1
|
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
|
2
|
Mbishi JV, Chombo S, Luoga P, Omary HJ, Paulo HA, Andrew J, Addo IY. Malaria in under-five children: prevalence and multi-factor analysis of high-risk African countries. BMC Public Health 2024; 24:1687. [PMID: 38915034 PMCID: PMC11197209 DOI: 10.1186/s12889-024-19206-1] [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: 03/22/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Malaria remains a significant public health challenge in Sub-Saharan Africa (SSA), particularly affecting under-five (UN5) children. Despite global efforts to control the disease, its prevalence in high-risk African countries continues to be alarming, with records of substantial morbidity and mortality rates. Understanding the association of multiple childhood, maternal, and household factors with malaria prevalence, especially among vulnerable young populations, is crucial for effective intervention strategies. OBJECTIVE This study examines the prevalence of malaria among UN5 children in selected high-risk SSA countries and analyzes its association with various childhood, maternal, and household factors. METHODS Data from the Malaria Indicator Surveys (MIS) spanning from 2010 to 2023 were analyzed. A weighted sample of 35,624 UN5 children from seven countries in sub-Saharan Africa (SSA) known for high malaria prevalence was considered in the analyses. Descriptive statistics and modified Poisson regression analysis were used to assess the association of multiple factors with malaria prevalence. Stata version 15 software was used in analyzing the data and statistical significance was set at a 5% significance level. RESULTS The overall pooled prevalence of malaria among the studied population was 26.2%, with substantial country-specific variations observed. In terms of child factors, a child's age was significantly associated with malaria prevalence (APR = 1.010, 95% CI: 1.007-1.012). Children of mothers with higher education levels (APR for higher education = 0.586, 95% CI: 0.425-0.806) and Fansidar uptake during pregnancy (APR = 0.731, 95% CI: 0.666-0.802) were associated with lower malaria risk. Children from middle-wealth (APR = 0.783, 95% CI: 0.706-0.869) and rich (APR = 0.499, 95% CI: 0.426-0.584) households had considerably lower malaria prevalence compared to those from poor households. Additionally, rural residency was associated with a higher risk of malaria compared to urban residency (APR = 1.545, 95% CI: 1.255-1.903). CONCLUSION The study highlights a notable malaria prevalence among under-five (UN5) children in high-risk SSA countries, influenced significantly by factors such as maternal education, Fansidar uptake during pregnancy, socioeconomic status, and residency. These findings underscore the importance of targeted malaria prevention strategies that address these key determinants to effectively reduce the malaria burden in this vulnerable population.
Collapse
Affiliation(s)
| | - Suleiman Chombo
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Pankras Luoga
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Huda Jaffar Omary
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | - Heavenlight A Paulo
- Muhimbili University of Health and Allied Sciences (MUHAS), Dar es Salaam, Tanzania
| | | | - Isaac Yeboah Addo
- Research Fellow and Tutor, Concord Clinical School, University of Sydney, Sydney, Australia
- Research Fellow, University of New South Wales, Sydney, Australia
| |
Collapse
|
3
|
Korsah MA, Johnston ST, Tiedje KE, Day KP, Flegg JA, Walker CR. Mathematical Assessment of the Role of Intervention Programs for Malaria Control. Bull Math Biol 2024; 86:91. [PMID: 38888640 PMCID: PMC11189351 DOI: 10.1007/s11538-024-01321-0] [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: 12/17/2023] [Accepted: 06/03/2024] [Indexed: 06/20/2024]
Abstract
Malaria remains a global health problem despite the many attempts to control and eradicate it. There is an urgent need to understand the current transmission dynamics of malaria and to determine the interventions necessary to control malaria. In this paper, we seek to develop a fit-for-purpose mathematical model to assess the interventions needed to control malaria in an endemic setting. To achieve this, we formulate a malaria transmission model to analyse the spread of malaria in the presence of interventions. A sensitivity analysis of the model is performed to determine the relative impact of the model parameters on disease transmission. We explore how existing variations in the recruitment and management of intervention strategies affect malaria transmission. Results obtained from the study imply that the discontinuation of existing interventions has a significant effect on malaria prevalence. Thus, the maintenance of interventions is imperative for malaria elimination and eradication. In a scenario study aimed at assessing the impact of long-lasting insecticidal nets (LLINs), indoor residual spraying (IRS), and localized individual measures, our findings indicate that increased LLINs utilization and extended IRS coverage (with longer-lasting insecticides) cause a more pronounced reduction in symptomatic malaria prevalence compared to a reduced LLINs utilization and shorter IRS coverage. Additionally, our study demonstrates the impact of localized preventive measures in mitigating the spread of malaria when compared to the absence of interventions.
Collapse
Affiliation(s)
- Maame Akua Korsah
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia.
| | - Stuart T Johnston
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
| | - Kathryn E Tiedje
- Department of Microbiology and Immunology, Bio21 Institute and Peter Doherty Institute, The University of Melbourne, Melbourne, Australia
| | - Karen P Day
- Department of Microbiology and Immunology, Bio21 Institute and Peter Doherty Institute, The University of Melbourne, Melbourne, Australia
| | - Jennifer A Flegg
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
| | - Camelia R Walker
- School of Mathematics and Statistics, The University of Melbourne, Melbourne, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| |
Collapse
|
4
|
Nandal R, Kumar D, Aggarwal N, Kumar V, Narasimhan B, Marwaha RK, Sharma PC, Kumar S, Bansal N, Chopra H, Deep A. Recent advances, challenges and updates on the development of therapeutics for malaria. EXCLI JOURNAL 2024; 23:672-713. [PMID: 38887396 PMCID: PMC11180964 DOI: 10.17179/excli2023-6856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 12/02/2023] [Accepted: 04/03/2024] [Indexed: 06/20/2024]
Abstract
Malaria has developed as a serious worldwide health issue as a result of the introduction of resistant Plasmodium species strains. Because of the common chemo resistance to most of the existing drugs on the market, it poses a severe health problem and significant obstacles in drug research. Malaria treatment has evolved during the last two decades in response to Plasmodium falciparum drug sensitivity and a return of the disease in tropical areas. Plasmodium falciparum is now highly resistant to the majority of antimalarial drugs. The parasite resistance drew focus to developing novel antimalarials to combat parasite resistance. The requirement for many novel antimalarial drugs in the future year necessitates adopting various drug development methodologies. Different innovative strategies for discovering antimalarial drugs are now being examined here. This review is primarily concerned with the description of newly synthesized antimalarial compounds, i.e. Tafenoquine, Cipargamin, Ferroquine, Artefenomel, DSM265, MMV390048 designed to improve the activity of pure antimalarial enantiomers. In this review, we selected the representative malarial drugs in clinical trials, classified them with detailed targets according to their action, discussed the relationship within the human trials, and generated a summative discussion with prospective expectations.
Collapse
Affiliation(s)
- Rimmy Nandal
- Shri Baba MastNath Institute of Pharmaceutical Sciences and Research, Baba Mast Nath University, Asthal Bohar, Rohtak-124001, Haryana, India
| | - Davinder Kumar
- College of Pharmacy, PGIMS University of Health Sciences, Rohtak-124001, Haryana, India
| | - Navidha Aggarwal
- MM College of Pharmacy, Maharishi Markandeshwar (Deemed to be University), Mullana, Ambala 133207, India
| | - Virender Kumar
- College of Pharmacy, PGIMS University of Health Sciences, Rohtak-124001, Haryana, India
| | | | - Rakesh Kumar Marwaha
- Department of Pharmaceutical Sciences, Maharishi Dayanand University, Rohtak 124001 Haryana, India
| | - Prabodh Chander Sharma
- Department of Pharmaceutical Chemistry, School of Pharmaceutical Sciences, Delhi Pharmaceutical Sciences and Research University, New Delhi 110017, India
| | - Surender Kumar
- Department of Chemistry, Chaudhary Bansi Lal University, Bhiwani-127021, India
| | - Nitin Bansal
- Department of Pharmaceutical Sciences, Chaudhary Bansi Lal University, Bhiwani-127021, Haryana, India
| | - Hitesh Chopra
- Department of Biosciences, Saveetha School of Engineering, Saveetha Institute of Medical and Technical Sciences, Chennai - 602105, Tamil Nadu, India
| | - Aakash Deep
- Department of Pharmaceutical Sciences, Chaudhary Bansi Lal University, Bhiwani-127021, Haryana, India
| |
Collapse
|
5
|
El Saftawy E, Farag MF, Gebreil HH, Abdelfatah M, Aboulhoda BE, Alghamdi M, Albadawi EA, Abd Elkhalek MA. Malaria: biochemical, physiological, diagnostic, and therapeutic updates. PeerJ 2024; 12:e17084. [PMID: 38529311 PMCID: PMC10962339 DOI: 10.7717/peerj.17084] [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: 09/19/2023] [Accepted: 02/19/2024] [Indexed: 03/27/2024] Open
Abstract
Background Malaria has been appraised as a significant vector-borne parasitic disease with grave morbidity and high-rate mortality. Several challenges have been confronting the efficient diagnosis and treatment of malaria. Method Google Scholar, PubMed, Web of Science, and the Egyptian Knowledge Bank (EKB) were all used to gather articles. Results Diverse biochemical and physiological indices can mirror complicated malaria e.g., hypoglycemia, dyslipidemia, elevated renal and hepatic functions in addition to the lower antioxidant capacity that does not only destroy the parasite but also induces endothelial damage. Multiple trials have been conducted to improve recent points of care in malaria involving biosensors, lap on-chip, and microdevices technology. Regarding recent therapeutic trials, chemical falcipain inhibitors and plant extracts with anti-plasmodial activities are presented. Moreover, antimalaria nano-medicine and the emergence of nanocarrier (either active or passive) in drug transportation are promising. The combination therapeutic trials e.g., amodiaquine + artemether + lumefantrine are presented to safely counterbalance the emerging drug resistance in addition to the Tafenoquine as a new anti-relapse therapy. Conclusion Recognizing the pathophysiology indices potentiate diagnosis of malaria. The new points of care can smartly manipulate the biochemical and hematological alterations for a more sensitive and specific diagnosis of malaria. Nano-medicine appeared promising. Chemical and plant extracts remain points of research.
Collapse
Affiliation(s)
- Enas El Saftawy
- Department of Medical Parasitology, Faculty of Medicine, Cairo University, Cairo, Giza, Egypt
- Department of Medical Parasitology, Armed Forces College of Medicine, Cairo, Egypt
| | - Mohamed F. Farag
- Department of Medical Physiology, Armed Forces College of Medicine, Cairo, Giza, Egypt
| | - Hossam H. Gebreil
- Department of Medical Biochemistry & Molecular Biology, Armed Forces College of Medicine, Cairo, Egypt
| | - Mohamed Abdelfatah
- Department of Medical Physiology, Armed Forces College of Medicine, Cairo, Giza, Egypt
| | - Basma Emad Aboulhoda
- Department of Anatomy and Embryology, Faculty of Medicine, Cairo University, Cairo, Giza, Egypt
| | - Mansour Alghamdi
- Department of Anatomy, College of Medicine, King Khalid University, Abha, Saudi Arabia
- Genomics and Personalized Medicine Unit, College of Medicine, King Khalid University, Abha, Saudi Arabia
| | - Emad A. Albadawi
- Department of Anatomy, College of Medicine, Taibah University, Madinah, Saudi Arabia
| | - Marwa Ali Abd Elkhalek
- Department of Medical Biochemistry & Molecular Biology, Armed Forces College of Medicine, Cairo, Egypt
- Medical Biochemistry & Molecular Biology, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| |
Collapse
|
6
|
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
|
7
|
Abossie A, Demissew A, Getachew H, Tsegaye A, Degefa T, Habtamu K, Zhong D, Wang X, Lee MC, Zhou G, King CL, Kazura JW, Yan G, Yewhalaw D. Higher outdoor mosquito density and Plasmodium infection rates in and around malaria index case households in low transmission settings of Ethiopia: Implications for vector control. Parasit Vectors 2024; 17:53. [PMID: 38321572 PMCID: PMC10848356 DOI: 10.1186/s13071-023-06088-2] [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: 04/07/2023] [Accepted: 12/07/2023] [Indexed: 02/08/2024] Open
Abstract
BACKGROUND Understanding the clustering of infections for persistent malaria transmission is critical to determining how and where to target specific interventions. This study aimed to determine the density, blood meal sources and malaria transmission risk of anopheline vectors by targeting malaria index cases, their neighboring households and control villages in Arjo-Didessa, southwestern Ethiopia. METHODS An entomological study was conducted concurrently with a reactive case detection (RCD) study from November 2019 to October 2021 in Arjo Didessa and the surrounding vicinity, southwestern Ethiopia. Anopheline mosquitoes were collected indoors and outdoors in index case households and their surrounding households (neighboring households), as well as in control households, using pyrethrum spray cache (PSC) and U.S. Centers for Disease Control and Prevention (CDC) light traps. Adult mosquitoes were morphologically identified, and speciation in the Anopheles gambiae complex was done by PCR. Mosquito Plasmodium infections and host blood meal sources were detected by circumsporozoite protein enzyme-linked immunosorbent assay (CSP-ELISA) and cytochrome b-based blood meal PCR, respectively. RESULTS Among the 770 anopheline mosquitoes collected, An. gambiae sensu lato (A. gambiae s.l.) was the predominant species, accounting for 87.1% (n = 671/770) of the catch, followed by the Anopheles coustani complex and Anopheles pharoensis, which accounted for 12.6% (n = 97/770) and 0.26% (n = 2/770) of the catch, respectively. From the sub-samples of An. gambiae s.l.analyzed with PCR, An. arabiensis and Anopheles amharicus were identified. The overall mean density of mosquitoes was 1.26 mosquitoes per trap per night using the CDC light traps. Outdoor mosquito density was significantly higher than indoor mosquito density in the index and neighboring households (P = 0.0001). The human blood index (HBI) and bovine blood index (BBI) of An. arabiensis were 20.8% (n = 34/168) and 24.0% (n = 41/168), respectively. The overall Plasmodium sporozoite infection rate of anophelines (An. arabiensis and An. coustani complex) was 4.4% (n = 34/770). Sporozoites were detected indoors and outdoors in captured anopheline mosquitoes. Of these CSP-positive species for Pv-210, Pv-247 and Pf, 41.1% (n = 14/34) were captured outdoors. A significantly higher proportion of sporozoite-infected mosquitoes were caught in index case households (5.6%, n = 8/141) compared to control households (1.1%, n = 2/181) (P = 0.02), and in neighboring households (5.3%, n = 24/448) compared to control households (P = 0.01). CONCLUSIONS The findings of this study indicated that malaria index cases and their neighboring households had higher outdoor mosquito densities and Plasmodium infection rates. The study also highlighted a relatively higher outdoor mosquito density, which could increase the potential risk of outdoor malaria transmission and may play a role in residual malaria transmission. Thus, it is important to strengthen the implementation of vector control interventions, such as targeted indoor residual spraying, long-lasting insecticidal nets and other supplementary vector control measures such as larval source management and community engagement approaches. Furthermore, in low transmission settings, such as the Arjo Didessa Sugarcane Plantation, providing health education to local communities, enhanced environmental management and entomological surveillance, along with case detection and management by targeting of malaria index cases and their immediate neighboring households, could be important measures to control residual malaria transmission and achieve the targeted elimination goals.
Collapse
Affiliation(s)
- Ashenafi Abossie
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia.
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia.
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia.
| | - Assalif Demissew
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Ambo University, Ambo, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Hallelujah Getachew
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
- Department of Medical Laboratory Technology, Arba Minch College of Health Sciences, Arba Minch, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Arega Tsegaye
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
- Department of Biology, College of Natural Science, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Teshome Degefa
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Kassahun Habtamu
- Menelik II College of Health Sciences, Addis Ababa, Ethiopia
- Department of Microbial, Cellular and Molecular Biology, College of Natural Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Daibin Zhong
- Program in Public Health, University of California at Irvine, Irvine, CA, 92697, USA
| | - Xiaoming Wang
- Program in Public Health, University of California at Irvine, Irvine, CA, 92697, USA
| | - Ming-Chieh Lee
- Program in Public Health, University of California at Irvine, Irvine, CA, 92697, USA
| | - Guofa Zhou
- Program in Public Health, University of California at Irvine, Irvine, CA, 92697, USA
| | - Christopher L King
- Center for Global Health & Diseases, School of Medicine, Case Western Reserve University, Cleveland, 44106 OH, USA
| | - James W Kazura
- Center for Global Health & Diseases, School of Medicine, Case Western Reserve University, Cleveland, 44106 OH, USA
| | - Guiyun Yan
- Program in Public Health, University of California at Irvine, Irvine, CA, 92697, USA
| | - Delenasaw Yewhalaw
- School of Medical Laboratory Sciences, Faculty of Health Sciences, Jimma University, Jimma, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| |
Collapse
|
8
|
Mumali RK, Okolimong C, Kabuuka T, Lubaale YM, Okibure A, Okello F, Soita D, Olupot-Olupot P. Health workers' adherence to the malaria test, treat and track strategy during the COVID-19 pandemic in malaria high transmission area in Eastern Uganda. Malar J 2023; 22:360. [PMID: 38012638 PMCID: PMC10680176 DOI: 10.1186/s12936-023-04786-x] [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: 06/06/2023] [Accepted: 11/08/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) pandemic affected malaria control activities in sub-Saharan Africa (SSA) resulting in 690,000 excess deaths in the year 2021. The authors hypothesized that COVID-19 affected the World Health Organization (WHO) Test, Treat and Track (T3) strategy that has been implemented in Uganda since 2010. In this study, health worker's adherence to the T3 strategy during COVID-19 pandemic in Eastern Uganda was studied by assessing their knowledge, skills and practices. METHODS A cross-sectional study utilizing mixed quantitative and qualitative data collections methods was conducted at Mbale Regional Referral Hospital in Eastern Uganda between November and December in 2020. Data were captured on demographics, knowledge, skills and practices for both health workers (HWs) and patients. Quantitative data were analysed using STATA 15.0 and reported as descriptive statistics, proportions and statistical associations. Moreover, qualitative data were collected via key informant interviews (KII) among purposively sampled study participants and analysed thematically using NVIVO software. Ethical approval was obtained prior to the study. RESULTS A total of 436 study participants, of whom 103/436 (24%) and 333/436 (76%) were HWs and patients, respectively were studied. Among the HWs with mean age of 34 years (SD = 8.8 years), 81/103 (79%) had good practices, most 63/103 (61%) had good knowledge, and only 11/103 (10.7%) had good skills. Specifically, on the cadres, the laboratory personnel 19/103 (18%) had good knowledge 14/19 (74%) OR: 2.0 (95% CI 0.7-6) and were highly skilled OR: 4.6 (95% CI 1.2-18.1; P < 0.0150) compared to other cadres, respectively. Among the patients whose age ranged 3 months to 80 years (mean 17.8 years) and females 177/333 (53%); a majority 257/333 (77%) were tested, of whom 139/333 (42%) tested positive. Out of the positive cases, 115/333 (35%) were treated and tracked. About 75/333 (23%) were not tested but treated for malaria. Of the 168/239 (70.3%) patients tested, 115/168 (68.5%) were positive and treated, P = 0.0001. The KII revealed low level of In-service training, overwhelming number of patients and stock-out of supplies as a key factor for poor HW adherence to T3 strategy. CONCLUSIONS During COVID-19 pandemic period HWs adherence to T3 initiative was low as 27% malaria patients did not receive treatment.
Collapse
Affiliation(s)
- Richard Kabaka Mumali
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda.
- National Agricultural Research Organization (NARO), National Livestock Resources Research Institute (NaLIRRI), P.O. Box 5704, Kampala, Uganda.
| | - Charles Okolimong
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Tonny Kabuuka
- National Agricultural Research Organization (NARO), National Livestock Resources Research Institute (NaLIRRI), P.O. Box 5704, Kampala, Uganda
| | - Yovani Moses Lubaale
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | | | - Francis Okello
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
- Varimetrics Group Limited, Mbale, Uganda
| | - David Soita
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
| | - Peter Olupot-Olupot
- Department of Community and Public Health, Busitema University Faculty of Health Sciences, Mbale, Uganda
- Mbale Clinical Research Institute, P.O. Box 1966, Mbale, Uganda
| |
Collapse
|
9
|
Singh N, Chatterjee A, Chanu WK, Vaishalli PM, Singh CB, Nagaraj VA. Antimalarial activity of Toona ciliata MJ Roem aqueous methanolic leaf extract and its antioxidant and phytochemical properties. J Tradit Complement Med 2023; 13:550-560. [PMID: 38020553 PMCID: PMC10658347 DOI: 10.1016/j.jtcme.2023.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 05/08/2023] [Accepted: 05/30/2023] [Indexed: 12/01/2023] Open
Abstract
Background and aim Malaria is a global health issue causing substantial morbidity and mortality. Screening of various traditionally important medicinal plants is a key source for the discovery of new antimalarials. We evaluated the antimalarial and antioxidant activities, and performed detailed phytochemical analyses of Toona ciliata MJ Roem aqueous methanolic leaf extract (TcMLE). Experimental procedures In vitro antiplasmodial studies in Plasmodium falciparum (Pf) 3D7 and PfCam3.IR539T strains were performed by [3H]-hypoxanthine uptake assays. In vitro cytotoxicity in HeLa and HEK293T cell lines was evaluated using MTT assays. Hemolysis assay was performed using RBCs. Phytochemical analysis by GC-MS and in vitro antioxidant studies by DPPH and ABTS assays were performed. In vivo antimalarial studies in Pb-infected mice were carried out using Rane's test and Peters' 4-day test. Results and conclusions TcMLE showed significant in vitro antioxidant activity and had phytochemicals reported for antimalarial activity. In vitro studies showed prominent antiplasmodial activity against Pf3D7 strain (IC50 ∼22 μg/ml) and PfCam3. IR539Tstrain (IC50 value ∼43 μg/ml). In vitro cytotoxicity studies, in vitro hemolytic assays, and in vivo acute toxicity studies further suggested that TcMLE is nontoxic. In vivo antimalarial studies using Rane's test showed a significant decrease in parasitemia by ∼70% at 1200 mg/kg doses and delayed the mortality of mice by ∼10-14 days. Peters' 4-day test also showed a similar pattern. The present study demonstrated the antimalarial potential of TcMLE. These findings deliver a platform for further studies to identify the active components of TcMLE and discover new antimalarials.
Collapse
Affiliation(s)
- Nalini Singh
- Infectious Disease Biology, Institute of Life Sciences, Bhubaneswar, 751023, Odisha, India
| | - Aditi Chatterjee
- Infectious Disease Biology, Institute of Life Sciences, Bhubaneswar, 751023, Odisha, India
- School of Biotechnology, Kalinga Institute of Industrial Technology, Bhubaneswar, 751024, Odisha, India
| | - Wahengbam Kabita Chanu
- Plant Bioresources Division, Institute of Bioresources and Sustainable Development, Imphal, 795001, Manipur, India
| | - Pradeep Mini Vaishalli
- Infectious Disease Biology, Institute of Life Sciences, Bhubaneswar, 751023, Odisha, India
| | - Chingakham Brajakishor Singh
- Plant Bioresources Division, Institute of Bioresources and Sustainable Development, Imphal, 795001, Manipur, India
| | | |
Collapse
|
10
|
Lelisa K, Hailemeskel E, Bekele D, Dugassa S. Malaria positivity rate trend analysis at water resources development project of Wonji Sugar Estate Oromia, Ethiopia. Parasitol Res 2023; 122:2259-2266. [PMID: 37507541 DOI: 10.1007/s00436-023-07923-2] [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: 10/06/2022] [Accepted: 07/04/2023] [Indexed: 07/30/2023]
Abstract
Evidence on the trends of the proportion of malaria infections detected by routine passive case detection at health facilities is important for public health decision making especially in areas moving towards elimination. The objective was to assess nine years of trends on clinical malaria infections detected at health facility and its associated climate factors, in the water resource development set up of Wonji sugar estate, Oromia, Ethiopia. Retrospective data were collected from malaria-suspected patient recording logbook at Wonji sugar factory's primary hospital. Monthly average meteorological data were obtained from the estate meteorological station. Data were collected from April through June 2018 and January 2022. The data were analyzed using Stata version 16.0 software for Chi-square and regression analysis. Over the last nine years, 34,388 cases were legible for analysis with complete data. Of these, 11.75% (4039/34388) were positive for clinical malaria. Plasmodium vivax test positivity was the highest proportion (8.2%, n = 2820) followed by Plasmodium falciparum (3.48%, n = 1197) and mixed infections (P. falciparum and P. vivax, 0.06%, n = 21). The odds of being positive for malaria was highest in males (AOR = 1.46; 95%CI = 1.36-1.52; P < 0.001) compared to females and in older individuals of above 15 years old (AOR = 4.55, 95%CI = 4.01-5.17, P < 0.001) followed by school-aged children (5-15 years old) (AOR = 2.16; 95%CI = 1.88-2.49, P < 0.001). There was no significant variation in the proportion of malaria-positive cases in the dry and wet seasons (P = 0.059). Malaria test positivity rates were associated with average monthly rainfall (AdjIRR = 1.00; 95%CI = 1.00-1.001, P < 0.001) while negatively associated with average monthly minim temperature (adjIRR = 0.94; 95%CI = 0.94-0.95; P < 0.001) and average monthly relative humidity (adjIRR = 0.99, 95%CI = 0.99-1.00, P = 0.023). There was year-round malaria transmission, adults especially males and school children frequently tested malaria positive. Hence, alternative vector management tools like larval source management have to be deployed besides ITNs and IRS in such water development areas to achieve the malaria elimination goal.
Collapse
Affiliation(s)
- Kidane Lelisa
- Vector Biology and Control Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia.
- Department of Biology, College of Natural and Computational Sciences, Dilla University, PO Box 419, Dilla, Ethiopia.
| | - Elifaged Hailemeskel
- Malaria and Neglected Tropical Diseases Directorate, Armauer Hansen Research Institute, PO Box 1005, Addis Ababa, Ethiopia.
- Department of Biology, College of Natural and Computational Sciences, Wollo University, PO Box 1145, Dessie, Ethiopia.
- Department of Medical Microbiology, Radboud University Medical Center, 6525 GA, Nijmegen, The Netherlands.
| | - Damtew Bekele
- Department of Biology, College of Natural and Computational Sciences, Ambo University, PO Box 19, Ambo, Ethiopia
| | - Sisay Dugassa
- Vector Biology and Control Research Unit, Aklilu Lemma Institute of Pathobiology, Addis Ababa University, PO Box 1176, Addis Ababa, Ethiopia
| |
Collapse
|
11
|
Pradhan S, Hore S, Roy S, Manna S, Dam P, Mondal R, Ghati A, Biswas T, Shaw S, Sharma S, Singh WS, Maji SK, Roy S, Basu A, Pandey KC, Samanta S, Vashisht K, Dolai TK, Kundu PK, Mitra S, Biswas D, Sadat A, Shokriyan M, Maity AB, Mandal AK, İnce İA. Geo-environmental factors and the effectiveness of mulberry leaf extract in managing malaria. Sci Rep 2023; 13:14808. [PMID: 37684270 PMCID: PMC10491663 DOI: 10.1038/s41598-023-41668-3] [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: 05/21/2023] [Accepted: 08/29/2023] [Indexed: 09/10/2023] Open
Abstract
Malaria prevalence has become medically important and a socioeconomic impediment for the endemic regions, including Purulia, West Bengal. Geo-environmental variables, humidity, altitude, and land use patterns are responsible for malaria. For surveillance of the endemic nature of Purulia's blocks, statistical and spatiotemporal factors analysis have been done here. Also, a novel approach for the Pf malaria treatment using methanolic leaf extract of Morus alba S1 has significantly reduced the parasite load. The EC50 value (1.852) of the methanolic extract of M. alba S1 with P. falciparum 3D7 strain is close to the EC50 value (0.998) of the standard drug chloroquine with the same chloroquine-sensitive strain. Further studies with an in-silico model have shown successful interaction between DHFR and the phytochemicals. Both 1-octadecyne and oxirane interacted favourably, which was depicted through GC-MS analysis. The predicted binary logistic regression model will help the policy makers for epidemiological surveillance in malaria-prone areas worldwide when substantial climate variables create a circumstance favourable for malaria. From the in vitro and in silico studies, it can be concluded that the methanolic extract of M. alba S1 leaves were proven to have promising antiplasmodial activity. Thus, there is a scope for policy-driven approach for discovering and developing these lead compounds and undermining the rising resistance to the frontline anti-malarial drugs in the world.
Collapse
Affiliation(s)
- Sayantan Pradhan
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
- Hematology Department, Nil Ratan Sircar Medical College and Hospital, Kolkata, 700014, India
| | - Samrat Hore
- Department of Statistics, Tripura University, Agartala, Tripura, 799022, India
| | - Stabak Roy
- Department of Geography and Disaster Management, Tripura University, Agartala, Tripura, 799022, India
| | - Simi Manna
- Department of Bio-Medical Laboratory Science and Management, Vidyasagar University, Midnapore, West Bengal, 721102, India
| | - Paulami Dam
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Rittick Mondal
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Amit Ghati
- Department of Microbiology, Barrackpore Rastraguru Surendranath College, Barrackpore, West Bengal, 700120, India
| | - Trishanjan Biswas
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Subhajit Shaw
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Supriya Sharma
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077, India
| | | | - Suman Kumar Maji
- District Public Health Centre, Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, 723101, India
| | - Sankarsan Roy
- PH and CD Branch, Office of the Chief Medical Officer of Health, Purulia, West Bengal, 723101, India
| | - Aparajita Basu
- Department of Microbiology, University of Calcutta, Kolkata, West Bengal, 700019, India
| | - Kailash C Pandey
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077, India
| | - Soumadri Samanta
- Advanced Functional Nanomaterials, Energy and Environment Unit, Institute of Nano Science and Technology (INST), Phase X, SAS Nagar, Mohali, Punjab, 160062, India
| | - Kapil Vashisht
- ICMR-National Institute of Malaria Research, Sector-8, Dwarka, New Delhi, 110077, India
| | - Tuphan Kanti Dolai
- Hematology Department, Nil Ratan Sircar Medical College and Hospital, Kolkata, 700014, India
| | - Pratip Kumar Kundu
- Department of Microbiology, Santiniketan Medical College, Gobindapur, Muluk, Bolpur, Birbhum, West Bengal, 731204, India
| | - Saptarshi Mitra
- Department of Geography and Disaster Management, Tripura University, Agartala, Tripura, 799022, India
| | - Debasish Biswas
- Department of Economics, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Abdul Sadat
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India
| | - Masuma Shokriyan
- Department of Medical Microbiology, School of Medicine, Acibadem Mehmet Ali Aydınlar University, 34752, Ataşehir, Istanbul, Turkey
| | - Amit Bikram Maity
- Department of Otorhinolaryngology, Institute of Post Graduate Medical Education and Research (S.S.K.M. Hospital), Kolkata, West Bengal, 700020, India.
| | - Amit Kumar Mandal
- Department of Sericulture, Raiganj University, North Dinajpur, West Bengal, 733134, India.
- Centre for Nanotechnology Sciences, Raiganj University, North Dinajpur, West Bengal, 733134, India.
| | - İkbal Agah İnce
- Department of Medical Microbiology, School of Medicine, Acibadem Mehmet Ali Aydınlar University, 34752, Ataşehir, Istanbul, Turkey.
| |
Collapse
|
12
|
Abdelmohsen UR, Bayoumi SAL, Mohamed NM, Mostafa YA, Ngwa CJ, Pradel G, Farag SF. Naturally occurring phenylethanoids and phenylpropanoids: antimalarial potential. RSC Adv 2023; 13:26804-26811. [PMID: 37692342 PMCID: PMC10483269 DOI: 10.1039/d3ra04242a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Accepted: 08/27/2023] [Indexed: 09/12/2023] Open
Abstract
Malaria as an infectious disease is one of the world's most dangerous parasitic diseases. There is an urgent need for the development of new antimalarial drugs. Natural products are a very rich source of new bioactive compounds. Our research aims to shed light on the recent studies which demonstrated the antimalarial potential of phenylpropanoids as a major natural-products class. This study involves an in silico analysis of naturally-occurring phenylpropanoids and phenylethanoids which showed 25 compounds with moderate to strong binding affinity to various amino acid residues lining the active site; P. falciparum kinase (PfPK5), P. falciparum cytochrome bc1 complex (cyt bc1), and P. falciparum lysyl-tRNA synthetase (PfKRS1); of Plasmodium falciparum parasite, a unicellular protozoan which causes the most severe and life-threatening malaria. Furthermore, the study was augmented by the assessment of antiplasmodial activity of glandularin, a naturally occurring dibenzylbutyrolactolic lignan, against chloroquine-sensitive 3D7 strain of P. falciparum using SYBR green I-based fluorescence assay, which showed high antimalarial activity with IC50 value of 11.2 μM after 24 hours of incubation. Our results highlight phenylpropanoids and glandularin in particular as a promising chemical lead for development of antimalarial drugs.
Collapse
Affiliation(s)
- Usama Ramadan Abdelmohsen
- Department of Pharmacognosy, Faculty of Pharmacy, Minia University Minia 61519 Egypt
- Department of Pharmacognosy, Faculty of Pharmacy, Deraya University 7 Universities Zone 61111 New Minia City Egypt
| | - Soad A L Bayoumi
- Department of Pharmacognosy, Faculty of Pharmacy, Assiut University Assiut 71526 Egypt
| | - Nesma M Mohamed
- Department of Pharmacognosy, Faculty of Pharmacy, Assiut University Assiut 71526 Egypt
- Department of Pharmacognosy, Faculty of Pharmacy, Badr University in Assiut Assiut 77771 Egypt
| | - Yaser A Mostafa
- Pharmaceutical Organic Chemistry Department, Faculty of Pharmacy, Assiut University 71526 Assiut Egypt
- Pharmaceutical Chemistry Department, Faculty of Pharmacy, Badr University in Assiut Assiut 77771 Egypt
| | - Che J Ngwa
- Division of Cellular and Applied Infection Biology, Institute of Zoology, RWTH Aachen University 52074 Aachen Germany
| | - Gabriele Pradel
- Division of Cellular and Applied Infection Biology, Institute of Zoology, RWTH Aachen University 52074 Aachen Germany
| | - Salwa F Farag
- Department of Pharmacognosy, Faculty of Pharmacy, Assiut University Assiut 71526 Egypt
- Department of Pharmacognosy, College of Pharmacy, Taif University P.O. Box 11099 Taif 21944 Saudi Arabia
| |
Collapse
|
13
|
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
|
14
|
Van Iseghem T, Jacobs I, Vanden Bossche D, Delobelle P, Willems S, Masquillier C, Decat P. The role of community health workers in primary healthcare in the WHO-EU region: a scoping review. Int J Equity Health 2023; 22:134. [PMID: 37474937 PMCID: PMC10357780 DOI: 10.1186/s12939-023-01944-0] [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: 04/12/2023] [Accepted: 06/26/2023] [Indexed: 07/22/2023] Open
Abstract
BACKGROUND Existing evidence on the role of community health workers (CHWs) in primary healthcare originates primarily from the United States, Canada and Australia, and from low- and middle-income countries. Little is known about the role of CHWs in primary healthcare in European countries. This scoping review aimed to contribute to filling this gap by providing an overview of literature reporting on the involvement of CHWs in primary healthcare in WHO-EU countries since 2001 with a focus on the role, training, recruitment and remuneration. METHODS This systematic scoping review followed the guidelines of the Preferred Reporting Items for Systematic reviews and Meta-Analyses, extension for Scoping Reviews. All published peer-reviewed literature indexed in PubMed, Web of Science, and Embase databases from Jan 2001 to Feb 2023 were reviewed for inclusion. Included studies were screened on title, abstract and full text according to predetermined eligibility criteria. Studies were included if they were conducted in the WHO-EU region and provided information regarding the role, training, recruitment or remuneration of CHWs. RESULTS Forty studies were included in this review, originating from eight countries. The involvement of CHWs in the WHO-EU regions was usually project-based, except in the United Kingdom. A substantial amount of literature with variability in the terminology used to describe CHWs, the areas of involvement, recruitment, training, and remuneration strategies was found. The included studies reported a trend towards recruitment from within the communities with some form of training and payment of CHWs. A salient finding was the social embeddedness of CHWs in the communities they served. Their roles can be classified into one or a combination of the following: educational; navigational and supportive. CONCLUSION Future research projects involving CHWs should detail their involvement and elaborate on CHWs' role, training and recruitment procedures. In addition, further research on CHW programmes in the WHO-EU region is necessary to prepare for their integration into the broader national health systems.
Collapse
Affiliation(s)
- Tijs Van Iseghem
- Interuniversity Centre for Health Economics Research (ICHER), Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.
| | - Ilka Jacobs
- Equity Research Group, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Dorien Vanden Bossche
- Unit Family Medicine, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Peter Delobelle
- Chronic Diseases Initiative for Africa, Department of Medicine, University of Cape Town, Cape Town, South Africa
- MENT Research Group, Department of Public Health, Vrije Universiteit Brussel, Brussels, Belgium
| | - Sara Willems
- Equity Research Group, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Caroline Masquillier
- 'Family Medicine and Population Health' - FAMPOP, Faculty of Medical Sciences & 'Centre for Family, Population and Health', Faculty of Social sciences, University of Antwerp, Antwerp, Belgium
| | - Peter Decat
- Unit Family Medicine, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| |
Collapse
|
15
|
Alyahya HS. Comparative study of three herbal formulations against dengue vectors Aedes aegypti. Saudi J Biol Sci 2023; 30:103651. [PMID: 37138927 PMCID: PMC10149404 DOI: 10.1016/j.sjbs.2023.103651] [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: 03/04/2023] [Revised: 03/17/2023] [Accepted: 04/09/2023] [Indexed: 05/05/2023] Open
Abstract
The efficacy of three formulations (i.e., natural lavender crude, essential oil, and gel) extracted from Lavender angustifolia was tested against vectors of the epidemic dengue virus, Aedesaegypti, to evaluate their larvicidal activity effect. The ethanolic extract of the lavender crude was prepared using a rotary evaporator, while the other extracts, such as essential oil and gel, were obtained from iHerb, a supplier of medicinal herbs in the US. The mortality rate of larvae was evaluated 24 h after exposure. Larvicidal activity of the lavender crude was 91% mortality at 150 ppm, 94% for essential oil at a concentration of 3000 ppm, and 97% for lavender gel at a 1000 ppm. Natural lavender crude was one of the most promising extracts tested against Ae.aegypti larvae, with lethal concentrations at LC50 and LC90 of 76.4 and 174.5 ppm post-treatment. The essential oil had the least effect on mosquito larvae, with LC50 and LC90 reaching 1814.8 and 3381.9 ppm, respectively. The lavender gel was moderately effective against Ae. aegypti larvae, with LC50 and LC90 values reaching 416.3 and 987.7 ppm after exposure. The occurrence of morphological abnormalities in the larvae treated with the three compounds, in turn, resulted in an incomplete life cycle. Therefore, our results indicated that natural lavender crude displayed the highest larvicidal activity against larvae, followed by gel and essential oil. Thus, this study concluded that lavender crude is an effective, eco-friendly compound that can be used as an alternative to chemical products to control vector-borne epidemic diseases.
Collapse
|
16
|
Kshirsagar A, Choi G, Santosh V, Harvey T, Bernhards RC, Guan W. Handheld Purification-Free Nucleic Acid Testing Device for Point-of-Need Detection of Malaria from Whole Blood. ACS Sens 2023; 8:673-683. [PMID: 36696460 PMCID: PMC11214673 DOI: 10.1021/acssensors.2c02169] [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] [Indexed: 01/26/2023]
Abstract
World Health Organization's aim to eliminate malaria from developing/resource-limited economies requires easy access to low-cost, highly sensitive, and specific screening. We present a handheld nucleic acid testing device with on-chip automated sample preparation to detect malaria (Plasmodium falciparum) infection from a whole blood sample as a feasibility study. We used a simple two-reagent-based purification-free protocol to prepare the whole blood sample on a piezo pump pressure-driven microfluidic cartridge. The cartridge includes a unique mixing chamber for sample preparation and metering structures to dispense a predetermined volume of the sample lysate mixture into four chambers containing a reaction mix. The parasite genomic DNA concentration can be estimated by monitoring the fluorescence generated from the loop-mediated isothermal amplification reaction in real time. We achieved a sensitivity of ∼0.42 parasite/μL of whole blood, sufficient for detecting asymptomatic malaria parasite carriers.
Collapse
Affiliation(s)
- Aneesh Kshirsagar
- School of Electrical Engineering and Computer Science, Pennsylvania State University, University Park 16802, USA
| | - Gihoon Choi
- School of Electrical Engineering and Computer Science, Pennsylvania State University, University Park 16802, USA
| | - Vishaka Santosh
- U.S. Army, DEVCOM Chemical Biological Center, Aberdeen Proving Ground, MD, 21010, USA
| | - Tara Harvey
- U.S. Army, DEVCOM Chemical Biological Center, Aberdeen Proving Ground, MD, 21010, USA
| | - Robert Cory Bernhards
- U.S. Army, DEVCOM Chemical Biological Center, Aberdeen Proving Ground, MD, 21010, USA
| | - Weihua Guan
- School of Electrical Engineering and Computer Science, Pennsylvania State University, University Park 16802, USA
- Department of Biomedical Engineering, Pennsylvania State University, University Park 16802, USA
| |
Collapse
|
17
|
Bain LE, Akondeng C, Njamnshi WY, Mandi HE, Amu H, Njamnshi AK. Community engagement in research in sub-Saharan Africa: current practices, barriers, facilitators, ethical considerations and the role of gender - a systematic review. Pan Afr Med J 2022; 43:152. [PMID: 36785694 PMCID: PMC9922083 DOI: 10.11604/pamj.2022.43.152.36861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/20/2022] [Indexed: 02/15/2023] Open
Abstract
Introduction meaningful community engagement is increasingly being considered the major determinant of successful research, innovation and intervention uptake. Even though there is available literature recommending community engagement in health research, there are still knowledge gaps in how communities might be best engaged in Sub-Saharan Africa. We, therefore, synthesized the existing literature on the current practices, barriers and facilitators, ethical considerations, and gender mainstreaming in the engagement of communities in research in sub-Saharan Africa. Methods this synthesis was developed following the Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A combination of keywords and medical subject headings was used to search MEDLINE, EMBASE, Global Health Library through OVID SP, the Cochrane Library, PsychINFO, CINAHL, WHO Afro Library, WHO Global Index Medicus and the National Institute for Health Research, for all literature published between 1 January 2000 to 31 July 2021. Results thirty articles met our inclusion criteria. The key reported facilitators of effective community engagement in research included appropriate community entry and engagement of stakeholders. Barriers to effective community engagement in research included the availability of prohibitive cultural, historical and religious practices; geographical/spatial limitations, difficulties in planning and executing community engagement activities and communication barriers. Awareness creation and sensitization on the research through drama, social media, documentaries, and community durbars are some of the existing practices adopted in engaging communities in research. Gender mainstreaming was not considered appropriately in the engagement of communities in research, as only a few studies made provisions for gender considerations, and most of the time, interchanging gender for sex. Respect for autonomy, privacy and informed consent were the main ethical issues reported. Conclusion gender mainstreaming and ethical standards were reported as important, but not explored in depth. Gender as a social construct needs to be carefully integrated in the entire research cycle. Clear ethical concerns within a research project have to be co-discussed by the research team, community members and potential research participants.
Collapse
Affiliation(s)
- Luchuo Engelbert Bain
- Triangle Research Foundation (TRIFT), Limbe, Cameroon
- Department of Psychology, Faculty of Humanities, University of Johannesburg, Johannesburg, South Africa
- Global South Health Services and Research (GSHS), Amsterdam, The Netherlands
| | - Claudine Akondeng
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
- Cameroon National Association of Family Welfare (CAMNAFAW), Yaoundé, Cameroun
| | - Wepnyu Yembe Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
- Education and Learning for All (ELFA) Cameroon, Yaoundé, Cameroon
- Division of Operational Research in Health, DROS, Ministry of Public Health, Yaoundé, Cameroon
| | - Henshaw Eyambe Mandi
- Triangle Research Foundation (TRIFT), Limbe, Cameroon
- Coalition for Epidemic Preparedness Innovations, Oslo, Norway
| | - Hubert Amu
- Department of Population and Behavioral Sciences, Fred N. Binka School of Public Health, University of Health and Allied Sciences, Hohoe, Ghana
| | - Alfred Kongnyu Njamnshi
- Brain Research Africa Initiative (BRAIN), Yaoundé, Cameroon
- Education and Learning for All (ELFA) Cameroon, Yaoundé, Cameroon
- Faculty of Medicine and Biomedical Sciences (FMBS), The University of Yaoundé I, Yaoundé, Cameroon
| |
Collapse
|
18
|
Abebe MT, Degefu MA, Assen M, Legass A. Dynamics of land use/land cover: implications on environmental resources and human livelihoods in the Middle Awash Valley of Ethiopia. ENVIRONMENTAL MONITORING AND ASSESSMENT 2022; 194:833. [PMID: 36166173 DOI: 10.1007/s10661-022-10498-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/10/2022] [Indexed: 06/16/2023]
Abstract
Quantifying the recent LULC changes and associated impacts on pastoral and agro-pastoral livelihood systems is important since the effects of LULC changes on environmental resources and human livelihood are not fully understood in our study area. This paper analysed the trend of land use/land cover (LULC) dynamics and its implications on natural resources and human livelihood in the Middle Awash Valley, Central Ethiopian Rift Valley. For the purpose, Landsat imageries of thematic mapper (1987), enhanced thematic mapper (2002) and operational land imager and thermal infrared sensor (2016) were employed and analysed using Remote Sensing and Geographic Information System (GIS) software and techniques, and qualitative data analysis had been performed as well. The results showed that cultivated land expanded at a rate of 2.6% year-1, whereas forestland and grassland shrunk at a rate of 1.2% year-1 and 2.4% year-1, respectively. The invasive Prosopis juliflora has been expanded from 3.7% in 1987 to 37.9% in 2016 at a rate of 1.2% year-1. The introduction of both small- and large-scale commercial irrigation farming and the implementation of villagization programme focused on transforming pastoralists into sedentary lifestyles. Consequently, irrigation farming, launching of villagization, climate variability as in series of droughts, construction of water dam and the rapid expansion of Prosopis juliflora were the major drivers of LULC changes in the study area. Although we found some positive developments such as improvement on infrastructural and social services (e.g. school and domestic water supply), income diversification and ecological benefits from Prosopis juliflora (e.g. saline soil treatment, carbon sequestration and soil erosion control), there were a range of negative impacts resulting from LULC changes in the study area. LULC changes reduced quality of rangeland resources as the ecologically and economically valuable indigenous tree and grass varieties were significantly degraded. As a result, the traditional pastoral livelihood system has been much vulnerable with the LULC dynamism of the study area. Furthermore, the implementation of the villagization programme has brought socioeconomic impacts on the community and challenges on the ecology, e.g. changing productive rangeland to irrigation crop farms. Our research results, thus, suggest the urgent need for relevant policy interventions in support of the pastoral livelihoods and landscapes with the modification in the implementation of villagization as well as irrigation farming programmes and its better management and controlling Prosopis juliflora expansion in the study area.
Collapse
Affiliation(s)
- Mathias Tesfaye Abebe
- Department of Geography and Environmental Studies, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mekonnen Adnew Degefu
- Department of Geography and Environmental Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Mohammed Assen
- Department of Geography and Environmental Studies, Addis Ababa University, Addis Ababa, Ethiopia
| | - Asmamaw Legass
- Department of Geography and Environmental Studies, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
19
|
Nararak J, Giorgio CD, Thanispong K, Sukkanon C, Sanguanpong U, Mahiou-Leddet V, Ollivier E, Chareonviriyaphap T, Manguin S. Behavioral avoidance and biological safety of vetiver oil and its constituents against Aedes aegypti (L.), Aedes albopictus (Skuse) and Culex quinquefasciatus Say. CURRENT RESEARCH IN INSECT SCIENCE 2022; 2:100044. [PMID: 36683957 PMCID: PMC9846461 DOI: 10.1016/j.cris.2022.100044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 07/29/2022] [Accepted: 08/02/2022] [Indexed: 06/17/2023]
Abstract
Numerous plant-based repellents are widely used for personal protection against host-seeking mosquitoes. Vitiveria zizanioides (L.) Nash essential oil and its constituents have demonstrated various mosquito repellent activities. In this study, three chemical actions of vetiver oil and five constituents (terpinen-4-ol, α-terpineol, valencene, vetiverol and vetivone) were characterized against Aedes aegypti, Aedes albopictus and Culex quinquefasciatus by using the high-throughput screening assay system (HITSS). Significant contact escape responses in Ae. aegypti and Ae. albopictus to all test compounds at concentrations between 2.5 and 5% were observed. Spatial repellency responses were also observed in some tested mosquito populations depending upon concentrations. The most significant toxic response on mosquitoes was found at the highest concentration, except for vetivone which had no toxic effect on Ae. aegypti and Ae. albopictus. Results on phototoxic and genotoxic hazard revealed that vetiver oil and their constituents showed no phototoxic potential or any significant genotoxic response. In conclusion, vetiver oil and two constituents, valencene and vetiverol, are potentials as active ingredients for mosquito repellency and present no toxicity.
Collapse
Affiliation(s)
- Jirod Nararak
- Department of Entomology, Faculty of Agriculture, Kasetsart University, Bangkok 10900, Thailand
- HSM, University of Montpellier, CNRS, IRD, Montpellier, France
| | - Carole Di Giorgio
- Aix Marseille Univ., Avignon Université, CNRS, IRD, IMBE, FAC PHARM, Marseille, France
| | - Kanutcharee Thanispong
- Division of Vector Borne Diseases, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Chutipong Sukkanon
- Department of Medical Technology, School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat 80161, Thailand
| | - Unchalee Sanguanpong
- Maejo University International College (MJU-IC) 63 Moo 4 Nongharn Sub district, Chiang Mai, 50290 Thailand
| | - Valerie Mahiou-Leddet
- Aix Marseille Univ., Avignon Université, CNRS, IRD, IMBE, FAC PHARM, Marseille, France
| | - Evelyne Ollivier
- Aix Marseille Univ., Avignon Université, CNRS, IRD, IMBE, FAC PHARM, Marseille, France
| | | | - Sylvie Manguin
- HSM, University of Montpellier, CNRS, IRD, Montpellier, France
| |
Collapse
|
20
|
Lingani M, Zango SH, Valéa I, Sanou M, Ouoba S, Samadoulougou S, Robert A, Tinto H, Dramaix M, Donnen P. Prevalence and risk factors of malaria among first antenatal care attendees in rural Burkina Faso. Trop Med Health 2022; 50:49. [PMID: 35879789 PMCID: PMC9317114 DOI: 10.1186/s41182-022-00442-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/16/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The WHO recommends continuous surveillance of malaria in endemic countries to identify areas and populations most in need for targeted interventions. The aim of this study was to assess the prevalence of malaria and its associated factors among first antenatal care (ANC) attendees in rural Burkina Faso. METHODS A cross-sectional survey was conducted between August 2019 and September 2020 at the Yako health district and included 1067 first ANC attendees. Sociodemographic, gyneco-obstetric, and medical characteristics were collected. Malaria was diagnosed by standard microscopy and hemoglobin level was measured by spectrophotometry. A multivariate logistic regression analysis was used to identify factors associated with malaria infection. RESULTS Overall malaria infection prevalence was 16.1% (167/1039). Among malaria-positive women, the geometric mean parasite density was 1204 [95% confidence interval (CI) 934-1552] parasites/µL and the proportion of very low (1-199 parasites/µL), low (200-999 parasites/µL), medium (1000-9999 parasites/µL) and high (≥ 10,000 parasites/µL) parasite densities were 15.0%, 35.3%, 38.3% and 11.4%, respectively. Age < 20 years (adjusted odds ratio (aOR): 2.2; 95% CI 1.4-3.5), anemia (hemoglobin < 11 g/deciliter) (aOR: 3.4; 95% CI 2.2-5.5), the non-use of bed net (aOR: 1.8; 95% CI 1.1-2.8), and the absence of intermittent preventive treatment with sulfadoxine-pyrimethamine (aOR: 5.8; 95% CI 2.1-24.5) were positively associated with malaria infection. CONCLUSIONS The study showed that one out of six pregnant women had a microscopy-detected P. falciparum malaria infection at their first ANC visit. Strengthening malaria prevention strategies during the first ANC visit is needed to prevent unfavorable birth outcomes.
Collapse
Affiliation(s)
- Moussa Lingani
- École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgique.
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso.
| | - Serge H Zango
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
- Epidemiology and Biostatistics Research Division, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Bruxelles, Belgique
| | - Innocent Valéa
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Maïmouna Sanou
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Serge Ouoba
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Sékou Samadoulougou
- Evaluation Platform on Obesity Prevention, Quebec Heart and Lung Institute Research Center, Quebec, Canada
| | - Annie Robert
- Epidemiology and Biostatistics Research Division, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Bruxelles, Belgique
| | - Halidou Tinto
- Institut de Recherche en Sciences de la Santé/Direction Régionale du Centre Ouest (IRSS/DRCO), Nanoro, Burkina Faso
| | - Michèle Dramaix
- École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgique
| | - Philippe Donnen
- École de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgique
| |
Collapse
|
21
|
Doe MTT, Bajinka O, Barrow A. Antenatal care positive responses to pregnant women in preventing and controlling malaria in pregnancy: the sub-Saharan African perspective. World J Pediatr 2022; 18:453-462. [PMID: 35616810 DOI: 10.1007/s12519-022-00549-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/27/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND The response to antenatal care (ANC) for maternal and offspring outcomes, especially in pregnant women has been thoroughly studied. However, despite the number of interventional studies on the treatment of sulfadoxine-pyrimethamine combination (IPTp-SP) uptake, the point in point cases of the positive responses of ANC in improving health conditions of pregnant women are not found in the literature. DATA SOURCES This review collected ANC responses to the positive health outcomes for pregnant women with malaria, the challenges faced regarding IPTp-SP uptake during ANC visits and the role of ANC in preventing and controlling malaria in sub-Saharan Africa. It elucidated ANC and uptake of optimal intermittent preventive IPTp-SP and further described ANC as a tool for heterogeneity for malaria prevention. RESULTS ANC is seen as a microscope to malaria in pregnacy, maternal iron deficiency and anemia checkpoints, ANC and malaria treatment strategies, and ANC and the use of insecticide treated nets (ITN). The review further discussed ANC attendance influencing factors, limitations to ANC implications and the prospects in ANC visits on preventing malaria in pregnancy. CONCLUSIONS A declining trend of malaria transmission in Africa has been observed in recent years. However, the burden of malaria in pregnancy remains a health concern. The rate of SP resistance, low uptake of IPTp-SP, low LLINs distribution, late gestational ANC visits and low turnaround for optimal ANC visits for first time mothers' aggrevated the malaria-endemic settings among pregnant women in sub-Saharan Africa.
Collapse
Affiliation(s)
- Margaret Tete Telay Doe
- Department of Occupational and Environmental Health, Xiangya School of Public Health, Central South University, Changsha, People's Republic of China.
| | - Ousman Bajinka
- Department of Microbiology, Central South University, Changsha, Hunan Provinces, China.,China-Africa Research Centre of Infectious Diseases, School of Basic Medical Sciences, Central South University, Changsha, 410078, Hunan, China.,School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| | - Amadou Barrow
- Heidelberg, Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University, Heidelberg, Germany.,School of Medicine and Allied Health Sciences, University of The Gambia, Banjul, The Gambia
| |
Collapse
|
22
|
Golumbeanu M, Yang GJ, Camponovo F, Stuckey EM, Hamon N, Mondy M, Rees S, Chitnis N, Cameron E, Penny MA. Leveraging mathematical models of disease dynamics and machine learning to improve development of novel malaria interventions. Infect Dis Poverty 2022; 11:61. [PMID: 35659301 PMCID: PMC9167503 DOI: 10.1186/s40249-022-00981-1] [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: 03/13/2022] [Accepted: 05/04/2022] [Indexed: 01/04/2023] Open
Abstract
Background Substantial research is underway to develop next-generation interventions that address current malaria control challenges. As there is limited testing in their early development, it is difficult to predefine intervention properties such as efficacy that achieve target health goals, and therefore challenging to prioritize selection of novel candidate interventions. Here, we present a quantitative approach to guide intervention development using mathematical models of malaria dynamics coupled with machine learning. Our analysis identifies requirements of efficacy, coverage, and duration of effect for five novel malaria interventions to achieve targeted reductions in malaria prevalence. Methods A mathematical model of malaria transmission dynamics is used to simulate deployment and predict potential impact of new malaria interventions by considering operational, health-system, population, and disease characteristics. Our method relies on consultation with product development stakeholders to define the putative space of novel intervention specifications. We couple the disease model with machine learning to search this multi-dimensional space and efficiently identify optimal intervention properties that achieve specified health goals. Results We apply our approach to five malaria interventions under development. Aiming for malaria prevalence reduction, we identify and quantify key determinants of intervention impact along with their minimal properties required to achieve the desired health goals. While coverage is generally identified as the largest driver of impact, higher efficacy, longer protection duration or multiple deployments per year are needed to increase prevalence reduction. We show that interventions on multiple parasite or vector targets, as well as combinations the new interventions with drug treatment, lead to significant burden reductions and lower efficacy or duration requirements. Conclusions Our approach uses disease dynamic models and machine learning to support decision-making and resource investment, facilitating development of new malaria interventions. By evaluating the intervention capabilities in relation to the targeted health goal, our analysis allows prioritization of interventions and of their specifications from an early stage in development, and subsequent investments to be channeled cost-effectively towards impact maximization. This study highlights the role of mathematical models to support intervention development. Although we focus on five malaria interventions, the analysis is generalizable to other new malaria interventions. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s40249-022-00981-1.
Collapse
Affiliation(s)
- Monica Golumbeanu
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Guo-Jing Yang
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,Key Laboratory of Tropical Translational Medicine of Ministry of Education and School of Tropical Medicine and Laboratory Medicine, The First and Second Affiliated Hospital of Hainan Medical University, Hainan Medical University, Haikou, Hainan, People's Republic of China.,University of Basel, Basel, Switzerland
| | - Flavia Camponovo
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland.,Center for Communicable Disease Dynamics, Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, 02115, USA
| | | | | | | | - Sarah Rees
- Innovative Vector Control Consortium, Liverpool, UK
| | - Nakul Chitnis
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland.,University of Basel, Basel, Switzerland
| | - Ewan Cameron
- Malaria Atlas Project, Big Data Institute, University of Oxford, Oxford, UK.,Curtin University, Perth, Australia.,Telethon Kids Institute, Perth Children's Hospital, Perth, Australia
| | - Melissa A Penny
- Swiss Tropical and Public Health Institute, Allschwil, Switzerland. .,University of Basel, Basel, Switzerland.
| |
Collapse
|
23
|
Asale A, Kassie M, Abro Z, Enchalew B, Belay A, Sangoro PO, Tchouassi DP, Mutero CM. The combined impact of LLINs, house screening, and pull-push technology for improved malaria control and livelihoods in rural Ethiopia: study protocol for household randomised controlled trial. BMC Public Health 2022; 22:930. [PMID: 35538444 PMCID: PMC9088127 DOI: 10.1186/s12889-022-12919-1] [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: 07/30/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Abstract
Background The combined application of long-lasting insecticidal nets (LLINs) and indoor residual spraying (IRS) are commonly used malaria interventions that target indoor Anopheles vectors. Recent studies on the effects of house screening (HS) and LLINs have demonstrated a reduction in indoor vector densities and malaria when the interventions are combined. In addition, complementary interventions are needed to curb co-occurring pest populations which pose menace to agricultural crop productivity and food security. However, interventions that impact malaria mainly centre on public health strategies, overlooking subtle but important component of agricultural measures. Addressing the coexisting risks of malaria and crop pests could contribute to improved livelihood of communities. Methods A four-armed household, cluster-randomized, controlled study will be conducted to assess the combined impact of HS, LLINs and push-pull agricultural technology (PPT) against clinical malaria in children in Ethiopia. The unit of randomization will be the household, which includes a house and its occupants. A total of 838 households will be enrolled in this study. In this trial 246 households will receive LLINs and HS, 250 will receive LLINs, HS and PPT, 175 households will receive LLINs and PPT. The remaining 167 houses which receive LLINs only will be used as control. One child aged ≤14 years will be enrolled per household in each treatment and followed for clinical malaria using active case detection to estimate malaria incidence for two malaria transmission seasons. Discussion Episodes of clinical malaria, density of indoor biting malaria vectors, sporozoite infection rate, improved crop infestation rate, crop yield gain, livestock productivity and cost effectiveness analysis will be the end points of this study. Socio-economic, social demographic, cost-effectiveness analysis will be conducted using qualitative and participatory methods to explore the acceptability of HS and PPT. Documenting the combined impact of LLINs, HS and PPT on the prevalence of clinical malaria and crop pest damage will be the first of its kind. Trial registration Pan African Clinical Trials Registry, PACTR202006878245287. 24/06/2020. https://pactr.samrc.ac.za/TrialDisplay.aspx?TrialID=11101. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-12919-1.
Collapse
Affiliation(s)
- Abebe Asale
- International Centre of Insect Physiology and Ecology, Addis Ababa, Ethiopia.
| | - Menale Kassie
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Zewdu Abro
- International Centre of Insect Physiology and Ecology, Addis Ababa, Ethiopia
| | - Bayu Enchalew
- International Centre of Insect Physiology and Ecology, Addis Ababa, Ethiopia
| | - Aklilu Belay
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya.,University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| | - Peter O Sangoro
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - David P Tchouassi
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya
| | - Clifford M Mutero
- International Centre of Insect Physiology and Ecology, Nairobi, Kenya.,University of Pretoria Institute for Sustainable Malaria Control, School of Health Systems and Public Health, University of Pretoria, Pretoria, South Africa
| |
Collapse
|
24
|
Kim MJ, Chu KB, Kang HJ, Yoon KW, Lee DH, Lee SH, Moon EK, Quan FS. Influenza virus-like particle vaccine containing both apical membrane antigen 1 and microneme-associated antigen proteins of Plasmodium berghei confers protection in mice. BMC Immunol 2022; 23:21. [PMID: 35468726 PMCID: PMC9040335 DOI: 10.1186/s12865-022-00494-4] [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: 04/20/2021] [Accepted: 04/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Apical membrane antigen 1 (AMA1) and microneme-associated antigen (MIC) of Plasmodium parasites are important factors involved in host cell invasion. Methods In this study, influenza VLP vaccines containing both codon-optimized AMA1 and MIC were generated and the vaccine efficacy was evaluated in mice. Results VLPs vaccine immunization elicited higher levels of parasite-specific IgG and IgG2a antibody responses in sera. CD4+ and CD8+ T cells and germinal center B cells in blood, inguinal lymph nodes (ILN) and spleen were found to be significantly increased. Importantly, VLPs vaccination significantly reduced the levels of pro-inflammatory cytokines IFN-γ and TNF-α, decreased parasitemia in blood, resulting in lower body weight loss and longer survival time compared to control. Conclusion These results indicated that VLPs containing P. berghei AMA1 and MIC could be a candidate for malaria blood-stage vaccine design. Supplementary Information The online version contains supplementary material available at 10.1186/s12865-022-00494-4.
Collapse
Affiliation(s)
- Min-Ju Kim
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Ki-Back Chu
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Hae-Ji Kang
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Keon-Woong Yoon
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Dong-Hun Lee
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Su-Hwa Lee
- Department of Biomedical Science, Graduate School, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Eun-Kyung Moon
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul, 02447, Republic of Korea
| | - Fu-Shi Quan
- Department of Medical Zoology, Kyung Hee University School of Medicine, Seoul, 02447, Republic of Korea. .,Department of Medical Research Center for Bioreaction to Reactive Oxygen Species and Biomedical Science Institute, School of Medicine, Graduate School, Kyung Hee University, 26, Kyungheedae-ro, Dongdaemun-gu, Seoul, 02447, Republic of Korea.
| |
Collapse
|
25
|
Shah HA, Carrasco LR, Hamlet A, Murray KA. Exploring agricultural land-use and childhood malaria associations in sub-Saharan Africa. Sci Rep 2022; 12:4124. [PMID: 35260722 PMCID: PMC8904834 DOI: 10.1038/s41598-022-07837-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 02/24/2022] [Indexed: 11/09/2022] Open
Abstract
Agriculture in Africa is rapidly expanding but with this comes potential disbenefits for the environment and human health. Here, we retrospectively assess whether childhood malaria in sub-Saharan Africa varies across differing agricultural land uses after controlling for socio-economic and environmental confounders. Using a multi-model inference hierarchical modelling framework, we found that rainfed cropland was associated with increased malaria in rural (OR 1.10, CI 1.03-1.18) but not urban areas, while irrigated or post flooding cropland was associated with malaria in urban (OR 1.09, CI 1.00-1.18) but not rural areas. In contrast, although malaria was associated with complete forest cover (OR 1.35, CI 1.24-1.47), the presence of natural vegetation in agricultural lands potentially reduces the odds of malaria depending on rural-urban context. In contrast, no associations with malaria were observed for natural vegetation interspersed with cropland (veg-dominant mosaic). Agricultural expansion through rainfed or irrigated cropland may increase childhood malaria in rural or urban contexts in sub-Saharan Africa but retaining some natural vegetation within croplands could help mitigate this risk and provide environmental co-benefits.
Collapse
Affiliation(s)
- Hiral Anil Shah
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK.
- Grantham Institute - Climate Change and the Environment - Imperial College London, London, UK.
| | - Luis Roman Carrasco
- Department of Biological Sciences, National University of Singapore, Singapore, Singapore
| | - Arran Hamlet
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
| | - Kris A Murray
- MRC Centre for Global Infectious Disease Analysis, Department of Infectious Disease Epidemiology, School of Public Health, Imperial College London, London, UK
- MRC Unit The Gambia at London, School of Hygiene and Tropical Medicine, Atlantic Boulevard, Fajara, The Gambia
- Centre on Climate Change and Planetary Health, London School of Hygiene & Tropical Medicine, London, UK
| |
Collapse
|
26
|
Abate A, Assefa M, Golassa L. Five-Year Trend of Malaria Prevalence in Mojo Town, Central Ethiopia: Shifting Burden of the Disease and Its Implication for Malaria Elimination: A Retrospective Study. Infect Drug Resist 2022; 15:455-464. [PMID: 35177912 PMCID: PMC8846561 DOI: 10.2147/idr.s348203] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 02/05/2022] [Indexed: 12/16/2022] Open
Abstract
Introduction Malaria continues to strike hardest against the health and economic development in Ethiopia. The peak of malaria incidence follows the main rainfall season in each year; however, its transmission tends to be highly heterogeneous within or between years and from area to area. Thus, this study was aimed to determine the trend prevalence of malaria in Mojo town, central Ethiopia. Methods A retrospective study was conducted in Mojo town, East Shoa zone, Ethiopia from February to March 2021. Malaria cases and related data documented between 2016 and 2020 were carefully reviewed from laboratory registration logbooks. The collected data were analyzed using descriptive statistics. Results A total of 19,106 blood films were examined from malaria-suspected patients. The overall microscopically confirmed prevalence of malaria was 4.2% (793/19,106). Plasmodium vivax was the predominant species accounting for 76.2% (604/793) of positive samples. Malaria cases declined from 259 in 2016 to 77 in 2020. The proportion of malaria was higher among males (64.8%, 514/793) than females (35.2%, 279/793) (P < 0.0001). Higher malaria cases were observed from the age group 15–24 years followed by the age group of 25–34 (P < 0.0001). The number of malaria cases was at a high level from September to November and lowest from December to February. Conclusion Despite a declining trend of malaria prevalence, it remains a public health burden in the area. P. vivax, the predominant species, should get attention during prevention and control strategies for the successful progress of the malaria elimination program.
Collapse
Affiliation(s)
- Andargie Abate
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Correspondence: Andargie Abate, Email
| | - Mesfin Assefa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
- College of Medicine and Health Sciences, Wachamo University, Hossaena, Ethiopia
| | - Lemu Golassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| |
Collapse
|
27
|
Agins B, Case P, Chandramohan D, Chen I, Chikodzore R, Chitapi P, Chung A, Gosling R, Gosling J, Gumbi M, Ikeda D, Madinga M, Mnguni P, Murungu J, Gueye CS, Tulloch J, Viljoen G. Effective management of district-level malaria control and elimination: implementing quality and participative process improvements. BMC Public Health 2022; 22:140. [PMID: 35057789 PMCID: PMC8772105 DOI: 10.1186/s12889-021-12322-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 11/28/2021] [Indexed: 11/10/2022] Open
Abstract
Although it is widely recognized that strong program management is essential to achieving better health outcomes, this priority is not recognized in malaria programmatic practices. Increased management precision offers the opportunity to improve the effectiveness of malaria interventions, overcoming operational barriers to intervention coverage and accelerating the path to elimination. Here we propose a combined approach involving quality improvement, quality management, and participative process improvement, which we refer to as Combined Quality and Process Improvement (CQPI), to improve upon malaria program management. We draw on evidence from other areas of public health, as well as pilot implementation studies in Eswatini, Namibia and Zimbabwe to support the proposal. Summaries of the methodological approaches employed in the pilot studies, overview of activities and an outline of lessons learned from the implementation of CQPI are provided. Our findings suggest that a malaria management strategy that prioritizes quality and participative process improvements at the district-level can strengthen teamwork and communication while enabling the empowerment of subnational staff to solve service delivery challenges. Despite the promise of CQPI, however, policy makers and donors are not aware of its potential. Investments are therefore needed to allow CQPI to come to fruition.
Collapse
Affiliation(s)
- Bruce Agins
- HEALTHQUAL, Institute of Global Health Sciences, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Peter Case
- Bristol Business School, University of West of England, Frenchay Campus, Coldharbour Lane, Bristol, BS16 1QY, UK
- College of Business, Law & Governance, James Cook University, Douglas, Australia
| | - Daniel Chandramohan
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK
| | - Ingrid Chen
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
- Malaria Elimination Initiative, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Rudo Chikodzore
- Ministry of Health and Child Care Matabeleland South Province, New Government Complex, Third Ave, Gwanda, Zimbabwe
| | - Precious Chitapi
- Precious Innovations, 11 Dougal Rd, The Grange, Harare, Zimbabwe
| | - Amanda Chung
- Malaria Elimination Initiative, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Roly Gosling
- Department of Epidemiology and Biostatistics, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
- Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel Street, London, WC1E 7HT, UK.
- Malaria Elimination Initiative, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA.
| | - Jonathan Gosling
- University of Exeter Business School, Rennes Dr, Exeter, EX4 4PU, UK
| | - Matsiliso Gumbi
- Ditsong Museums of South Africa, 70 WF Nkomo St, Pretoria, South Africa
| | - Daniel Ikeda
- HEALTHQUAL, Institute of Global Health Sciences, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Munashe Madinga
- Clinton Health Access Initiative, Mount Pleasant, Harare, Zimbabwe
| | - Peliwe Mnguni
- Gaduate School of Business Leadership, University of South Africa, Preller St, Muckleneuk, Pretoria, South Africa
| | - Joseph Murungu
- HEALTHQUAL, Institute of Global Health Sciences, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Cara Smith Gueye
- Malaria Elimination Initiative, University of California San Francisco, 550 16th Street, San Francisco, CA, 94158, USA
| | - Jim Tulloch
- Independent Consultant, GPO Box 1566, Adelaide, 5001, South Australia
| | - Greyling Viljoen
- Independent Consultant, 342 Albert Street, Waterkloof, Pretoria, South Africa
| |
Collapse
|
28
|
Simpson VL, Hass ZJ, Panchal J, McGowan B. Understanding the Development, Evaluation, and Sustainability of Community Health Networks Using Social Network Analysis: A Scoping Review. Am J Health Promot 2021; 36:318-327. [PMID: 34865522 DOI: 10.1177/08901171211045984] [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: 11/16/2022]
Abstract
OBJECTIVE Identify the scope of the literature which reports use of social network analysis to inform, support, or evaluate health promotion-focused community network/partnership development. DATA SOURCE A comprehensive search (not date-limited) of PubMed, CINAHL, Web of Science Core Collection, PsycInfo, and the Cochrane Library Database for Systematic Reviews. INCLUSION AND EXCLUSION CRITERIA Criteria for inclusion included published in the English language and used social network analysis to inform, support, or evaluate development of community networks/partnerships aiding health promotion efforts. Studies were excluded if they did not use social network analysis or were not focused upon health promotion. DATA EXTRACTION Three of the four authors extracted data using a summary chart to document information regarding study aims, target issue/population, methods, and key outcomes of the social network analysis. DATA SYNTHESIS The extracted data were qualitatively analyzed by 3 authors to categorize key social network analysis outcomes into categories. RESULTS Ninety-seven studies representing 9 geographical regions were included, with the majority (69) published after 2010. Key outcomes included the effectiveness of social network analysis to identify network characteristics, track network change over time, compare similar networks across locations, and correlate network attributes with outcomes. CONCLUSION Findings support the utility of social network analysis to inform, support, and evaluate development of sustainable health promotion-focused networks/partnerships.
Collapse
Affiliation(s)
| | - Zachary Joseph Hass
- Regenstrief Center for Healthcare Engineering Core Faculty, Schools of Nursing and Industrial Engineering, 311308Purdue University, West Lafayette, IN, USA
| | - Jitesh Panchal
- School of Mechanical Engineering, 311308Purdue University, West Lafayette, IN, USA
| | - Bethany McGowan
- Libraries and School of Information Studies, 311308Purdue University, West Lafayette, IN, USA
| |
Collapse
|
29
|
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
|
30
|
de Graeff N, Jongsma KR, Lunshof JE, Bredenoord AL. Governing Gene Drive Technologies: A Qualitative Interview Study. AJOB Empir Bioeth 2021; 13:107-124. [PMID: 34219621 DOI: 10.1080/23294515.2021.1941417] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Gene drive technologies (GDTs) bias the inheritance of a genetic element within a population of non-human organisms, promoting its progressive spread across this population. If successful, GDTs may be used to counter intractable problems such as vector-borne diseases. A key issue in the debate on GDTs relates to what governance is appropriate for these technologies. While governance mechanisms for GDTs are to a significant extent proposed and shaped by professional experts, the perspectives of these experts have not been explored in depth. METHODS A total of 33 GDT experts from different professional disciplines were interviewed to identify, better understand, and juxtapose their perspectives on GDT governance. The pseudonymized transcripts were analyzed thematically. RESULTS Three main themes were identified: (1) engagement of communities, stakeholders, and publics; (2) power dynamics, and (3) decision-making. There was broad consensus amongst respondents that it is important to engage communities, stakeholders, and publics. Nonetheless, respondents had diverging views on the reasons for doing so and the timing and design of engagement. Respondents also outlined complexities and challenges related to engagement. Moreover, they brought up the power dynamics that are present in GDT research. Respondents stressed the importance of preventing the recurrence of historical injustices and reflected on dilemmas regarding whether and to what extent (foreign) researchers can legitimately make demands regarding local governance. Finally, respondents had diverging views on whether decisions about GDTs should be made in the same way as decisions about other environmental interventions, and on the decision-making model that should be used to decide about GDT deployment. CONCLUSIONS The insights obtained in this interview study give rise to recommendations for the design and evaluation of GDT governance. Moreover, these insights point to unresolved normative questions that need to be addressed to move from general commitments to concrete obligations.
Collapse
Affiliation(s)
- N de Graeff
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Karin R Jongsma
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jeantine E Lunshof
- Wyss Institute for Biologically Inspired Engineering, Harvard University, Boston, Massachusetts, USA.,Department of Global Health and Social Medicine, Center for Bioethics, Harvard Medical School, Boston, Massachusetts, USA.,European Research Institute for the Biology of Ageing (ERIBA), University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Annelien L Bredenoord
- Department of Medical Humanities, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| |
Collapse
|
31
|
Akpodiete NO, Tripet F. Improvement of water quality for mass anopheline rearing: evaluation of the impact of ammonia-capturing zeolite on larval development and adult phenotypic quality. Parasit Vectors 2021; 14:268. [PMID: 34016175 PMCID: PMC8139152 DOI: 10.1186/s13071-021-04763-w] [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: 10/16/2020] [Accepted: 05/03/2021] [Indexed: 11/28/2022] Open
Abstract
Background Malaria vector control approaches that rely on mosquito releases such as the sterile insect technique (SIT) and suppression or replacement strategies relying on genetically modified mosquitoes (GMM) depend on effective mass production of Anopheles mosquitoes. Anophelines typically require relatively clean larval rearing water, and water management techniques that minimise toxic ammonia are key to achieving optimal rearing conditions in small and large rearing facilities. Zeolites are extensively used in closed-system fish aquaculture to improve water quality and reduce water consumption, thanks to their selective adsorption of ammonia and toxic heavy metals. The many advantages of zeolites include low cost, abundance in many parts of the world and environmental friendliness. However, so far, their potential benefit for mosquito rearing has not been evaluated. Methods This study evaluated the independent effects of zeolite and daily water changes (to simulate a continuous flow system) on the rearing of An. coluzzii under two feed regimes (powder and slurry feed) and larval densities (200 and 400 larvae per tray). The duration of larval development, adult emergence success and phenotypic quality (body size) were recorded to assess the impact of water treatments on mosquito numbers, phenotypic quality and identification of optimal feeding regimes and larval density for the use of zeolite. Results Overall, mosquito emergence, duration of development and adult phenotypic quality were significantly better in treatments with daily water changes. In treatments without daily water changes, zeolite significantly improved water quality at the lower larval rearing density, resulting in higher mosquito emergence and shorter development time. At the lower larval rearing density, the adult phenotypic quality did not significantly differ between zeolite treatment without water changes and those with daily changes. Conclusions These results suggest that treating rearing water with zeolite can improve mosquito production in smaller facilities. Zeolite could also offer cost-effective and environmentally friendly solutions for water recycling management systems in larger production facilities. Further studies are needed to optimise and assess the costs and benefits of such applications to Anopheles gambiae (s.l.) mosquito-rearing programmes. Graphic abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1186/s13071-021-04763-w.
Collapse
Affiliation(s)
- Nwamaka Oluchukwu Akpodiete
- Centre for Applied Entomology and Parasitology, School of Life Sciences, Keele University, Staffordshire, UK
| | - Frédéric Tripet
- Centre for Applied Entomology and Parasitology, School of Life Sciences, Keele University, Staffordshire, UK.
| |
Collapse
|
32
|
Jiang AL, Lee MC, Zhou G, Zhong D, Hawaria D, Kibret S, Yewhalaw D, Sanders BF, Yan G, Hsu K. Predicting distribution of malaria vector larval habitats in Ethiopia by integrating distributed hydrologic modeling with remotely sensed data. Sci Rep 2021; 11:10150. [PMID: 33980945 PMCID: PMC8115507 DOI: 10.1038/s41598-021-89576-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Accepted: 04/16/2021] [Indexed: 02/03/2023] Open
Abstract
Larval source management has gained renewed interest as a malaria control strategy in Africa but the widespread and transient nature of larval breeding sites poses a challenge to its implementation. To address this problem, we propose combining an integrated high resolution (50 m) distributed hydrological model and remotely sensed data to simulate potential malaria vector aquatic habitats. The novelty of our approach lies in its consideration of irrigation practices and its ability to resolve complex ponding processes that contribute to potential larval habitats. The simulation was performed for the year of 2018 using ParFlow-Common Land Model (CLM) in a sugarcane plantation in the Oromia region, Ethiopia to examine the effects of rainfall and irrigation. The model was calibrated using field observations of larval habitats to successfully predict ponding at all surveyed locations from the validation dataset. Results show that without irrigation, at least half of the area inside the farms had a 40% probability of potential larval habitat occurrence. With irrigation, the probability increased to 56%. Irrigation dampened the seasonality of the potential larval habitats such that the peak larval habitat occurrence window during the rainy season was extended into the dry season. Furthermore, the stability of the habitats was prolonged, with a significant shift from semi-permanent to permanent habitats. Our study provides a hydrological perspective on the impact of environmental modification on malaria vector ecology, which can potentially inform malaria control strategies through better water management.
Collapse
Affiliation(s)
- Ai-Ling Jiang
- Department of Civil and Environmental Engineering, University of California Irvine, Irvine, CA, USA.
| | - Ming-Chieh Lee
- Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Guofa Zhou
- Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Daibin Zhong
- Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Dawit Hawaria
- Yirgalem Hospital Medical College, Yirgalem, Ethiopia
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
| | - Solomon Kibret
- Program in Public Health, University of California Irvine, Irvine, CA, USA
| | - Delenasaw Yewhalaw
- Tropical and Infectious Diseases Research Center (TIDRC), Jimma University, Jimma, Ethiopia
- Department of Medical Laboratory Sciences, Institute of Health, Jimma University, Jimma, Ethiopia
| | - Brett F Sanders
- Department of Civil and Environmental Engineering, University of California Irvine, Irvine, CA, USA
- Department of Urban Planning and Public Policy, University of California Irvine, Irvine, CA, USA
| | - Guiyun Yan
- Program in Public Health, University of California Irvine, Irvine, CA, USA.
| | - Kuolin Hsu
- Department of Civil and Environmental Engineering, University of California Irvine, Irvine, CA, USA.
| |
Collapse
|
33
|
Ghazali SZ, Mohamed Noor NR, Mustaffa KMF. Anti-plasmodial activity of aqueous neem leaf extract mediated green synthesis-based silver nitrate nanoparticles. Prep Biochem Biotechnol 2021; 52:99-107. [PMID: 33890844 DOI: 10.1080/10826068.2021.1913602] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The objective of this study is to synthesize neem-silver nitrate nanoparticles (neem-AgNPs) using aqueous extracts of Azadirachta indica A. Juss for malaria therapy. Neem leaves collected from FRIM Malaysia were authenticated and extracted using Soxhlet extraction method. The extract was introduced to 1 mM of silver nitrate solution for neem-AgNPs synthesis. Synthesized AgNPs were further characterized by ultraviolet-visible spectroscopy and the electron-scanning microscopy. Meanwhile, for the anti-plasmodial activity of the neem-AgNPs, two lab-adapted Plasmodium falciparum strains, 3D7 (chloroquine-sensitive), and W2 (chloroquine-resistant) were tested. Red blood cells hemolysis was monitored to observe the effects of neem-AgNPs on normal and parasitized red blood cells. The synthesized neem-AgNPs were spherical in shape and showed a diameter range from 31-43 nm. When compared to aqueous neem leaves extract, the half inhibitory concentration (IC50) of the synthesized neem-AgNPs showed a four-fold IC50 decrease against both parasite strains with IC50 value of 40.920 µg/mL to 8.815 µg/mL for 3D7, and IC50 value of 98.770 µg/mL to 23.110 µg/mL on W2 strain. The hemolysis assay indicates that the synthesized neem-AgNPs and aqueous extract alone do not have hemolysis activity against normal and parasitized red blood cells. Therefore, this study shows the synthesized neem-AgNPs has a great potential to be used for malaria therapy.
Collapse
Affiliation(s)
- Siti Zulaiha Ghazali
- Institute of Research in Molecular Medicine, (INFORMM), Health Campus Universiti Sains Malaysia (USM), Kelantan, Malaysia
| | | | - Khairul Mohd Fadzli Mustaffa
- Institute of Research in Molecular Medicine, (INFORMM), Health Campus Universiti Sains Malaysia (USM), Kelantan, Malaysia
| |
Collapse
|
34
|
Baldé MA, Tuenter E, Traoré MS, Peeters L, Matheeussen A, Cos P, Caljon G, Vermeyen T, Herrebout W, Balde AM, Foubert K, Pieters L. Antiplasmodial Oleanane Triterpenoids from Terminalia albida Root Bark. JOURNAL OF NATURAL PRODUCTS 2021; 84:666-675. [PMID: 33667089 DOI: 10.1021/acs.jnatprod.0c01119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Phytochemical investigation of the n-BuOH extract of the roots of Terminalia albida Sc. Elliot (Combretaceae) led to the isolation and identification of 10 oleanane triterpenoids (1-10), among which six new compounds, i.e., albidanoside A (2), albidic acid A (4), albidinolic acid (5), albidienic acid (8), albidolic acid (9), and albidiolic acid (10), and two triterpenoid aglycones, i.e., albidic acid B (6) and albidic acid C (7), were isolated here for the first time from a natural source, along with two known compounds. The structures of these constituents were established by means of 1D and 2D NMR spectroscopy and ESI mass spectrometry. The isolated compounds were evaluated for their antiplasmodial and antimicrobial activity against the chloroquine-resistant strain Plasmodium falciparum K1, Candida albicans, and Staphylococcus aureus. Compounds 1-4, 6, 7, and 8 showed moderate antiplasmodial activity with IC50 values between 5 and 15 μM. None of the tested compounds were active against C. albicans or S. aureus. These findings emphasize the potential of T. albida as a source for discovery of new antiplasmodial compounds.
Collapse
Affiliation(s)
- Mamadou A Baldé
- Natural Products & Food Research and Analysis (NatuRA), Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Emmy Tuenter
- Natural Products & Food Research and Analysis (NatuRA), Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Mohamed S Traoré
- Department of Pharmacy, University Gamal Abdel Nasser of Conakry, BP 1017, Conakry, Guinea
- Research and Valorization Center on Medicinal Plants Dubreka, BP 6411, Conakry, Guinea
| | - Laura Peeters
- Natural Products & Food Research and Analysis (NatuRA), Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - An Matheeussen
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Paul Cos
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Guy Caljon
- Laboratory of Microbiology, Parasitology and Hygiene (LMPH), Faculty of Pharmaceutical, Biomedical and Veterinary Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Tom Vermeyen
- MolSpec Research Group, Department of Chemistry, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Wouter Herrebout
- MolSpec Research Group, Department of Chemistry, University of Antwerp, Groenenborgerlaan 171, 2020 Antwerp, Belgium
| | - Aliou M Balde
- Department of Pharmacy, University Gamal Abdel Nasser of Conakry, BP 1017, Conakry, Guinea
- Research and Valorization Center on Medicinal Plants Dubreka, BP 6411, Conakry, Guinea
| | - Kenn Foubert
- Natural Products & Food Research and Analysis (NatuRA), Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| | - Luc Pieters
- Natural Products & Food Research and Analysis (NatuRA), Department of Pharmaceutical Sciences, University of Antwerp, Universiteitsplein 1, B-2610 Antwerp, Belgium
| |
Collapse
|
35
|
Chakrabarti M, Joshi N, Kumari G, Singh P, Shoaib R, Munjal A, Kumar V, Behl A, Abid M, Garg S, Gupta S, Singh S. Interaction of Plasmodium falciparum apicortin with α- and β-tubulin is critical for parasite growth and survival. Sci Rep 2021; 11:4688. [PMID: 33633135 PMCID: PMC7907060 DOI: 10.1038/s41598-021-83513-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 12/16/2020] [Indexed: 01/31/2023] Open
Abstract
Cytoskeletal structures of Apicomplexan parasites are important for parasite replication, motility, invasion to the host cell and survival. Apicortin, an Apicomplexan specific protein appears to be a crucial factor in maintaining stability of the parasite cytoskeletal assemblies. However, the function of apicortin, in terms of interaction with microtubules still remains elusive. Herein, we have attempted to elucidate the function of Plasmodium falciparum apicortin by monitoring its interaction with two main components of parasite microtubular structure, α-tubulin-I and β-tubulin through in silico and in vitro studies. Further, a p25 domain binding generic drug Tamoxifen (TMX), was used to disrupt PfApicortin-tubulin interactions which led to the inhibition in growth and progression of blood stage life cycle of P. falciparum.
Collapse
Affiliation(s)
- Malabika Chakrabarti
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Nishant Joshi
- grid.410868.30000 0004 1781 342XDepartment of Life Sciences, School of Natural Sciences, Shiv Nadar University, Gautam Budh Nagar, Noida, 201314 UP India
| | - Geeta Kumari
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Preeti Singh
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Rumaisha Shoaib
- grid.411818.50000 0004 0498 8255Medicinal Chemistry Laboratory, Department of Biosciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
| | - Akshay Munjal
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Vikash Kumar
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Ankita Behl
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Mohammad Abid
- grid.411818.50000 0004 0498 8255Medicinal Chemistry Laboratory, Department of Biosciences, Jamia Millia Islamia, Jamia Nagar, New Delhi, 110025 India
| | - Swati Garg
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Sonal Gupta
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India
| | - Shailja Singh
- grid.10706.300000 0004 0498 924XSpecial Centre for Molecular Medicine, Jawaharlal Nehru University, New Delhi, 110067 India ,grid.410868.30000 0004 1781 342XDepartment of Life Sciences, School of Natural Sciences, Shiv Nadar University, Gautam Budh Nagar, Noida, 201314 UP India
| |
Collapse
|
36
|
Enguita-Fernàndez C, Alonso Y, Lusengi W, Mayembe A, Manun'Ebo MF, Ranaivontiavina S, Rasoamananjaranahary AM, Mucavele E, Macete E, Nwankwo O, Meremikwu M, Roman E, Pagnoni F, Menéndez C, Munguambe K. Trust, community health workers and delivery of intermittent preventive treatment of malaria in pregnancy: a comparative qualitative analysis of four sub-Saharan countries. Glob Public Health 2020; 16:1889-1903. [PMID: 33290172 DOI: 10.1080/17441692.2020.1851742] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This qualitative study is part of a project aiming to evaluate a community-based approach to the delivery of intermittent preventive treatment of malaria in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP) through community health workers (CHWs) in four sub-Saharan African countries: the Democratic Republic of Congo (DRC), Madagascar, Mozambique and Nigeria. The study aimed to understand the factors that influence the anticipated acceptability of this intervention. A total of 216 in-depth interviews and 62 focus group discussions were carried out in the four country sites with pregnant women, women of reproductive age, community leaders, pregnant women's relatives, CHWs, formal and informal health providers. Grounded theory guided the study design and data collection, and content and thematic analysis was performed through a comparative lens. This paper focuses on one crosscutting theme: trust-building. Two mechanisms that underpin communities' trust in delivery of IPTp via CHWs were identified: 'perceived competence' and 'community and healthcare system integration'. Communities' perception of CHWs' competence shapes their trust in them, which suggests that CHWs' credentials should be made public and that specialised training in maternal health is required for them. Integration depends on the promotion of socially embedded practices and the involvement of formal healthcare systems in CHWs' work.
Collapse
Affiliation(s)
| | - Yara Alonso
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Wade Lusengi
- Bureau d'Étude et de Gestion de l'Information Statistique (BÉGIS), Kinshasa, DRC
| | - Alain Mayembe
- Bureau d'Étude et de Gestion de l'Information Statistique (BÉGIS), Kinshasa, DRC
| | - Manu F Manun'Ebo
- Bureau d'Étude et de Gestion de l'Information Statistique (BÉGIS), Kinshasa, DRC
| | - Sylviane Ranaivontiavina
- Malagasy Associates for Numerical Information and Statistical Analysis (MANISA), Antananarivo, Madagascar
| | | | - Estêvão Mucavele
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Eusebio Macete
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Ogonna Nwankwo
- Department of Community Medicine, University of Calabar, Calabar, Cross River State, Nigeria
| | - Martin Meremikwu
- Cross River Health and Demographic Surveillance System, University of Calabar, Cross River State, Nigeria
| | - Elaine Roman
- Jhpiego, affiliate of Johns Hopkins University, Baltimore, Maryland, USA
| | - Franco Pagnoni
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain
| | - Clara Menéndez
- ISGlobal, Hospital Clínic - Universitat de Barcelona, Barcelona, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP)
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique.,Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique
| |
Collapse
|
37
|
Smit C, Peeters MYM, van den Anker JN, Knibbe CAJ. Chloroquine for SARS-CoV-2: Implications of Its Unique Pharmacokinetic and Safety Properties. Clin Pharmacokinet 2020; 59:659-669. [PMID: 32306288 PMCID: PMC7165255 DOI: 10.1007/s40262-020-00891-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Since in vitro studies and a preliminary clinical report suggested the efficacy of chloroquine for COVID-19-associated pneumonia, there is increasing interest in this old antimalarial drug. In this article, we discuss the pharmacokinetics and safety of chloroquine that should be considered in light of use in SARS-CoV-2 infections. Chloroquine is well absorbed and distributes extensively resulting in a large volume of distribution with an apparent and terminal half-life of 1.6 days and 2 weeks, respectively. Chloroquine is metabolized by cytochrome P450 and renal clearance is responsible for one third of total clearance. The lack of reliable information on target concentrations or doses for COVID-19 implies that for both adults and children, doses that proved effective and safe in malaria should be considered, such as 'loading doses' in adults (30 mg/kg over 48 h) and children (70 mg/kg over 5 days), which reported good tolerability. Here, plasma concentrations were < 2.5 μmol/L, which is associated with (minor) toxicity. While the influence of renal dysfunction, critical illness, or obesity seems small, in critically ill patients, reduced absorption may be anticipated. Clinical experience has shown that chloroquine has a narrow safety margin, as three times the adult therapeutic dosage for malaria can be lethal when given as a single dose. Although infrequent, poisoning in children is extremely dangerous where one to two tablets can potentially be fatal. In conclusion, the pharmacokinetic and safety properties of chloroquine suggest that chloroquine can be used safely for an acute virus infection, under corrected QT monitoring, but also that the safety margin is small, particularly in children.
Collapse
Affiliation(s)
- Cornelis Smit
- Pediatric Pharmacology and Pharmacometrics Research Center, University of Basel Children's Hospital, Basel, Switzerland
- Department of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands
| | - Mariska Y M Peeters
- Department of Clinical Pharmacy, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands
| | - John N van den Anker
- Pediatric Pharmacology and Pharmacometrics Research Center, University of Basel Children's Hospital, Basel, Switzerland
- Division of Clinical Pharmacology, Children's National Hospital, Washington, DC, USA
| | - Catherijne A J Knibbe
- Department of Systems Biomedicine and Pharmacology, Leiden Academic Centre for Drug Research, Leiden University, Leiden, The Netherlands.
- Department of Clinical Pharmacy, St. Antonius Hospital, Koekoekslaan 1, 3435 CM, Nieuwegein, The Netherlands.
| |
Collapse
|