MalariaWorld journal最新文献

{"title":"Assessment of competence of participants before and after 7-day intensive malaria microscopy training courses in Nigeria.","authors":"Yetunde A Olukosi, Chimere O Agomo, Oluwagbemiga O Aina, Samuel K Akindele, Hilary I Okoh, Margaret O Akinyele, Olusola Ajibaye, Bassey A Orok, Bamidele A Iwalokun, Veronica Enya, Uche T Igbasi, Samson Awolola","doi":"10.5281/zenodo.10870129","DOIUrl":"10.5281/zenodo.10870129","url":null,"abstract":"<p><strong>Background: </strong>The accuracy of malaria diagnosis by microscopy has been a challenge in health facilities in Nigeria due to poor competence of microscopists and inability to report on malaria species other than <i>Plasmodium falciparum.</i> Short microscopy courses were conducted to improve the skills of laboratory personnel to perform malaria microscopy in public health facilities in Nigeria.</p><p><strong>Materials and methods: </strong>Seven-day malaria microscopy courses were conducted annually between 2011 and 2013 for microscopists in public health facilities. The training courses contained theoretical and practical sessions. Impact of the training was evaluated by practical and theoretical pre- and post-training assessments on malaria slide reading, parasite enumeration and basic malariology.</p><p><strong>Results: </strong>The 102 participants who completed the training consisted of medical laboratory scientists (62; 60.8%), medical laboratory technicians (24; 23.5%) and other healthcare workers (16; 15.7%). The knowledge of basic malariology (theory) at pre- and post-tests were 34% (95% CI 31.7-36.3%) and 74.9% (95% CI 71.8-78.0%), respectively (P<0.001). The mean slide reading detection, species and counting agreements in pre-training assessment were 48.9%, 27.9% and 0%, respectively, and in post-training 56.8%, 39.2% and 25%, respectively. The mean species agreements in picture test pre- and post-training were 21.9% and 55.1%, respectively. There were significant differences (P<0.05) in the median pre-test scores in picture tests and basic malariology of the three categories of participants but not in malaria slide reading and parasite counting tests. However, post-training, a significant difference in test scores of the three categories of participants was recorded only for basic malariology (P=0.0003).</p><p><strong>Conclusions: </strong>The 7-day malaria microscopy courses significantly increased the knowledge and microscopy skills of the trainees and were sufficient to bridge the significant difference in baseline microscopy skills of the different categories of trainees that participated in the training courses.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"6 ","pages":"6"},"PeriodicalIF":0.0,"publicationDate":"2015-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107866/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of the Affordable Medicines Facility for malaria (AMFm) on the availability of antimalarials in Nigeria.","authors":"Arinola Joda, Nnenna Ezeigwe, Lilian Oguguo, Ogori Taylor, Godwin Ntadom","doi":"10.5281/zenodo.10870095","DOIUrl":"10.5281/zenodo.10870095","url":null,"abstract":"<p><strong>Background: </strong>Malaria is one of the most important causes of mortality worldwide. Use of the most effective treatments remains inadequate for those in need and there is concern over the emergence of resistance. Rapid, accurate and accessible detection of malaria parasites plays a role in promoting more rational use of increasingly costly drugs in many endemic areas. Rapid diagnostic tests (RDTs) offer the potential to provide accurate diagnosis to all at-risk populations for the first time, reaching those unable to access good quality microscopy services. In 2010, the Global Fund launched the Affordable Medicines Facility for malaria (AMFm) designed to increase access and use of good quality artemisinin-based combination therapies (ACTs) for malaria treatment. AMFm involves manufacturer price negotiations, subsidies and other interventions. The aim of this study was to document the availability of ACTs and RDTs provided under the National Malaria Elimination Programme via the AMFm financing strategy.</p><p><strong>Materials and methods: </strong>Investigators were systematically selected and trained on the data collection tool from the World Health Organization/Health Action International (WHO/HAI) Workbook. Data was collected from public and private facilities in 12 states in the six geopolitical zones of Nigeria in April and May 2014. Returned survey forms were checked, entered and verified. Data analysis was carried out using the embedded analysis toolkit in the WHO/HAI Workbook after double-entry and auto-checking of data. Data was analysed for the public and private sectors.</p><p><strong>Results: </strong>Seven AMFm products are available in the country, and include AL (IPCA), Artemef (Cipla), Coartem AMFm (Novartis), Combisunate (Ajanta), Lumartem (Cipla) as well as Arsuamoon (Guilin) and Coarsucam (Sanofi-Winthrop). The results reveal that antimalarials are largely concentrated in the private sector (private pharmacies and PPMVs). About 86% of the surveyed facilities had at least one AMFm AL product whereas only 18% had any AMFm AA product. Results show that the availability of the various AMFm AL products varies across the country. Lumartem by Cipla has the highest national availability with 26.4%, closely followed by AL (IPCA) with 25.7%. Twenty seven (%) of the facilities had an RDT in stock.</p><p><strong>Conclusion: </strong>The results obtained in this survey show that continuous monitoring of the antimalarial drug landscape is required to track progress in the fight against malaria in the country.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"6 ","pages":"5"},"PeriodicalIF":0.0,"publicationDate":"2015-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107871/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082975","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Buthionine sulfoximine increases the efficacy of arteether antimalarial activity in arteether-resistant <i>Plasmodium vinckei</i> by glutathione depletion.","authors":"Ramesh Chandra, Santosh Kumar, Sunil Kumar Puri","doi":"10.5281/zenodo.10870048","DOIUrl":"10.5281/zenodo.10870048","url":null,"abstract":"<p><strong>Background: </strong>L-buthionine (S,R)-sulfoximine (BSO) regulates the glutathione (GSH) level, which in turn exhibits remarkable regulation of several important aspects of cellular metabolism. We hypothesised that increasing the cellular levels of glutathione leads to an increased resistance to arteether, whereas decreasing these by using a GSH inhibitor increases the parasite sensitivity to arteether in the rodent malaria parasite <i>Plasmodium vinckei</i>.</p><p><strong>Materials and methods: </strong>We tested <i>in vivo</i> effects of BSO on GSH and hemozoin formation in arteether-sensitive and - resistant strains. Experimental groups of 7-8 Swiss mice were inoculated by intraperitoneal injection (i.p.) with 1×10⁶ parasitized erythrocytes of PvAS (sensitive) or PvAR (resistant) strain of <i>P. vinckei</i>. The infected mice were treated with BSO (Sigma) 400 mg/kg twice a day for four days and blood was collected after the last injection with BSO.</p><p><strong>Results: </strong>A relatively stronger inhibition of GSH level was observed in the blood of mice infected with resistant parasites (62.64%; p<0.0001), whereas inhibition in sensitive strain-infected mice and uninfected mice was 32% (p=0.034) and 35% (p=0.034), respectively. The results also show an inverse relationship between GSH and hemozoin in the arteether-sensitive and -resistant strains. The hemozoin contents in the resistant strain are 0.27±0.09, 0.69±0.14 and 5.30±0.79 μmol/10⁹ cells at 5, 10 and 20% parasitemia, respectively, whereas hemozoin contents in the sensitive strain at the same parasitemia levels are 0.59±0.29, 12.38±1.96 and 30.80±2.27 μmol/10⁹ cells. Moreover, hemozoin formation increased by 80% through the administration of BSO in the arteether-resistant strain, whereas insignificant changes occurred in the sensitive strain. BSO was also found to increase the efficacy of arteether antimalarial activity against the resistant strain <i>in vivo</i>.</p><p><strong>Conclusions: </strong>Treatment with BSO significantly reduces the level of GSH, which leads to insufficient growth of resistant parasites. These results suggest that BSO might be helpful in prolonging the persistence of the drug, and pose a promising lead to help reducing the chance of resistance development against artemisinin and its derivatives.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"6 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2015-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107870/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082973","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inhibitory effect of deltorphin-II on development of malaria in <i>Plasmodium berghei</i>-infected mice.","authors":"Garasiya A Ajitbhai, Prati P Singh, Mukesh Kumar, Rajinder Singh, Vandana Dhiman","doi":"10.5281/zenodo.10870022","DOIUrl":"10.5281/zenodo.10870022","url":null,"abstract":"<p><strong>Background: </strong>Drug resistance has been one of the main obstacles in the fight against vector-borne infectious diseases. Among these diseases, malaria represents a serious public health challenge, mainly in the tropics, where vector-favourable climates are a crucial factor. Each of the various anti-malarial drugs currently used against this disease, such as quinolones, sulphonamides and artemisinins are inadequate and new strategies are required. Peptides are known to have a huge number of biological effects. Antimicrobial peptides (AMPs) have been proven to be effective against bacterial, fungal and viral infections. This study explored the effect of the peptide 'deltorphin-II' in <i>Plasmodium berghei-</i>infected mice.</p><p><strong>Materials and methods: </strong>Mean percentage parasitaemia was calculated by studying infected erythrocytes after microscopic examination of 10⁴ erythrocytes from infected mice on days 4, 7, 10, 14 and 21 after infection in all groups. <b>Results.</b> Deltorphin-II shows maximum activity at a dose of 0.8 mg/kg/day from day 4 to day 21. Pre-treatment of infected mice with naltriben abrogates the deltorphin-II-mediated effect.</p><p><strong>Conclusion: </strong>Deltorphin-II inhibits the development of malaria, most probably via activation of the δ₂ receptor.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"6 ","pages":"3"},"PeriodicalIF":0.0,"publicationDate":"2015-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107872/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082976","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Willingness to accept malaria vaccine among caregivers of under-5 children in Ibadan North Local Government Area, Nigeria.","authors":"Beliretu I Abdulkadir, Ikeoluwapo O Ajayi","doi":"10.5281/zenodo.10870005","DOIUrl":"10.5281/zenodo.10870005","url":null,"abstract":"<p><strong>Background: </strong>Malaria vaccine is a potentially effective addition to the armamentarium for malaria control. The candidate RTS,S malaria vaccine has undergone phase III clinical trials and WHO has indicated that a policy recommendation is possible in 2015. Given the delays with adoption of other novel interventions including vaccines, there is a need to ensure that all elements that will inform the decision to adopt a malaria vaccine, including community willingness, will be available on time. This study was carried out to assess the willingness of caregivers of under-5 children to accept a malaria vaccine once available and recommended for use.</p><p><strong>Materials and methods: </strong>427 consenting caregivers, selected using a cluster sampling technique, from five communities in Ibadan, Nigeria, participated in a questionnaire. In-depth interviews (IDIs) were conducted among 47 key community members. Data were analysed using descriptive statistics, Chi-square and logistic regression at <i>p</i>≤0.05. Thematic content analysis was used to analyse the transcribed IDI data.</p><p><strong>Results: </strong>The mean age of survey respondents was 29.8±5.8 years. Only 20.1% of the respondents had ever heard of malaria vaccine; 87.0% showed willingness to accept a malaria vaccine. Reasons stated for not willing included 'husband did not want immunisation' (73.6%), 'felt it might be expensive' (47.2%) and 'felt it might paralyse children' (24.5%). Nearly half (48.7%) of the respondents said that if vaccine is not given orally like polio vaccine it might not be accepted. Influence of community health workers was found to predict willingness to accept a malaria vaccine (OR: 0.316, 95% CI: 0.142-0.705). IDI participants were favourably disposed to introduction of a vaccine against malaria, although they had concerns about the formulation of the vaccine and possible adverse events.</p><p><strong>Conclusion: </strong>Well-designed communication strategies implemented prior to the introduction of a malaria vaccine would be essential to foster a supportive environment for eventual adoption and acceptance thereof.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"6 ","pages":"2"},"PeriodicalIF":0.0,"publicationDate":"2015-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107874/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082987","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Large-scale production of the malaria vector biocontrol agent <i>Romanomermis iyengari</i> (Nematoda: Mermithidae) in Benin, West Africa.","authors":"Thiery Bc Alavo, Ayaba Z Abagli, Rafael Pérez-Pacheco, Edward G Platzer","doi":"10.5281/zenodo.10869973","DOIUrl":"10.5281/zenodo.10869973","url":null,"abstract":"<p><strong>Background: </strong>The mermithid nematode <i>Romanomermis iyengari</i> is one of several natural control alternatives to synthetic pesticides for mosquito suppression. The commonly used mass rearing procedure of <i>R. iyengari</i> involves the use of coarse sand as a substrate for nematode maturation and oviposition. The coarse sand technique gives excellent nematode productivity in North America. However, under West African climatic conditions, this technique generates relatively lesser amounts of infectious worms. We evaluated coconut coir fibres as a replacement for coarse sand to improve yields in large-scale production of <i>R. iyengari</i> in Benin, West Africa.</p><p><strong>Materials and methods: </strong><i>Culex quinquefasciatus</i> was the host for the nematodes, and mosquitoes were blood-fed on chickens. Four days after blood feeding, egg rafts were collected and transferred into trays, each containing 2 l of water. The mosquito larvae were fed with fish food. When the mosquito larvae reached the second instar, preparasites (J2) were added (3 J2/larva) to the incubation trays. Eight days after infection, post-parasitic juveniles were separated from the water containing dead mosquito larvae and other debris using sieves and needles; 2 g of them were deposited in containers with coarse sand or coconut coir fibres and water. Three hours later, the water was drained, the jars covered and stored for eight weeks, after which J2 abundance was determined, using a total of 320 containers for each substrate. The abundance of J2 preparasites was also assessed 3-5 months after storage to determine the impact of long-term storage on the J2 yield.</p><p><strong>Results: </strong>After 2 months storage, 2 g of post-parasites (~457 females and 583 males) yielded an average of 559,300±6094 J2 and 155,818±4427 J2 per container for coconut fibres and for coarse sand, respectively. During long-term storage, yields of J2 on coconut fibres substrate slowly decreased from 442,180±9322 J2 (3 months storage) to 163,632±12,416 J2 per container (5 months storage). On coarse sand substrate, the yield was relatively low and decreased from 49,812±1200 J2 at 3 months storage to 3046±229 J2 at 5 months storage.</p><p><strong>Conclusion: </strong>Under West African climatic conditions, coconut coir fibres gave significantly higher preparasitic nematode yields than the coarse sand technique.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"6 ","pages":"1"},"PeriodicalIF":0.0,"publicationDate":"2015-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11107864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Performance and clinical usefulness of the Optimal-IT^® test in the treatment of confirmed malaria cases in rural areas in Côte d'Ivoire.","authors":"Yapo T Aba, Emmanuel Bissagnené, Ouffoué Kra, Serge B Assi, Raoul Moh, Pulchérie Goly, Nogbou Ello, Alain Kassi, Bessy R Yao, Franklin Abouo, Eboi Ehui","doi":"10.5281/zenodo.10887947","DOIUrl":"10.5281/zenodo.10887947","url":null,"abstract":"<p><strong>Background: </strong>In Africa, malaria care is mostly based on clinical presumption and the general application of antimalarial treatment to all febrile episodes over several years. Treatment limited to confirmed cases might curb the practice of equating fever with malaria, antimalarial drug abuse and the extension of <i>Plasmodium</i> resistance, provided that powerful and reliable rapid diagnostic tests are used. This study aimed at determining the performances of the Optimal-IT^® test in the strategy for the exclusive treatment of uncomplicated malaria in rural areas.</p><p><strong>Materials and methods: </strong>A prospective study conducted in the forest region of San Pedro, Côte d'Ivoire, included patients exhibiting clinical signs of uncomplicated malaria who gave their consent and benefited from thick blood film (TBF), blood smear (BS) and Optimal-IT^® (<i>pLDH</i>-based) test. Rapid diagnostic test (RDT) results were taken into consideration to decide on malaria treatment and then compared with TBF/BS results (reference) to assess the performances and clinical usefulness of the RDT.</p><p><strong>Results: </strong>The mean age of the 384 patients included (209 men, 175 women) was 28 years and the mean temperature was 38.1°C. TBF/BS and Optimal-IT^® were concordant in 92% of patients but discordant in 10 false negative (3%) and 19 false-positive patients (5%). The average parasite density of <i>P. falciparum</i> was 25,600 trophozoites/μl. The performances calculated were: sensitivity=95%, specificity=91%, positive predictive value=90%, negative predictive value=95%, positive likelihood ratio=10, negative likelihood ratio=0.06 and diagnostic odds ratio=166, indicating that Optimal-IT^® is a powerful and credible diagnostic tool. The 193 RDT-positive patients treated were healed, despite three recurrence cases at day (D) D₁₇, D₂₅ and D₂₇, respectively. RDT-negative patients received various treatments (antibiotics, paracetamol), but two patients among them presented with a bout of malaria on D₇. None of the previously untreated patients returned with severe malaria.</p><p><strong>Conclusions: </strong>The Optimal-IT^® test, which is already used in the field, showed good performances to effectively detect patients with and without malaria. It is therefore adapted to the malaria treatment strategy limited to confirmed cases.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"5 ","pages":"12"},"PeriodicalIF":0.0,"publicationDate":"2014-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066297","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HPLC separation and <i>in vitro</i> antimalarial studies of <i>Artemisia annua</i> plants from two different origins: Cameroon versus Luxembourg.","authors":"Mutaz Akkawi, Suhair Jaber, Saleh Abu-Lafi, Mutaz Qutob, Qassem Abu-Rmeleh, Pierre Lutgen","doi":"10.5281/zenodo.10887904","DOIUrl":"10.5281/zenodo.10887904","url":null,"abstract":"<p><strong>Background: </strong>Malaria is a devastating disease, particularly in Africa, due to development of resistance by <i>Plasmodium falciparum</i> against all known antimalarial drugs, including artemisinin. Therefore, the search for new antimalarial drugs is urgently needed, especially drugs that can impede the heme detoxification pathway in the malaria parasite, a crucial requirement for parasite survival in host erythrocytes.</p><p><strong>Materials and methods: </strong>Water infusions of <i>Artemisia annua</i> plants from two different origins, Cameroon and Luxembourg, were used in this study. A semi-quantitative <i>in vitro</i> method, based on the inhibition of ferriprotoporphyrin IX (FP) biomineralisation developed by Deharo <i>et al.</i> [16], was used to reveal the differences in antimalarial activity of both plants. Reversed phase preparative liquid chromatography coupled to a photo diode array (PDA) detector was also used to test for differences in antimalarial activity.</p><p><strong>Results: </strong>Water extracts from the leaves of the Cameroon plant showed a higher potential antimalarial activity, represented by a higher ability to inhibit <i>β</i>-haematin formation <i>in vitro</i> than <i>A. annua</i> extracts from Luxembourg. Although extracts of the plants of both origins showed comparable efficiencies at high concentrations, the absorbance value at 405 nm of a 10% dilution of the Cameroon plant extract was 0.075, whereas it was 1.515 for the Luxembourg plant extract. The absorbance is inversely proportional to the antimalarial activity. According to the Prep-HPLC chromatogram of the Cameroon crude sample, seven major compounds at 325 nm were found. However, only four much less pronounced compounds appeared in the Luxembourg crude sample under the same chromatographic conditions and concentration. These were preliminarily identified as polyphenolic compounds.</p><p><strong>Conclusion: </strong><i>A. annua</i> infusions are widely used by people who cannot afford other treatments. Depending on the cultivation locality different chemical profiles exist. This results in differences in hemozoin formation and will therefore also lead to alterations in antimalarial activity.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"5 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2014-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enabling factors facilitating the use of neem-based remedies for the management of malaria in the Lower Shire District of Chikwawa, Malawi.","authors":"Edson Dembo, Fraction Dzinjalamala, Annette Habluetzel","doi":"10.5281/zenodo.10887837","DOIUrl":"10.5281/zenodo.10887837","url":null,"abstract":"<p><strong>Background: </strong>Malaria remains a major public health threat in Malawi, affecting mostly children under five and pregnant women. Despite the availability of chemotherapy and chemoprophylaxis, resistance to sulfadoxine pyrimethamine and the high cost and complicated regimen of artemether-lumefantrine have accelerated the use of home-based remedies for the management of malaria in Chikwawa district, Malawi. This study aimed to determine factors that facilitate the use of herbal remedies within communities in the management of malaria in the presence of free health care services, with the intention of assessing the feasibility of developing improved herbal products as anti-malarial prophylaxis.</p><p><strong>Materials and methods: </strong>Data on factors driving the use of neem-based preparations commonly used in the management of malaria were collected through qualitative interviews and focus group discussions. Qualitative data were analysed drawing on the Framework Analysis approach.</p><p><strong>Results: </strong>Neem and moringa were identified as the principal plants used for the management of malaria, with neem being the most frequently used. Factors favouring the communal use of neem-based remedies included the habit of resorting to herbal remedies as first aid treatment, lack of drugs and proper medical care in modern health facilities, and the need for preventive anti-malarial remedies during the high-transmission season. The perceived effectiveness of neem-based herbal remedies was based on their fast action against the symptoms of malaria, thereby providing immediate relief to the patient, which might explain their wide-scale use for malaria treatment.</p><p><strong>Conclusions: </strong>Local communities prefer to use neem and/or moringa remedies for their primary healthcare needs in the management of malaria because of their ease of access, preparation and administration without frequent adverse events, as opposed to ACTs. These remedies are already being used as prophylaxis in unimproved/non-standardised formulation. This suggests that standardised herbal preparations would be culturally acceptable at community level. Evidence-based research is required to validate parasitological and clinical efficacy and determine safety of these anti-malarial herbs.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"5 ","pages":"10"},"PeriodicalIF":0.0,"publicationDate":"2014-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100364/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The current status of infrastructure for monitoring the efficacy of antimalarial therapeutics in Zambia.","authors":"Ellah Zingani, Satoshi Inoue, Lungwani Tyson M Muungo","doi":"10.5281/zenodo.10887816","DOIUrl":"10.5281/zenodo.10887816","url":null,"abstract":"<p><strong>Background: </strong>Sub-Saharan countries have experienced centuries of high morbidity and mortality due to malaria. In addition to insecticide-treated mosquito nets and indoor residual spraying, modern antimalarial medicines have been developed to reduce disease prevalence, although the emergence of drug-resistant strains has compromised their efficacy. The purpose of this study was to evaluate the current status of malaria diagnosis and treatment, and to monitor the therapeutic efficacy of antimalarial drugs.</p><p><strong>Materials and methods: </strong>A descriptive cross-sectional survey was conducted from 2011 to 2013 at 10 district hospitals in Zambia designated as malaria sentinel sites as well as at the National Malaria Control Centre. District medical officers at each site completed interview questionnaires.</p><p><strong>Results: </strong>Although basic infrastructure necessary for monitoring antimalarial drug resistance (such as laboratory, dispensary, admission ward, database unit, administration offices, bed space, examination and emergency rooms) was present at all sites, there was a shortage of licensed healthcare personnel. At some sites, antimalarial drugs were prescribed for malaria-like symptoms without diagnostic confirmation by blood smear. There was no regular monitoring of antimalarial drug resistance: only one trial was conducted among all sites in the previous 24 months.</p><p><strong>Conclusion: </strong>A lack of antimalarial drug resistance monitoring might be associated with personnel and funding shortages. Additional financial support would be necessary to avoid the development and spread of drug-resistant malaria in Zambia.</p>","PeriodicalId":74100,"journal":{"name":"MalariaWorld journal","volume":"5 ","pages":"9"},"PeriodicalIF":0.0,"publicationDate":"2014-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11100366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141066366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}