
|
44
|
Gabani BB, Dixit A, Kiran V, Bestha RM, Narayanan B, Srinivas NR, Mullangi R. Enantioselective in vitro ADME, absolute oral bioavailability, and pharmacokinetics of (-)-lumefantrine and (+)-lumefantrine in mice. Xenobiotica 2020; 51:202-209. [PMID: 32930648 DOI: 10.1080/00498254.2020.1823523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Lumefantrine (LFN) is a chiral antimalarial drug. Enantioselective in vitro attributes and absolute oral pharmacokinetics for (-)-LFN and (+)-LFN have been characterized in mice. No stereoselectivity was seen with either of the enantiomers when compared with rac-LFN in the executed in vitro studies (solubility, metabolic stability, protein binding, permeability and blood partitioning). Post intravenous or oral administration of rac-LFN, the AUC0-∞ and MRT of (+)-LFN was higher over (-)-LFN, which is reflected in higher clearance value for (-)-LFN. Following (-)-LFN intravenous administration to mice, the key PK parameters were comparable to (-)-LFN from rac-LFN; however, post intravenous administration of (+)-LFN alone to mice, the AUC0-∞ was 1.3-fold higher than (+)-LFN from rac-LFN. Similarly, post oral administration of (-)-LFN to mice, both AUC0-∞ and Cmax were 1.3-fold higher than (-)-LFN from rac-LFN. On other hand, (+)-LFN showed 1.4-fold higher AUC0-∞ and 1.7-fold higher Cmax post oral administration over (+)-LFN from rac-LFN.
Collapse
Affiliation(s)
- Bhavesh Babulal Gabani
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, Industrial Suburb, Bangalore, India
| | - Abhishek Dixit
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, Industrial Suburb, Bangalore, India
| | - Vinay Kiran
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, Industrial Suburb, Bangalore, India
| | - Ram Murthi Bestha
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, Industrial Suburb, Bangalore, India
| | - Balaji Narayanan
- Analytical Department, Jubilant Biosys, Industrial Suburb, Bangalore, India
| | | | - Ramesh Mullangi
- Drug Metabolism and Pharmacokinetics, Jubilant Biosys, Industrial Suburb, Bangalore, India
| |
Collapse
|
45
|
Lopes SC, Mugizi R, Pires JE, David F, Martins J, Dimbu PR, Fortes F, Rosário J, Allan R. Malaria Test, Treat and Track policy implementation in Angola: a retrospective study to assess the progress achieved after 4 years of programme implementation. Malar J 2020; 19:262. [PMID: 32690009 PMCID: PMC7372868 DOI: 10.1186/s12936-020-03338-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Accepted: 07/14/2020] [Indexed: 11/10/2022] Open
Abstract
Background Malaria is one of the main causes of death in Angola, particularly among children under 5 years of age. An essential means to improve the situation is with strong malaria case management; this includes diagnosing suspected patients with a confirmatory test, either with a rapid diagnostic test (RDT) or microscopy, prompt and correct treatment with artemisinin-based combination therapy (ACT), and proper case registration (track). In 2011, the United States President’s Malaria Initiative (PMI) launched a country-wide programme to improve malaria case management through the provision of regular training and supervision at different levels of health care provision. An evaluation of malaria testing, treatment and registration practices in eight provinces, and at health facilities of various capacities, across Angola was conducted to assess progress of the national programme implementation. Methods A retrospective assessment analysed data collected during supervision visits to health facilities conducted between 2012 and 2016 in 8 provinces in Angola. The supervision tool used data collected for malaria knowledge, testing, treatment and case registration practices among health workers as well as health facilities stock outs from different levels of health care delivery. Contingency tables with Pearson chi-squared (χ2) tests were used to identify factors associated with “knowledge”, “test”, “treat” and “track.” Multivariable logistic regression models were used to assess factors associated with the defined outcomes. Results A total of 7156 supervisions were conducted between September 2012 and July 2016. The overall knowledge, testing, treatment and tracking practices among health care workers (HCWs) increased significantly from 2013 to 2016. Health care workers in 2016 were 3.3 times (95% CI: 2.7–3.9) as likely to have a higher knowledge about malaria case management as in 2013 (p < 0.01), 7.4 (95% CI: 6.1–9.0) times as likely to test more suspected cases (p < 0.01), 10.9 (95% CI: 8.6–13.6) times as likely to treat more confirmed cases (p < 0.01) and 3.7 (95% CI: 3.2–4.4) times as likely to report more accurately in the same period (p < 0.01). Discussion Improvements demonstrated in knowledge about malaria case management, testing with RDT and treatment with artemisinin-based combinations among HCWs is likely associated with malaria case management trainings and supportive supervisions. Gaps in testing and treatment practices are associated with RDT and ACT medicines stock outs in health facilities. Tracking of malaria cases still poses a major challenge, despite training and supervision. Hospitals consistently performed better compared to other health facilities against all parameters assessed; likely due to a better profile of HCWs. Conclusion Significant progress in malaria case management in eight provinces Angola was achieved in the period of 2013–2016. Continued training and supportive supervision is essential to sustain gains and close existing gaps in malaria case management and reporting in Angola.
Collapse
Affiliation(s)
- Sergio C Lopes
- PMI Eye Kutoloka Project, The MENTOR Initiative, Haywards Heath, UK.
| | - Rukaaka Mugizi
- PMI Eye Kutoloka Project, The MENTOR Initiative, Haywards Heath, UK
| | | | - Fernando David
- PMI Eye Kutoloka Project, World Learning, Luanda, Angola
| | - José Martins
- National Malaria Control Programme, Luanda, Angola
| | | | | | - Joana Rosário
- PMI Eye Kutoloka Project, World Learning, Luanda, Angola
| | - Richard Allan
- PMI Eye Kutoloka Project, The MENTOR Initiative, Haywards Heath, UK
| |
Collapse
|
46
|
Chipukuma HM, Halwiindi H, Zulu JM, Azizi SC, Jacobs C. Evaluating fidelity of community health worker roles in malaria prevention and control programs in Livingstone District, Zambia-A bottleneck analysis. BMC Health Serv Res 2020; 20:612. [PMID: 32615960 PMCID: PMC7331272 DOI: 10.1186/s12913-020-05458-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 06/23/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Community Health Workers (CHWs) are an important human resource in improving community malaria intervention coverages and success in reducing malaria incidence has been attributed to them. However, despite this attribution, malaria resurgence cases have been reported in various countries including Zambia. This study aims to evaluate the implementation fidelity of CHW roles in malaria prevention and control programs in Livingstone through performance and service quality assessment. METHODS A mixed method concurrent cross-sectional study based on quantitative and qualitative approaches was used to evaluate performance and service quality of the CHW roles for selected catchments areas in Livingstone district. For the quantitative approach, (34) CHWs were interviewed and a community survey was also done with 464 community participants. For qualitative approach, two focused group discussions with CHWs and three key informant interviews from the CHW supervisors were done. RESULTS Overall implementation fidelity to the CHW roles was low with only 5(14.7%) of the CHWs having good performance and least good quality service while 29 (85.3%) performed poorly with substandard service. About 30% of house-holds reported having experienced malaria cases but CHWs had low coverage in testing with RDT (27%) for malaria index case service response with treatment at 14% coverage and provision of health education at 23%. For other households without malaria cases, only 27% had received malaria health education and 15% were screened for malaria. However, ITN distribution, sensitization for IRS were among other CHW services received by the community but were not documented in CHW registers for evaluation. Factors that shaped fidelity were being married, record for reports, supervision, and work experience as significant factors associated with performance. Lack of supplies, insufficient remuneration and lack of ownership by the supervising district were reported to hinder ideal implementation of the CHW strategy. CONCLUSION Fidelity to the malaria CHW roles was low as performance and quality of service was poor. A systems approach for malaria CHW facilitation considering supervision, stock supply and recruiting more CHWs on a more standardized level of recognition and remuneration would render an effective quality implementation of the CHW roles in malaria.
Collapse
Affiliation(s)
- Helen Mwiinga Chipukuma
- Department of Health Policy and Management, School of Public Health, University of Zambia, P. O. Box 50110, Lusaka, Zambia.
| | - Hikabasa Halwiindi
- Department of Environmental Health, School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Joseph Mumba Zulu
- Department of Health promotion and Education, School of Public Health, University of Zambia, P.O. Box 50110, Lusaka, Zambia
| | - Steven Chifundo Azizi
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, P. O. Box 50110, Lusaka, Zambia
| | - Choolwe Jacobs
- Department of Epidemiology and Biostatistics, School of Public Health, University of Zambia, P. O. Box 50110, Lusaka, Zambia
| |
Collapse
|
47
|
Utilization of biodiesel waste in the development of botanical-based floating tablet formulation against early stages of mosquitoes. ACTA ACUST UNITED AC 2020. [DOI: 10.1007/s42768-020-00041-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
48
|
Alegana VA, Okiro EA, Snow RW. Routine data for malaria morbidity estimation in Africa: challenges and prospects. BMC Med 2020; 18:121. [PMID: 32487080 PMCID: PMC7268363 DOI: 10.1186/s12916-020-01593-y] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/14/2020] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The burden of malaria in sub-Saharan Africa remains challenging to measure relying on epidemiological modelling to evaluate the impact of investments and providing an in-depth analysis of progress and trends in malaria response globally. In malaria-endemic countries of Africa, there is increasing use of routine surveillance data to define national strategic targets, estimate malaria case burdens and measure control progress to identify financing priorities. Existing research focuses mainly on the strengths of these data with less emphasis on existing challenges and opportunities presented. CONCLUSION Here we define the current imperfections common to routine malaria morbidity data at national levels and offer prospects into their future use to reflect changing disease burdens.
Collapse
Affiliation(s)
- Victor A Alegana
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, P.O. Box 43640, Nairobi, 00100, Kenya.
- Geography and Environmental Science, University of Southampton, Southampton, SO17 1BJ, UK.
- Faculty of Science and Technology, Lancaster University, Lancaster, LAI 4YW, UK.
| | - Emelda A Okiro
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, P.O. Box 43640, Nairobi, 00100, Kenya
| | - Robert W Snow
- Population Health Unit, Kenya Medical Research Institute - Wellcome Trust Research Programme, P.O. Box 43640, Nairobi, 00100, Kenya
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, OX3 7LJ, UK
| |
Collapse
|
49
|
Lee WS, Kang T, Kwak KJ, Park K, Yi SY, Lee UJ, Shin YB, Jeong J. Simple, rapid, and accurate malaria diagnostic platform using microfluidic-based immunoassay of Plasmodium falciparum lactate dehydrogenase. NANO CONVERGENCE 2020; 7:13. [PMID: 32279129 PMCID: PMC7150666 DOI: 10.1186/s40580-020-00223-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 03/31/2020] [Indexed: 05/15/2023]
Abstract
This work reports on a rapid diagnostic platform for the detection of Plasmodium falciparum lactate dehydrogenase (PfLDH), a representative malaria biomarker, using a microfluidic microplate-based immunoassay. In this study, the microfluidic microplate made it possible to diagnose PfLDH with a small volume of sample (only 5 μL) and short time (< 90 min) compared to conventional immunoassays such as enzyme-linked immunosorbent assay (ELISA). Moreover, the diagnostic performance of PfLDH showed high sensitivity, specificity, and selectivity (i.e., 0.025 pg/μL in phosphate-buffered saline and 1 pg/μL in human serum). The microfluidic-based microplate sensing platform has the potential to adapt simple, rapid, and accurate diagnoses to the practical detection of malaria.
Collapse
Affiliation(s)
- Wang Sik Lee
- Environmental Disease Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
- Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon, 34113, Republic of Korea
| | - Taejoon Kang
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Kyung Jin Kwak
- Environmental Disease Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Kyoungsook Park
- Dept. of General Education, Daejeon Health Institute of Technology, 21 Chungjeon-ro, Dong-gu, Daejeon, 34504, Republic of Korea
| | - So Yeon Yi
- BioNano Health Guard Research Center, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon, 34134, Republic of Korea
| | - Ui Jin Lee
- BioNano Health Guard Research Center, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
- Department of Biochemistry, College of Natural Sciences, Chungnam National University, 99 Daehak-ro, Yuseong-gu, Daejeon, 34134, Republic of Korea
| | - Yong Beom Shin
- Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon, 34113, Republic of Korea
- Bionanotechnology Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
- BioNano Health Guard Research Center, 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea
| | - Jinyoung Jeong
- Environmental Disease Research Center, Korea Research Institute of Bioscience and Biotechnology (KRIBB), 125 Gwahak-ro, Yuseong-gu, Daejeon, 34141, Republic of Korea.
- Department of Nanobiotechnology, KRIBB School of Biotechnology, University of Science and Technology (UST), 217 Gajeong-ro, Yuseong-gu, Daejeon, 34113, Republic of Korea.
| |
Collapse
|
50
|
Tesfahunegn A, Zenebe D, Addisu A. Determinants of malaria treatment delay in northwestern zone of Tigray region, Northern Ethiopia, 2018. Malar J 2019; 18:358. [PMID: 31706356 PMCID: PMC6842532 DOI: 10.1186/s12936-019-2992-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 11/04/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Globally malaria affects 212 million people and causes 438,000 deaths each year. Ensuring early and timely treatment of malaria is important for preventing and controlling of life-threatening complications and further transmission. Even though malaria treatment is widely available in Ethiopia, 47-84% of patients present after 24 h of onset of first symptoms. This study assessed the determinants of delay for malaria treatment in Tigray, Ethiopia. METHODS A health facility-based case-control study design in northwestern zone of Tigray was conducted from September 2018 to January 2019. All the study participants enrolled were confirmed malaria patients (by microscopy or rapid diagnostic test) and who sought treatment. Cases were defined as malaria patients who sought treatment after 24 h of the onset of the first symptom and control were those who sought treatment within 24 h onset of symptom. A structured questionnaire was used to collect data on the determinants of malaria treatment delay. Data were entered into EpiInfo 7.0 and exported to SPSS 20.0 for analysis. Binary logistic regression was computed to identify predictors of delay for malaria treatment. RESULTS In total 161 cases and 161 controls were identified. Being residents of Tahtay Adyabo district (AOR = 2.84, 95% CI 1.29-6.27), having no formal education (AOR = 2.39, 95% CI 1.09-5.22), the decisions to seek health care being taken by the patient (AOR = 2.38 95% CI 1.09-5.2), the decisions to seek health care being taken by their fathers (AOR = 2.52, 95% CI 1.13-5.62), and having good knowledge about malaria symptoms (AOR = 2.02, 95% CI 1.21-3.39) were found determinants of delay for malaria treatment. CONCLUSION In this study, delays in obtaining treatment for malaria were associated with having no formal education, knowing about the signs and symptoms of malaria, living in Tahtay Adyabo district, and decision-making on seeking malaria treatment. The results suggests having treatment commenced at sites closer to the community and strengthened awareness-raising activity about the importance of early seeking for all with malaria-like symptoms, especially for household heads would contribute to improved treatment and reduced complications from malaria.
Collapse
Affiliation(s)
- Afewerki Tesfahunegn
- Epidemiology Department, School of Public Health, Mekelle University, Mekelle, Ethiopia.
| | - Dawit Zenebe
- Epidemiology Department, School of Public Health, Mekelle University, Mekelle, Ethiopia
| | | |
Collapse
|