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Cryopreservation of Plasmodium Sporozoites. Pathogens 2022; 11:pathogens11121487. [PMID: 36558821 PMCID: PMC9784981 DOI: 10.3390/pathogens11121487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/28/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022] Open
Abstract
Malaria is a deadly disease caused by the parasite, Plasmodium, and impacts the lives of millions of people around the world. Following inoculation into mammalian hosts by infected mosquitoes, the sporozoite stage of Plasmodium undergoes obligate development in the liver before infecting erythrocytes and causing clinical malaria. The most promising vaccine candidates for malaria rely on the use of attenuated live sporozoites to induce protective immune responses. The scope of widespread testing or clinical use of such vaccines is limited by the absence of efficient, reliable, or transparent strategies for the long-term preservation of live sporozoites. Here we outline a method to cryopreserve the sporozoites of various human and murine Plasmodium species. We found that the structural integrity, viability, and in vivo or in vitro infectiousness were conserved in the recovered cryopreserved sporozoites. Cryopreservation using our approach also retained the transgenic properties of sporozoites and immunization with cryopreserved radiation attenuated sporozoites (RAS) elicited strong immune responses. Our work offers a reliable protocol for the long-term storage and recovery of human and murine Plasmodium sporozoites and lays the groundwork for the widespread use of live sporozoites for research and clinical applications.
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Aydemir O, Mensah B, Marsh PW, Abuaku B, Myers-Hansen JL, Bailey JA, Ghansah A. Immediate pools of malaria infections at diagnosis combined with targeted deep sequencing accurately quantifies frequency of drug resistance mutations. PeerJ 2021; 9:e11794. [PMID: 34820155 PMCID: PMC8588852 DOI: 10.7717/peerj.11794] [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: 12/09/2020] [Accepted: 06/25/2021] [Indexed: 12/03/2022] Open
Abstract
Antimalarial resistance surveillance in sub-Saharan Africa is often constrained by logistical and financial challenges limiting its breadth and frequency. At two sites in Ghana, we have piloted a streamlined sample pooling process created immediately by sequential addition of positive malaria cases at the time of diagnostic testing. This streamlined process involving a single tube minimized clinical and laboratory work and provided accurate frequencies of all known drug resistance mutations after high-throughput targeted sequencing using molecular inversion probes. Our study validates this method as a cost-efficient, accurate and highly-scalable approach for drug resistance mutation monitoring that can potentially be applied to other infectious diseases such as tuberculosis.
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Affiliation(s)
- Ozkan Aydemir
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Brown University, Providence, RI, United States of America
| | - Benedicta Mensah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Patrick W Marsh
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Brown University, Providence, RI, United States of America
| | - Benjamin Abuaku
- Department of Epidemiology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - James Leslie Myers-Hansen
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
| | - Jeffrey A Bailey
- Department of Pathology and Laboratory Medicine, Warren Alpert Medical School, Brown University, Brown University, Providence, RI, United States of America
| | - Anita Ghansah
- Department of Parasitology, Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, Accra, Ghana
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Maiga H, Grivoyannis A, Sagara I, Traore K, Traore OB, Tolo Y, Traore A, Bamadio A, Traore ZI, Sanogo K, Doumbo OK, Plowe CV, Djimde AA. Selection of pfcrt K76 and pfmdr1 N86 Coding Alleles after Uncomplicated Malaria Treatment by Artemether-Lumefantrine in Mali. Int J Mol Sci 2021; 22:ijms22116057. [PMID: 34205228 PMCID: PMC8200001 DOI: 10.3390/ijms22116057] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 03/18/2021] [Accepted: 03/19/2021] [Indexed: 11/18/2022] Open
Abstract
Background: Artemether-lumefantrine is a highly effective artemisinin-based combination therapy that was adopted in Mali as first-line treatment for uncomplicated Plasmodium falciparum malaria. This study was designed to measure the efficacy of artemether-lumefantrine and to assess the selection of the P. falciparum chloroquine resistance transporter (pfcrt) and P. falciparum multi-drug resistance 1 (pfmdr1) genotypes that have been associated with drug resistance. Methods: A 28-day follow-up efficacy trial of artemether-lumefantrine was conducted in patients aged 6 months and older suffering from uncomplicated falciparum malaria in four different Malian areas during the 2009 malaria transmission season. The polymorphic genetic markers MSP2, MSP1, and Ca1 were used to distinguish between recrudescence and reinfection. Reinfection and recrudescence were then grouped as recurrent infections and analyzed together by PCR-restriction fragment length polymorphism (RFLP) to identify candidate markers for artemether-lumefantrine tolerance in the P. falciparum chloroquine resistance transporter (pfcrt) gene and the P. falciparum multi-drug resistance 1 (pfmdr1) gene. Results: Clinical outcomes in 326 patients (96.7%) were analyzed and the 28-day uncorrected adequate clinical and parasitological response (ACPR) rate was 73.9%. The total PCR-corrected 28-day ACPR was 97.2%. The pfcrt 76T and pfmdr1 86Y population prevalence decreased from 49.3% and 11.0% at baseline (n = 337) to 38.8% and 0% in patients with recurrent infection (n = 85); p = 0.001), respectively. Conclusion: Parasite populations exposed to artemether-lumefantrine in this study were selected toward chloroquine-sensitivity and showed a promising trend that may warrant future targeted reintroduction of chloroquine or/and amodiaquine.
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Affiliation(s)
- Hamma Maiga
- Institut National de Sante Publique, INSP, Bamako P.O. Box 1771, Mali;
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | | | - Issaka Sagara
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Karim Traore
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Oumar B. Traore
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Youssouf Tolo
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Aliou Traore
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Amadou Bamadio
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Zoumana I. Traore
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Kassim Sanogo
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | - Ogobara K. Doumbo
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
| | | | - Abdoulaye A. Djimde
- Malaria Research & Training Center, Department of Epidemiology of Parasitic Diseases, Faculty of Pharmacy, Faculty of Medicine and Dentistry, University of Sciences, Techniques and Technologies of Bamako, Bamako P.O. Box 1805, Mali; (I.S.); (K.T.); (O.B.T.); (Y.T.); (A.T.); (A.B.); (Z.I.T.); (K.S.); (O.K.D.)
- Correspondence: ; Tel.: +223-2022-8109
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Kishoyian G, Njagi ENM, Orinda GO, Kimani FT, Thiongo K, Matoke-Muhia D. Efficacy of artemisinin-lumefantrine for treatment of uncomplicated malaria after more than a decade of its use in Kenya. Epidemiol Infect 2021; 149:e27. [PMID: 33397548 PMCID: PMC8057502 DOI: 10.1017/s0950268820003167] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND The resistance of Plasmodium falciparum to antimalarial drugs remains a major impairment in the treatment and eradication of malaria globally. Following the introduction of artemisinin-based combination therapy (ACT), there have been reports of delayed parasite clearance. In Kenya, artemether-lumefantrine (AL) is the recommended first-line treatment of uncomplicated malaria. This study sought to assess the efficacy of AL after a decade of use as the preferred method of managing malarial infections in Kenya. We assessed clinical and parasitological responses of children under 5 years between May and November 2015 in Chulaimbo sub-County, Kisumu, Kenya. Patients aged between 6 and 60 months with uncomplicated P. falciparum mono-infection, confirmed through microscopy, were enrolled in the study. The patients were admitted at the facility for 3 days, treated with a standard dose of AL, and then put under observation for the next 28 days for the assessment of clinical and parasitological responses. Of the 90 patients enrolled, 14 were lost to follow-up while 76 were followed through to the end of the study period. Seventy-five patients (98.7%) cleared the parasitaemia within a period of 48 h while one patient (1.3%) cleared on day 3. There was 100% adequate clinical and parasitological response. All the patients cleared the parasites on day 3 and there were no re-infections observed during the stated follow-up period. This study, therefore, concludes that AL is highly efficacious in clearing P. falciparum parasites in children aged ≥6 and ≤60 months. The study, however, underscores the need for continued monitoring of the drug to forestall both gradual ineffectiveness and possible resistance to the drug in all target users.
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Affiliation(s)
- Gabriel Kishoyian
- Department of Medical Laboratory Sciences, Kenya Medical Training College, P.O. Box2268-40100, Kisumu, Kenya
| | - Eliud N. M. Njagi
- Department of Biochemistry and Biotechnology, Kenyatta University, P.O.BOX 43844-00100, Nairobi, Kenya
| | - George O. Orinda
- Department of Biochemistry and Biotechnology, Kenyatta University, P.O.BOX 43844-00100, Nairobi, Kenya
| | - Francis T. Kimani
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Kevin Thiongo
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
| | - Damaris Matoke-Muhia
- Centre for Biotechnology Research and Development, Kenya Medical Research Institute, P.O. Box 54840-00200, Nairobi, Kenya
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Therapeutic Efficacy of Artemether-Lumefantrine (Coartem®) for the Treatment of Uncomplicated Falciparum Malaria in Africa: A Systematic Review. J Parasitol Res 2020; 2020:7371681. [PMID: 33145101 PMCID: PMC7599419 DOI: 10.1155/2020/7371681] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 09/09/2020] [Accepted: 09/22/2020] [Indexed: 12/18/2022] Open
Abstract
Background Africa still bears the largest burden of malaria as the majority of infections in the continent are caused by P. falciparum. Artemether-lumefantrine (AL, Coartem®) is the most widely used artemisinin-based combination therapy (ACT), for treating uncomplicated falciparum malaria globally. However, the development of resistance to antimalarial drugs is a major challenge for malaria control. In this review, the efficacy of AL for the treatment of uncomplicated falciparum malaria in Africa was evaluated. Methods Articles published between January 2015 and July 2019 were systematically searched using comprehensive search strings from PubMed/Medline, SCOPUS, and grey literature from Google Scholar. Interventional studies that followed patients for at least 28 days were included. Two reviewers independently assessed study eligibility, extracted data, and assessed risk of bias. All the included articles were measured to be good quality. While computing the efficacy of AL, polymerase chain reaction (PCR)–corrected cure rate (adequate clinical and parasitological response, ACPR) at day 28 was considered as the main endpoint. Meta-analysis was computed using STATA v 15 to calculate the pooled ACPR. Results In this review, 39 articles that reported the treatment outcome of 8,320 patients were included. After 28 days of follow-up, the pooled PCR uncorrected and corrected APCR was at 87% (95% CI: 85-90%) and 97.0% (95% CI: 96-98%), respectively. Moreover, the proportion of early treatment failure (ETF) was almost 0%, while most of the included articles reported <8% late treatment failures. The reinfection and recrudescence rate was less than 10% and 2.6%, respectively, within 28 days. We noted rapid fever and parasite clearance in which greater than 93% and 94% patients were parasite and fever free at day three following AL treatment. Conclusions This review discovered that despite more than a decade since its introduction, Coartem® remains effective and thus could continue to be the drug of choice for the treatment of uncomplicated falciparum malaria for all age groups in Africa. However, the risk of new emerging resistance for this combination warrants regular monitoring of its efficacy across the continent.
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Rout S, Mahapatra RK. Plasmodium falciparum: Multidrug resistance. Chem Biol Drug Des 2019; 93:737-759. [DOI: 10.1111/cbdd.13484] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/05/2019] [Accepted: 01/09/2019] [Indexed: 12/25/2022]
Affiliation(s)
- Subhashree Rout
- School of BiotechnologyKIIT University Bhubaneswar Odisha India
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Towards elimination of schistosomiasis after 5000 years of endemicity in Egypt. Acta Trop 2018; 181:112-121. [PMID: 29453950 DOI: 10.1016/j.actatropica.2018.02.005] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/29/2018] [Accepted: 02/11/2018] [Indexed: 11/21/2022]
Abstract
Schistosomiasis is a snail-transmitted infectious disease caused by a long lasting infection with a blood fluke of the genus Schistosoma. S. haematobium and S. mansoni are the species endemic in Egypt. The country has been plagued and seriously suffered from schistosomiasis over the past 5000 years. Great strides had been done in controlling the disease since 1922. The history, epidemiology and the different control approaches were reviewed. Currently, Egypt is preparing towards schistosomiasis elimination by 2020. The new strategy depends on four main axes; large scale treatment in all areas of residual transmission by targeting entire populations with PZQ, intensified snail control, heath education and behavioral changes and expansion of the complementary public health interventions. While on the road towards elimination, we addressed here the important challenges, lessons and the key issues from the different control strategies to help the achievement of our goal. Notably, frangibility of the drug based control, emergence of resistance against PZQ, persistence of some hot spots areas, the need of further control efforts to the high risk individuals and community involvement in the control programs, reconsideration of diagnostic tests used in surveillance, and continous monitoring of the field to detect changes in the snail intermediate host. Importantly, the adaptation between the parasite and its intermediate snail host throughout water bodies in Egypt merits attention as Schistosoma infection can be introduced to the new reclaimed areas. This review may help supplying information for the policy makers to tailor control measures suitable to the local context that could help in the transfer from control to elimination.
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Ganfon H, Ekanmian G, Amoussou L, Daniel-Garcia E, Allabi AC. Evaluation of the knowledge and attitude of pharmacists about the national malaria control policy in southern Benin. Malar J 2017; 16:231. [PMID: 28569154 PMCID: PMC5452350 DOI: 10.1186/s12936-017-1880-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 05/26/2017] [Indexed: 11/17/2022] Open
Abstract
Background The national strategy against malaria in an endemic country should involve all the health stakeholders. In Benin, the private sector is rarely present in the activities of the National Malaria Control Programme (NMCP), and its surveillance system does not cover private sector outlets that are a non-negligible part of the healthcare system. Objective The aim of this study was to describe the drug delivery practices within private pharmacies of Cotonou and Porto-Novo and the awareness of medicine providers concerning the national policy of malaria treatment. Methods A survey was performed among pharmacy staff members responsible for dispensing medicines and providing advice to patients within pharmacies of Cotonou and Porto-Novo. Dispensing/pharmacy assistants (‘dispensators’) from 82 pharmacies in Cotonou and 19 in Porto-Novo were surveyed. Data entry was performed using Epidata 3.1 software and data analysis was carried out using SPSS software version 21.1. Chi square test was used to compare proportions. A significance threshold of 0.05 was defined for the p value. Results 46% of providers did not know the artemisinin-based combination therapy recommended by the NMCP for treating uncomplicated malaria. 58.7% were not able to recognize the gravity signs of malaria. 89.8% of dispensators were used to deliver an anti-malarial upon patient request, without prior biological confirmation as requested by the NMCP policy. Conclusions Dispensing practices within the studied pharmacies from Cotonou and Porto-Novo were not in adequacy with the NMCP guidelines for uncomplicated malaria, which is a striking weakness in the training of drug providers on key elements of the guidelines for managing malaria. The NMCP needs to help dispensator from private pharmacies sector to standardize drug delivery practices according to its guidelines.
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Affiliation(s)
- Habib Ganfon
- Unité de formation et de recherche en Pharmacie, Faculté des Sciences de la Santé (FSS), Université d'Abomey-Calavi, 01 BP 188, Cotonou, Benin.,Centre d'Information Pharmaco-thérapeutique du Bénin, 06 BP 2610, Cotonou, Benin.,Réseau Médicament et Développement (ReMeD), 35 Rue Daviel, 75013, Paris, France
| | - Giraud Ekanmian
- Centre d'Information Pharmaco-thérapeutique du Bénin, 06 BP 2610, Cotonou, Benin.
| | - Louis Amoussou
- Unité de formation et de recherche en Pharmacie, Faculté des Sciences de la Santé (FSS), Université d'Abomey-Calavi, 01 BP 188, Cotonou, Benin
| | | | - Aurel Constant Allabi
- Unité de formation et de recherche en Pharmacie, Faculté des Sciences de la Santé (FSS), Université d'Abomey-Calavi, 01 BP 188, Cotonou, Benin
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Yang Y, Yu Y, Li X, Li J, Wu Y, Yu J, Ge J, Huang Z, Jiang L, Rao Y, Yang M. Target Elucidation by Cocrystal Structures of NADH-Ubiquinone Oxidoreductase of Plasmodium falciparum (PfNDH2) with Small Molecule To Eliminate Drug-Resistant Malaria. J Med Chem 2017; 60:1994-2005. [DOI: 10.1021/acs.jmedchem.6b01733] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Yiqing Yang
- MOE
Key Laboratory of Protein Sciences, School of Pharmaceutical Sciences, Tsinghua University, Beijing 100084, China
- MOE
Key Laboratory of Protein Sciences, Tsinghua-Peking Center for Life
Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - You Yu
- MOE
Key Laboratory of Protein Sciences, Tsinghua-Peking Center for Life
Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - Xiaolu Li
- Department
of Biochemistry and Molecular Biology, State Key Laboratory of Medical
Molecular Biology, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100005, China
| | - Jing Li
- MOE
Key Laboratory of Protein Sciences, Tsinghua-Peking Center for Life
Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - Yue Wu
- MOE
Key Laboratory of Protein Sciences, School of Pharmaceutical Sciences, Tsinghua University, Beijing 100084, China
| | - Jie Yu
- MOE
Key Laboratory of Protein Sciences, Tsinghua-Peking Center for Life
Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - Jingpeng Ge
- MOE
Key Laboratory of Protein Sciences, Tsinghua-Peking Center for Life
Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China
| | - Zhenghui Huang
- Institut Pasteur of Shanghai, CAS Key Laboratory of Molecular Virology and Immunology, Chinese Academy of Sciences, Shanghai 200031, China
| | - Lubin Jiang
- Institut Pasteur of Shanghai, CAS Key Laboratory of Molecular Virology and Immunology, Chinese Academy of Sciences, Shanghai 200031, China
| | - Yu Rao
- MOE
Key Laboratory of Protein Sciences, School of Pharmaceutical Sciences, Tsinghua University, Beijing 100084, China
| | - Maojun Yang
- MOE
Key Laboratory of Protein Sciences, Tsinghua-Peking Center for Life
Sciences, School of Life Sciences, Tsinghua University, Beijing 100084, China
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Lover AA, Gosling R, Feachem R, Tulloch J. Eliminate now: seven critical actions required to accelerate elimination of Plasmodium falciparum malaria in the Greater Mekong Subregion. Malar J 2016; 15:518. [PMID: 27769285 PMCID: PMC5073706 DOI: 10.1186/s12936-016-1564-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2016] [Accepted: 10/07/2016] [Indexed: 02/03/2023] Open
Abstract
The emergence in 2009 of Plasmodium falciparum parasites resistant to the primary therapies currently in use (artemisinin-based combination therapy, ACT) in Southeast Asia threatens to set back decades of global progress in malaria control and elimination. Progress to date through multiple sets of initiatives and partners to contain or eliminate these parasites has been hampered due to a wide range of organizational, financial, and health systems-level challenges. In this commentary, a set of seven specific and concrete actions are proposed to directly address these issues and to accelerate P. falciparum elimination within the Greater Mekong Subregion to avert a wider public health crisis. These actions are specifically needed to elevate the situation and response mechanisms to those of a true emergency; to address systems-level challenges with personnel limitations and stock-outs of key commodities; and to restructure the response mechanisms to be well-aligned with the required outcomes. Consideration of these issues is especially pressing with planning meetings for renewal of the Regional Artemisinin-resistance Initiative (RAI) framework slated for late 2016 and into 2017, but these suggestions are also relevant for malaria programmes globally.
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Affiliation(s)
- Andrew A Lover
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, USA.
| | - Roly Gosling
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, USA
| | - Richard Feachem
- Malaria Elimination Initiative, Global Health Group, University of California, San Francisco, USA
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Prophylactic effect of artemether on human schistosomiasis mansoni among Egyptian children: A randomized controlled trial. Acta Trop 2016; 158:52-58. [PMID: 26921676 DOI: 10.1016/j.actatropica.2016.02.015] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2015] [Revised: 02/15/2016] [Accepted: 02/21/2016] [Indexed: 11/23/2022]
Abstract
A double-blind, randomized controlled trial was conducted in an endemic focus for Schistosoma mansoni in Kafr El-Sheikh Governorate, Northern Nile Delta, Egypt, to evaluate the prophylactic effect of artemether (ART) given in conjunction with praziquantel (PZQ). The study encompassed 913 primary school children randomly assigned to two treatment groups PZQ/ART and PZQ/ART-placebo. At baseline, both groups received 40 mg/kg body weight of PZQ twice four weeks apart, after which one group received 6 mg/kg body weight of ART every 3 weeks in 5 cycles during the transmission season and the other group received ART-placebo. At the end of the study, prevalence of infection among the PZQ/ART was approximately half that of the PZQ/ART-placebo group, i.e. 6.7% versus 11.6%, and incidence of new infections for the PZQ/ART was 2.7% versus 6.5% for the PZQ/ART-placebo. In conclusion, PZQ/ART combined therapy might be considered as an adjunct measure against human schistosomiasis, by specifically reducing transmission and therefore contribute to disease elimination.
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