ABSTRACT
Introduction: Malaria is a major public health problem in Nigeria; with adverse outcomes on the poor; pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs). Aims and Objective: This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria. Materials and Methods: This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact; then every 2 months to check for malaria parasites using standard methods. Result: There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs. Conclusion: We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies
Subject(s)
Insecticide-Treated Bednets , Nurses , Plasmodium , Pregnant Women , Rural PopulationABSTRACT
Introduction: Malaria is a major public health problem in Nigeria; with adverse outcomes on the poor; pregnant women and children living in rural communities. A major component of current intervention in roll back malaria (RBM) initiative is vector control and insecticide-treated nets (ITNs). Aims and Objective: This research studied the impact of free distribution of ITNs on malaria parasitemia in a rural community in Nigeria. Materials and Methods: This is a longitudinal survey involving 990 pregnant and nursing mothers who received free ITNs between February 2007 and September 2008. Blood samples were collected at contact; then every 2 months to check for malaria parasites using standard methods. Result: There was a sustained but insignificant rise in asymptomatic malaria parasitemia post-distribution of ITNs. Conclusion: We conclude that ITN intervention remains important in malaria prophylaxis but must be complemented with awareness campaigns and other vector control strategies
Subject(s)
Insecticide-Treated Bednets , Malaria/prevention & control , Plasmodium , Pregnant Women , Rural PopulationABSTRACT
Background: Malaria is an important parasitic disease of humans caused by infection with a parasite of the genus Plasmodium and transmitted by female anopheles. Infection caused by P. falciparum is the most serious of all the other species (P. ovale; P. vivax and P. malariae) especially in terms of morbidity and mortality hence the reason why most of the research has been focussed on this species. The disease affects up to about 40 per cent of the world's population with around 300-500 million people currently infected and mainly in the tropics. It has a high morbidity and mortality especially in resource-poor tropical and subtropical regions with an economic fall of about US$ 12 billion annually in Africa alone. relevant literatures were reviewed from medical journals; library search and internet source. Other relevant websites like PATH; Malaria Vaccine Initiative and Global Fund were also visited to source for information. The key words employed were: malaria; vaccine; anopheles mosquito; insecticide treated bed-nets; pyrethroids and Plasmodium. several studies have underscored the need to develop an effective human malaria vaccine for the control and possible eradication of malaria across the globe with the view to reduce the morbidity and mortality associated with the disease; improve on the social and economic losses and also protect those at risk. It is very obvious that the need for effective human malaria vaccine is not only to serve those living in malaria endemic regions but also the non-immune travellers especially those travelling to malaria endemic areas; this would offer cost effective means of preventing the disease; reducing the morbidity and mortality associated with it in addition to closing the gap left by other control measures. It is very obvious that there is no single control measure known to be effective in the control of malaria; hence the need for combination of more than one method with the aim of achieving synergy in the total control and possible eradication of the disease. It suffices to say that despite the use of combination of more than one method (e.g. drugs treating patients; breaking the life cycle of the vector mosquito using larvicides; clearing swamps and other mosquito breeding sites); no much progress was made towards achieving this goal; hence the renewed interest especially with regards to vaccine development
Subject(s)
Anopheles , Insecticide-Treated Bednets , Malaria Vaccines , PlasmodiumABSTRACT
Purpose: The asexual proliferation of Plasmodium; inside the erythrocyte; is accompanied by the synthesis of huge quantities of phosphatidylcholine (PtdCho) and phospha- tidylethanolamine (PtdEtn). These needful phospholipids for the cytoplasmic membrane of the merozoites are provided by the precursors choline and ethanolamine. PtdCho and PtdEtn are synthesized by the parasite because the erythrocyte is unable to do it. In order to assess the dynamism of the phospholipid pathways; we aimed to inves- tigate the respective shape of the uptake of choline and ethanolamine by Plasmodium falciparum. Method: Time-course experiments and kinetic assays were performed respectively with fixed and ranged concentrations of radioactively-labelled choline and ethanolamine. The labelled-precursors were added in the culture of P. falciparum infected-erythrocytes and the incorporated molecules in phospholipids were measured with a scintigraph counter. Result: The results showed that the incorpo- ration of precursors in the infected-erythrocyte occurred with a Michaelis-Menten's kinetic shape. According to the maximum rate (Vmax); the pathway of ethanolamine incorpo- ration was faster than that of choline. Similarly; affinity for ethanolamine was greater than that of choline. Conclusion: Although PtdCho is the major phospholipid in the membrane; this study rules out that the influx of ethanolamine in the infected-erythrocyte; in vivo conditions; is more dynamic than choline
Subject(s)
Ethanolamine , Phospholipids , PlasmodiumABSTRACT
Malaria is the leading cause of morbidity and mortality in Sub-Saharan Africa. One key strategic intervention is provision of early diagnosis and prompt effective treatment. A major setback has been the development of drug resistance to commonly used antimalarials. To overcome this; most countries in Sub-Saharan Africa have adopted Artemisinin Combination Therapy (ACT) as a first line treatment for uncomplicated malaria. Artemether Lumefantrine (AL) and Artesunate Amodiaquine (ASAQ) are the main drugs of choice. There are key implementation issues; which may have a bearing on the scaling up of this new treatment. This article reviewed the published papers on ACT with focus on sustainability; compliance; and diagnosis. ACTs are costly; but highly effective. Their scaling up is the most cost effective malaria intervention currently available. Most countries rely heavily on the Global Fund for their scaling up. AL has a short shelf life; a complicated six-dose regimen that requires intake with fat to ensure sufficient bioavailability. High rates of adherence have been reported. Use of parasitic diagnosis is advocated to ensure rational use. Parasitic diagnostics like rapid test and microscopy are currently inadequate. The majority of malaria cases may continue to be diagnosed clinically leading to over prescription of drugs. ACTs are currently not available at the community level for home based management of malaria. Issues related to safety and rational use need to be addressed before their use in the informal health sector like community drug sellers and community health workers. The majority of malaria cases at the community level could go untreated or continue to be treated using less effective drugs. We conclude that ACTs are highly effective. A major challenge is ensuring rational use and access at the household level. It is hoped that addressing these issues will increase the likelihood that ACT achieves its intended goals of reducing morbidity and mortality due to malaria; and delaying the onset of drug resistance
Subject(s)
Antimalarials , Malaria , PlasmodiumABSTRACT
Notre travail est une etude retrospective realisee sur une periode de deux (2) ans au Laboratoire de Parasitologie de l'Institut Pasteur de Cocody; de janvier 2003 a decembre 2004. Elle a porte sur les examens parasitologiques du sang pour la recherche du Plasmodium. Ont ete inclus dans notre etude les nouveau-nes ages de moins de 7 jours et n'ayant pas recu de traitement antipaludique. Cette enquete a concerne 68 nouveau-nes et nous a permis d'evaluer l'incidence du paludisme congenital dans le Laboratoire de parasitologie de l'Institut Pasteur de Cocody. L'analyse de nos resultats fait ressortir que: -La prevalence du paludisme congenital est de 7;35 pour cent ; -L'espece en cause est Plasmodium falciparum ; -4 nouveau-nes febriles et un 1 nouveau-ne presentant un ictere neonatal ont presente une goutte epaisse positive ; -Les nouveau-nes atteints de PC avaient encore une parasitemie a Plasmodium faiciparum 48 heures apres le post-partum. La presence d'hyperthermie ou d'ictere neonatal et la mise en evidence de Plasmodium 48 heures apres l'accouchement; nous permettent d'affirmer qu'il s'agit de cas paludisme congenitale - maladie
Subject(s)
Cote d'Ivoire , Infant, Newborn , Malaria , PlasmodiumABSTRACT
"Haemoparasites of wild birds in Madagascar"": This study aims to evaluate the prevalence and density of haemoparasites in native Malagasy birds. Among the 387 birds; belonging to 43 species sampled at six localities in different bio-climatic zones of the island; 139 (35.9"
Subject(s)
Birds , Microfilariae , Parasites , PlasmodiumABSTRACT
A cross-sectional study of pregnant women was conducted at Nsambya Hospital in Kampala; to investigate the prevalence and effect of Plasmodium falciparum infections during pregnancy; in a peri-urban/urban location. Overall; 544 pregnant women were recruited when they presented answered a questionnaire and underwent a physical examination; and peripheral-blood samples were obtained. After each uncomplicated delivery; samples of placental and cord blood were obtained from the placenta and infant; respectively; and infant birthweights were recorded. Smears were prepared from the blood samples and checked for parasites. Only 46 and 36 of the 537 women investigated were positive for P. falciparum infection in their peripheral and placental blood; respectively. Plasmodium falciparum was the only parasite encountered. The prevalences of low birthweight and maternal parasitaemia and the intensities of maternal infection were each greater in primigravidae than secundi-or multi-gravidae. Despite the low prevalence of parasitaemia in this population; P. falciparum infection in the primigravidae was a significant contributor to their ill health; leading to low birth weights in their infants
Subject(s)
Anemia , Plasmodium , PregnancyABSTRACT
A cross-sectional study of pregnant women was conducted at Nsambya Hospital in Kampala; to investigate the prevalence and effect of Plasmodium falciparum infections during pregnancy; in a peri-urban/urban location. Overall; 544 pregnant women were recruited when they presented at the labout ward for delivery. After giving informed consent; each subject answered a questionnaire and underwent a physical examination; and peripheral-blood samples were obtained. After each uncomplicated delivery; samples of placental and cord blood were obtained from the placenta and infant; respectively; and infant birthweights were recorded. Smears were prepared from the blood samples and checked for parasites. Only 46 and 36 of the 537 women investigated were positive for P.falciparum infection in their peripheral and placental blood; respectively. Plasmodium falciparum was the only parasite encountered. The prevalences of low birthweight and maternal parasitaemia and the intensities of maternal infection were each greater in primigravidae than secundi-or multi-gravidae. Despite the low prevalence of parasitaemia in this population; P. falciparum infection in the primigravidae was a significant contributor to their ill health; leading to low birthweights in their infants
Subject(s)
Anemia , Infant , Infant, Low Birth Weight , Plasmodium , Pregnancy , Urban AreaABSTRACT
Malaria remains a major cause of mortality and morbidity in Africa. Many approaches to malaria control involve reducing the chances of infection but little is known of the relations between parasite exposure and the development of effective clinical immunity. So; the long-term effect of such approaches to control on the pattern and frequency of malaria cannot be predicted. Methods: We have prospectively recorded paediatric admissions with severe malaria over three to five years from five discrete communities in The Gambia and Kenya. Demographic analysis of the communities exposed to disease risk allowed the estimation of age-specific rates for severe malaria. Within each community; the exposure to Plasmodium falciparum infection was determined through repeated parasitological and serological surveys among children and infants. We used acute respiratory - tract ifnections (ARI) as a comparison. Findings: 3556 malaria admissions were recorded for the five sites. Marked differences were observed in age; clinical spectrum and rates of severe malaria between the five sites. Paradoxically; the risks of severe malaria; for example; admission rates (per 1000 per year) for children up to their 10th birthday were estimated as 3.9; 25.8;25.9; 16.7; and 18.0 in the five communities; the forces of infection estimated for those communities (new infections per infant per infant per month) were 0.001; 0.034; 0.050; 0.093; and 0.176; respectively. Similar trends were noted for cerebral malaria and for severe malaria anaemia but not for ARI. Mean age of disease decreased with increasing intensity. Interpretation: We propose that a critical determinant of life-time disease risk is the ability to develop clinical immunity early in life during a period when other protective meachanisms may operate. In highy endemic areas measures which reduce parasite transmission; and thus immunity; may lead to a change in both the clinical spectrum of severe disease and the overall burden of severe malaria morbidity. Source: Lancet. 1997 Jun 7; 349(9066):1650-4
Subject(s)
Child , Malaria , Morbidity , PlasmodiumABSTRACT
In an in vivo study of antimalarial sensitivity in kabarole district; Western Uganda; 82of asymptomatic malarial infections and 86of symptomatic infections were chloroquine sensitive. Of persons with symptomatic malaria; 88were sensitive to sulfadoxine-pyrimethamine (Fansidar). Amodiaquine cleared parasites in all persons in whom it was used. Over the course of the past five years; there appears to be no substantial increase in the extent of chloroquine resistance in Western Uganda. Source: Trop.Geogr.Med. 1994; 46(6):364-5
Subject(s)
Chloroquine , Malaria , PlasmodiumABSTRACT
Dans le cadre du reseau de surveillance de la chimioresistance du paludisme dans les Etats de l'OCCGE; des enquetes de chimioresistance ont ete menees par les equipes nationales. les tests d'etude in vivo ont principalement ete utilises en enquete de surveillance passive. Les sujets autochtones; generalement les enfants d'age scolaire; ont ete etudies. La chloroquinoresistance decelee chez ces sujets en 1987 au Benin a ete observee la meme annee au Togo et en Cote d'Ivoire. Durant l'annee 1988 elle est apparue au Senegal et au Burkina Faso. Elle a ete notee en 1989 au Niger et en 1990 au Mali. Seule la Mauritanie est encore epargnee. Les caracteristiques de cette resistance chez les sujets autochtones sont decrites. La resistance est surtout parasitologique et en moyenne; son taux se situe au dessous de 50 pour cent
Subject(s)
Antimalarials , Chloroquine , Drug Resistance , Malaria/drug therapy , Plasmodium/drug effectsABSTRACT
The relation between Plasmodium falciparum malaria and symptomatic human immunodeficiency virus 1 (HIV-1) infection was investigated in paediatric and adult patients in Kampala; Uganda; from 1987 to 1989. Both infections contributed largely to hospital morbidity. Of 1527 clinically suspicious in-patients; 61pc were positive for HIV-1 infection. 52pc of patients with positive HIV-1 serology fulfilled the World Health Organization clinical case definition for acquired immune deficiency syndrome (AIDS) in Africa. No association could be found between HIV-1 infection and malaria either in paediatrics or in adults. P. falciparum parasitaemia was present in 18pc of all patients and no differences in prevalence of malaria infection or in parasite density could be demonstrated between HIV-1 positive and HIV-1 negative patients. The comparison of clinical symptoms showed typical differences in AIDS-related morbidity but no difference in malaria-specific morbidity. Also; the response to malaria treatment was the same in HIV-1 positive and HIV-1 negative patients. P. falciparum malaria does not appear to act as an opportunistic agent in AIDS patients in Uganda