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1.
Rev. cuba. med. trop ; 73(1): e604, tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1280331

ABSTRACT

Introducción: El paludismo es una enfermedad febril aguda potencialmente mortal causada por parásitos que se transmiten al ser humano por la picadura de mosquitos del género Anopheles. De los 214 millones de casos de paludismo registrados en 2016, la mayoría de ellos se producen en niños menores de cinco años en África subsahariana. La mortalidad está dada por la presencia de sus complicaciones que deben ser detectadas y tratadas precozmente. Objetivo: Identificar la presencia de signos de alarma, y determinar su relación con otras variables clínicas y de laboratorio. Métodos: Se realizó un estudio descriptivo de 47 pacientes adultos con paludismo por Plasmodium falciparum importado, ingresados en el Departamento de Medicina del Instituto de Medicina Tropical Pedro Kourí, desde enero de 2016 a diciembre de 2018. Los datos fueron procesados en una base de datos en Microsoft Excel y luego analizados en el programa estadístico SPSS 11,5. Resultados: Predominaron los pacientes del sexo masculino, con una media de edad de 35,9 años. Fue significativa la relación existente entre los signos de alarma y la severidad del cuadro clínico, la hiperparasitemia, el supuesto estado no inmune de los pacientes, trombocitopenia y la demora en el ingreso. La respuesta al tratamiento es excelente con los esquemas combinados utilizados a base de quinina. Conclusiones: Los signos de alarma, dentro de los cuales podemos incluir la trombocitopenia, constituyen elementos importantes para poder prevenir futuras complicaciones(AU)


Introduction: Malaria is an acute potentially fatal febrile disease caused by parasites transmitted to humans through the bite of mosquitoes from the genus Anopheles. Most of the 214 million malaria cases reported in the year 2016 were children aged under five years from Sub-Saharan Africa. Mortality is due to the presence of complications which should be detected and treated timely. Objective: Identify the presence of warning signs and determine their relationship to other clinical and laboratory variables. Methods: A descriptive study was conducted of 47 adult patients with imported Plasmodium falciparum malaria admitted to the Medicine Department of Pedro Kourí Tropical Medicine Institute from January 2016 to December 2018. The data obtained were processed in a Microsoft Excel database and then analyzed with the statistical software SPSS 11.5. Results: Male patients prevailed, with a mean age of 35.9 years. A significant relationship was found between warning signs and severity of the clinical status, hyperparasitemia, the supposed non-immune status of patients, thrombocytopenia and admission delay. An excellent response was obtained to treatment with combined quinine-based schemes. Conclusions: Warning signs, among them thrombocytopenia, are important to prevent future complications(AU)


Subject(s)
Humans , Thrombocytopenia/etiology , Malaria/complications , Malaria/diagnosis , Epidemiology, Descriptive , Malaria/prevention & control
2.
Malar. j. (Online) ; 20(293): 1-10, 2021. Tab.
Article in English | AIM, RSDM, AIM | ID: biblio-1353124

ABSTRACT

Background: In Mozambique, socio-economic and cultural factors influence the wide adoption of disease preventive measures that are relevant for malaria control strategies to promote early recognition of disease, prompt seeking of medical care, sleeping under insecticide-treated nets (ITNs), and taking intermittent preventive treatment for pregnant women. However, there is a critical information gap regarding previous and ongoing malaria social and behavioural change (SBC) interventions. The aim of this study is to assess the knowledge, attitudes, practices of beneficiaries of SBC interventions. Methods: A descriptive cross-sectional survey was undertaken in 2018 in two rural districts of Zambezia Province, Mozambique. A structured questionnaire was administered to 773 randomly selected households. Respondents were the adult heads of the households. Descriptive statistics were done. Results: The main results show that 96.4% of respondents recalled hearing about malaria in the previous 6 months, 90.0% had knowledge of malaria prevention, and 70.0% of preventive measures. Of the 97.7% respondents that had received ITNs through a mass ITN distribution campaign, 81.7% had slept under an ITN the night before the survey. In terms of source of health information, 70.5% mentioned the role of community volunteers in dissemination of malaria prevention messages, 76.1% of respondents considered worship places (churches and mosques) to be the main places where they heard key malaria prevention messages, and 79.1% asserted that community dialogue sessions helped them better understand how to prevent malaria. Conclusions: Results show that volunteers/activists/teachers played an important role in dissemination of key malaria prevention messages, which brought the following successes: community actors are recognized and people have knowledge of malaria transmission, signs and symptoms, preventive measures, and where to get treatment. There is, however, room for improvement on SBC messaging regarding some malaria symptoms (anaemia and convulsions) and operational research is needed to ascertain the drivers of malaria prevalence and inform the SBC approach.


Subject(s)
Humans , Pregnancy , Malaria , Socioeconomic Factors , Therapeutics/methods , Prevalence , Surveys and Questionnaires , Health Strategies , Knowledge , Cultural Factors , Control , Information , Malaria/prevention & control , Medical Assistance , Mozambique
3.
Rev. cuba. med. trop ; 72(3): e518, sept.-dic. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1156545

ABSTRACT

Introducción: La infección por malaria durante el embarazo es un importante problema de salud en la mayoría de las regiones tropicales. Esta condición puede tener incidencia negativa tanto en la gestante como en el feto. Objetivo: Indagar en el impacto del tratamento preventivo intermitente con el medicamento antimalárico sulfadoxina-pirimetamina en la mujer embarazada. Métodos: Se realizó una revisión bibliográfica en la base de datos Medline/Pub Med y en artículos relevantes relacionados al tema de los últimos cinco años. Además, se tomó como referencia las guías para el tratamiento de malaria de la Organización Mundial de la Salud, verisón 2016-2017. Análisis y síntesis de los resultados: Durante el período 2015-2017 no se lograron avances significativos en la reducción del número de enfermos palúdicos. No obstante, se señala la anemia como causa de mortalidad en el curso de la malaria. También, se destacan los nuevos enfoques y compromisos para reducir la morbilidad atribuible al paludismo en la mujer embarazada en sus tres vertientes: tratamiento eficaz de los casos de paludismo, el uso de mosquiteros tratados con insecticidas, y la utilización del tratamiento preventivo intermitente con el antimalárico sulfadoxina-pirimetamina a partir del segundo trimestre del embarazo. La indicación de este tratamiento inlcuye mínimo dos dosis del fármaco antipalúdico, con un intervalo de un mes entre cada dosis, con independencia de que las embarazadas muestren o no síntomas de la enfermedad. Conclusiones: Esta intervención para prevenir el paludismo en el embarazo es una cuestión prioritaria en la iniciativa de salud materna, infantil y reproductiva; además, ayuda a mejorar y aumentar la cobertura de las medidas de control de esta enfermedad durante la gestación(AU)


Introduction: Malaria infection during pregnancy is an important health problem in most tropical regions. This condition may have a negative incidence on pregnant women and fetuses. Objective: Inquire into the effect of the intermittent preventive treatment with the malarial sulfadoxine / pyrimethamine in pregnant women. Methods: A bibliographic review was conducted in the database Medline / PubMed and in relevant papers about the topic published in the last five years. The Guidelines for the Treatment of Malaria 2016-2017 of the World Health Organization were also used as reference. Analysis and synthesis of results: Significant progress was not achieved in reducing the number of malaria patients in the period 2015-2017. However, anemia is reported as the cause of mortality during the course of malaria. New approaches and commitments are proposed to reduce malaria-related morbidity among pregnant women, namely effective treatment of malaria cases, use of insecticide-treated mosquito nets, and intermittent preventive treatment with the antimalarial sulfadoxine / pyrimethamine as of the second quarter of pregnancy. Indication of this treatment includes at least two doses of the malarial, with a separation of one month between the doses, regardless of whether the pregnant women have symptoms of the disease. Conclusions: The intervention to prevent malaria during pregnancy is a first-priority aspect of the mother, child, reproductive health initiative. It also helps improve and broaden the coverage of measures for the control of this disease during pregnancy(AU)


Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications/prevention & control , Sulfadoxine/therapeutic use , Malaria/prevention & control , Pyrimethamine/therapeutic use
4.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 13-28, Sept. 2020.
Article in English | LILACS | ID: biblio-1134098

ABSTRACT

Abstract The subdiscipline of historical epidemiology holds the promise of creating a more robust and more nuanced foundation for global public health decision-making by deepening the empirical record from which we draw lessons about past interventions. This essay draws upon historical epidemiological research on three global public health campaigns to illustrate this promise: the Rockefeller Foundation's efforts to control hookworm disease (1909-c.1930), the World Health Organization's pilot projects for malaria eradication in tropical Africa (1950s-1960s), and the international efforts to shut down the transmission of Ebola virus disease during outbreaks in tropical Africa (1974-2019).


Resumo A subdisciplina epidemiologia histórica se propõe a criar um alicerce robusto e refinado para o processo de tomada de decisões em saúde pública global, aprofundando registros empíricos que nos ensinam sobre intervenções passadas. Este artigo se baseia na pesquisa epidemiológica histórica de três campanhas globais de saúde pública para ilustrar essa proposta: os esforços da Fundação Rockefeller para controle da ancilostomose (1909-c.1930), os projetos-piloto da Organização Mundial da Saúde para erradicação da malária na África tropical (décadas de 1950-1960), e os esforços internacionais de interrupção da transmissão do vírus Ebola durante surtos na África tropical (1974-2019).


Subject(s)
Humans , History, 20th Century , Global Health/history , Epidemiology/history , Hemorrhagic Fever, Ebola/history , Health Promotion/history , Hookworm Infections/history , Malaria/history , World Health Organization/history , Public Health Practice/history , Communicable Disease Control/history , Hemorrhagic Fever, Ebola/prevention & control , Hemorrhagic Fever, Ebola/transmission , Africa , Hookworm Infections/prevention & control , Malaria/prevention & control
5.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 29-48, Sept. 2020.
Article in English | LILACS | ID: biblio-1134097

ABSTRACT

Abstract According to David Fidler, the governance of infectious diseases evolved from the mid-nineteenth to the twenty-first century as a series of institutional arrangements: the International Sanitary Regulations (non-interference and disease control at borders), the World Health Organization vertical programs (malaria and smallpox eradication campaigns), and a post-Westphalian regime standing beyond state-centrism and national interest. But can international public health be reduced to such a Westphalian image? We scrutinize three strategies that brought health borders into prominence: pre-empting weak states (eastern Mediterranean in the nineteenth century); preventing the spread of disease through nation-building (Macedonian public health system in the 1920s); and debordering the fight against epidemics (1920-1921 Russian-Polish war and the Warsaw 1922 Sanitary Conference).


Resumo Segundo David Fidler, a gestão de doenças infecciosas entre meados do século XIX e e o XXI guiou-se por uma série de acordos institucionais: Regulamento Sanitário Internacional (não interferência e controle de doenças em fronteiras), programas verticais da OMS (campanhas de erradicação da malária e varíola), e posicionamento pós-vestefaliano além do estado-centrismo e interesse nacional. Mas pode a saúde pública internacional ser reduzida à tal imagem vestefaliana? Examinamos três estratégias que destacaram as fronteiras sanitárias: prevenção em estados vulneráveis (Mediterrâneo oriental, século XIX); prevenção à disseminação de doenças via construção nacional (sistema público de saúde macedônico, anos 1920); remoção de fronteiras no combate às epidemias (guerra polaco-soviética, 1920-1921 e Conferência Sanitária de Varsóvia, 1922).


Subject(s)
History, 18th Century , History, 19th Century , History, 20th Century , History, 21st Century , Public Health Practice/history , Communicable Disease Control/history , Politics , Asia , World Health Organization/history , Quarantine/history , Communicable Disease Control/methods , Global Health/history , Europe , Hospitals, Isolation/history , Malaria/history , Malaria/prevention & control
6.
Hist. ciênc. saúde-Manguinhos ; 27(supl.1): 145-164, Sept. 2020.
Article in English | LILACS | ID: biblio-1134088

ABSTRACT

Abstract From its inception, in 1948, the World Health Organization made control of malaria a high priority. Early successes led many to believe that eradication was possible, although there were serious doubts concerning the continent of Africa. As evidence mounted that eradicating malaria was not a simple matter, the malaria eradication programme was downgraded to a unit in 1980. Revived interest in malaria followed the Roll Back Malaria Initiative adopted in 1998. This article presents an historical account of the globally changing ideas on control and elimination of the disease and argues that insufficient attention was paid to strengthening health services and specialized human resources.


Resumo Desde sua origem, em 1948, a Organização Mundial da Saúde priorizou o controle da malária. Os primeiros êxitos induziram à crença na viabilidade da erradicação, apesar de sérias dúvidas quanto ao continente africano. À medida que se somavam comprovações de que a erradicação da malária não seria simples, o projeto com essa finalidade foi rebaixado a uma unidade em 1980. O reavivamento do interesse na malária ocorreu após a iniciativa Roll Back Malaria, criada em 1998. Este artigo apresenta um panorama histórico das mudanças nas ideias, em âmbito global, ligadas ao controle e à eliminação da doença e defende a tese de que a atenção dada ao fortalecimento dos serviços de saúde e a recursos humanos especializados foi insuficiente.


Subject(s)
Humans , History, 20th Century , History, 21st Century , World Health Organization/history , Communicable Disease Control/history , Mosquito Control/history , Malaria/history , Communicable Disease Control/methods , Mosquito Control/methods , Africa , Disease Eradication/history , Goals , Malaria/prevention & control
7.
Rev. cuba. invest. bioméd ; 39(2): e597, abr.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1126606

ABSTRACT

Introducción: la investigación traslacional es una rama de la ciencia de reciente creación, su objetivo principal es la aplicación del conocimiento que se genera de las investigaciones, que no quede formando parte de la literatura gris, en el papel o para unos pocos, sino que pueda servir a la mayor cantidad posible de individuos y/o poblaciones. Objetivo: determinar los avances que se han dado a lo largo de los últimos años en la aplicación de la medicina traslacional en Perú. Métodos: se realizó una búsqueda por conveniencia en bases de datos (Google Scholar, Pubmed). Se han brindado ejemplos de cómo la investigación traslacional en Perú puede aportar en gran medida a la mejora de realidades y problemáticas específicas, esto refuerza la necesidad de que las decisiones políticas deben basarse en la medicina basada en la evidencia. Resultados: la medicina traslacional en Perú enfrenta muchas dificultades, como lo son los recursos limitados, tiempo escaso para implementar la investigación formativa, carencia de modelos pedagógicos actualizados, docentes preparados en escuelas antiguas y con capacidad limitada para la educación médica continua; obstáculos que deben de superarse para poder asegurar que la ciencia -y por ende la sociedad- progresen. Conclusiones: en Perú, el avance de la medicina traslacional ha derivado en la generación de personal de salud más capacitado que ha proporcionado los medios para el desarrollo de múltiples políticas públicas. Dichas políticas en muchos casos han terminado plasmadas en normas, reglamentos y hasta leyes en el país(AU)


Introduction: translational research is a branch of science of recent creation. Its main aim is the application of the knowledge generated by research so that it will not become grey literature printed on paper or for the use of a chosen few, but serve as many people and/or populations as possible. Objective: determine the progress made in recent years in the application of translational medicine in Peru. Methods: a convenience search was conducted in the databases Google Scholar and PubMed. Examples are offered of the way in which translational research may greatly contribute to improve specific realities and problems in Peru. This reinforces the need that political decisions be based on evidence-based medicine. Results: translational medicine is faced with many difficulties in Peru, such as limited resources, scant time to implement training research, lack of updated pedagogical models, and teachers trained in old schools and with a limited capacity for continuing medical education. These hurdles should be overcome to ensure the progress of science and therefore of society as well. Conclusions: progress of translational medicine in Peru has resulted in the training of more skilled health personnel, providing the means for the development of multiple public policies. In many cases those policies have been included in standards, regulations and even laws in the country(AU)


Subject(s)
Humans , Education, Medical, Continuing , Translational Medical Research/education , Translational Medical Research/methods , Peru , Gray Literature , Malaria/prevention & control
8.
Washington; Organización Panamericana de la Salud; abr. 6, 2020. 16 p.
Non-conventional in English, Spanish | LILACS | ID: biblio-1096784

ABSTRACT

El Programa Regional de Malaria de la OPS, consciente del inminente impacto negativo que la presente pandemia de COVID-19 está causando en los países y en sus sistemas de salud, y consecuentemente en la lucha contra la malaria en los países de las Américas, considera fundamental orientar a las autoridades nacionales y llamar la atención sobre medidas principales a tomar para mantener la continuidad de las acciones contra la malaria, protegiendo la salud de los trabajadores y en consonancia con las disposiciones nacionales de respuesta a la COVID-19. La OMS ha elaborado orientaciones específicas sobre malaria durante la respuesta a la COVID-19, que constituyen la referencia principal de este documento. Este material está sujeto a actualizaciones de la OMS y la OPS sobre malaria y sobre la respuesta a la COVID-19.


The PAHO Regional Malaria Program is aware of the imminent negative impact that the present COVID-19 pandemic is causing in the countries and their health systems, and consequently, in the fight against malaria in the countries of the Americas; considers that it is essential to guide national authorities; and draws attention to the main measures to be taken to maintain the continuity of actions against malaria, while protecting the health of healthcare workers and in line with national provisions for response to COVID-19. Malaria-specific guidance on the response to COVID-19 has been developed by WHO1 and is the main reference for this document. This material is subject to updates by WHO and PAHO on malaria and on the COVID-19 response.


Subject(s)
Humans , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Coronavirus Infections/epidemiology , Pandemics/prevention & control , Ambulatory Care/organization & administration , Betacoronavirus , Malaria/diagnosis , Malaria/prevention & control
9.
Malar. j. (Online) ; 19(133): 1-14, 2020. Mapas, Tab, Ilus
Article in English | AIM, RSDM, AIM | ID: biblio-1348624

ABSTRACT

Background: Conceptualizing gender dynamics and ways of bridging entrenched gender roles will contribute to better health promotion, policy and planning. Such processes are explored in relation to malaria in Mozambique. Methods: A multi-method, qualitative study using focus group discussions (FGDs) and in-depth interviews (IDIs) explored the perspectives of community members, leaders and stakeholders on malaria. The study was conducted in Nampula Province, in an intervention district for the Tchova Tchova Stop Malaria (TTSM) gender-sensitive community dialogues, and in a non-intervention district. Results: Participants (n=106) took part in six FGDs and fve IDIs in each district. Those exposed to TTSM commonly stated that the programme infuenced more equalitarian gender roles, attitudes and uptake of protective malariarelated practices. These positive changes occurred within the context of an observed, gendered decision-making matrix, which aligns inward- or outward-facing decisions with malaria prevention or treatment. Decisions more dependent on male or elder sanctioning at community level are outward-facing decisions, while decisions falling within women's domain at household level are inward-facing decisions. Related to prevention, using bed nets was largely an inward-facing prevention decision for women, who were generally tasked with hanging, washing and mak ing nets usable. Net purchase and appropriation for malaria prevention (rather than for instance for fshing) was men's prerogative. Regular net use was associated with sleeping together more regularly, bringing couples closer. Attending antenatal care to access intermittent preventive treatment during pregnancy was often an outward-facing prevention decision, under the purview of older, infuential women and ultimately needing sanctioning by men. With respect to seeking care for malaria symptoms, women typically sought help from traditional healers frst. This inward-facing treatment decision was within their control, in contrast to the frequently transport-dependent, outward-facing decision to attend a health facility. Sharing decisions was described as a feature of a "harmonious household," something that was said to be encouraged by the TTSM intervention and that was both lived and aspirational.


Subject(s)
Male , Female , Health Policy, Planning and Management , Population Studies in Public Health , Malaria/prevention & control , Beds/supply & distribution , World Health Organization , Family , Population Groups , Decision/prevention & control , Respect , Gender Identity , Men , Methods , Mozambique
11.
Malar. j. (Online) ; 18(190): 1-11, 20190606. Mapa, Tab.
Article in English | AIM, RSDM, AIM | ID: biblio-1352353

ABSTRACT

Mozambique has historically been one of the countries with the highest malaria burden in the world. Starting in the 1960s, malaria control efforts were intensified in the southern region of the country, especially in Maputo city and Maputo province, to aid regional initiatives aimed to eliminate malaria in South Africa and eSwatini. Despite significant reductions in malaria prevalence, elimination was never achieved. Following the World Health Organization's renewed vision of a malaria­free­world, and considering the achievements from the past, the Mozambican National Malaria Control Programme (NMCP) embarked on the development and implementation of a strategic plan to accelerate from malaria control to malaria elimination in southern Mozambique. An initial partnership, supported by the Bill and Melinda Gates Foundation and the La Caixa Foundation, led to the creation of the Mozambican Alliance Towards the Elimination of Malaria (MALTEM) and the Malaria Technical and Advisory Committee (MTAC) to promote national ownership and partner coordination to work towards the goal of malaria elimination in local and cross­border initiatives. Surveillance systems to generate epidemiological and entomological intelligence to inform the malaria control strategies were strengthened, and an impact and feasibility assessment of various interventions aimed to interrupt malaria transmission were conducted in Magude district (Maputo Province) through the "Magude Project". The primary aim of this project was to generate evidence to inform malaria elimination strategies for southern Mozambique. The goal of malaria elimination in areas of low transmission intensity is now included in the national malaria strategic plan for 2017­22 and the NMCP and its partners have started to work towards this goal while evidence continues to be generated to move the national elimination agenda forward.


Subject(s)
Disease Eradication/methods , Malaria/prevention & control , Prevalence , Program , Malaria/epidemiology , Mozambique/epidemiology
12.
Cad. Saúde Pública (Online) ; 35(2): e00020218, 2019. graf
Article in Portuguese | LILACS | ID: biblio-984141

ABSTRACT

O entendimento das relações entre as variáveis de precipitação e nível d'água dos rios com os casos de malária podem fornecer indícios importantes da modulação da doença no contexto da variabilidade climática local. No intuito de demonstrar como essas relações variam no mesmo espaço endêmico, realizou-se a análise de coerência e fase de ondeletas entre as variáveis ambientais e epidemiológica no período de 2003 a 2010 para 8 municípios do Estado do Amazonas (Barcelos, Borba, Canutama, Carauari, Coari, Eirunepé, Humaitá e São Gabriel da Cachoeira). Os resultados indicam coerências significativas principalmente na escala de variabilidade anual, contudo, escalas menores que 1 ano e bienal também foram encontradas. As análises mostram que casos de malária apresentam pico com aproximadamente 1 mês e meio antes ou depois dos picos de chuva, e em média 1-4 meses após o pico dos rios para grande parte dos municípios estudados. Foi notado que cada variável ambiental apresentou atuação local distinta no tempo e no espaço, sugerindo que outras variáveis locais (a topografia é um exemplo) possam controlar as condições ambientais favorecendo uma atuação diferenciada em cada município, porém, quando as análises são feitas em conjunto é possível ver uma ordem não aleatória destas relações acontecerem. Embora os fatores ambientais e climáticos denotem certa influência sobre a dinâmica da malária, questões de vigilância, prevenção e controle não devem ser desprezadas, significando que as atuações governamentais de saúde podem mascarar possíveis relações com as condições hidrológicas e climáticas locais.


La comprensión de las relaciones entre las variables de precipitaciones y el nivel de agua de los ríos con los casos de malaria pueden proporcionar indicios importantes sobre la modulación de la enfermedad en el contexto de la variabilidad climática local. Con el fin de demonstrar cómo varían esas relaciones en el mismo espacio endémico, se realizó un análisis de coherencia y fase de ondeletas entre las variables ambientales y epidemiológicas, durante el período de 2003 a 2010, en 8 municipios del estado de Amazonas (Barcelos, Borba, Canutama, Carauari, Coari, Eirunepé, Humaitá y São Gabriel da Cachoeira). Los resultados indican coherencias significativas, principalmente en la escala de variabilidad anual, sin embargo, también se detectaron escalas menores de 1 año y bienal. Los análisis muestran que los casos de malaria presentan un pico con aproximadamente 1 mes y medio antes o después de la pluviosidad más alta, y de media 1-4 meses tras el pico de los ríos para gran parte de los municipios estudiados. Se observó que cada variable ambiental presentó una actuación local distinta en el tiempo y en el espacio, sugiriendo que otras variables locales (la topografía es un ejemplo) puedan controlar las condiciones ambientales, favoreciendo una actuación diferenciada en cada municipio, no obstante, cuando los análisis se realizan en conjunto es posible ver un orden no aleatorio de estas relaciones para que se produzcan. A pesar de que los factores ambientales y climáticos denoten una cierta influencia sobre la dinámica de la malaria, cuestiones de vigilancia, prevención y control no se deben despreciar, lo que significa que las actuaciones gubernamentales de salud pueden enmascarar posibles relaciones con las condiciones hidrológicas y climáticas locales.


Understanding the relations between rainfall and river water levels and malaria cases can provide important clues on modulation of the disease in the context of local climatic variability. In order to demonstrate how these relations can vary in the same endemic space, a coherence and wavelet phase analysis was performed between environmental and epidemiological variables from 2003 to 2010 for 8 municipalities (counties) in the state of Amazonas, Brazil (Barcelos, Borba, Canutama, Carauari, Coari, Eirunepé, Humaitá, and São Gabriel da Cachoeira). The results suggest significant coherences, mainly on the scale of annual variability, but scales of less than 1 year and of 2 years were also found. The analyses show that malaria cases display a peak at approximately 1 and a half months before or after peak rainfall and on average 1-4 months after peak river water levels in most of the municipalities studied. Each environmental variable displayed distinct local behavior in time and in space, suggesting that other local variables (e.g. topography) may control environmental conditions, favoring different patterns in each municipality. However, when the analyses were performed jointly it was possible to show a non-random order in these relations. Although environmental and climatic factors indicate a certain influence on malaria dynamics, surveillance, prevention, and control issues should not be overlooked, meaning that government public health interventions can mask possible relations with local hydrological and climatic conditions.


Subject(s)
Humans , Animals , Rain , Hydrology , Climate , Malaria/prevention & control , Malaria/epidemiology , Seasons , Brazil/epidemiology , Residence Characteristics , Incidence , Rivers , Disease Vectors
13.
Mem. Inst. Oswaldo Cruz ; 114: e180350, 2019. tab, graf
Article in English | LILACS | ID: biblio-984756

ABSTRACT

BACKGROUND The prompt diagnosis of plasmodial species for effective treatment prevents worsening of individual health and avoids transmission maintenance or even malaria reintroduction in areas where Plasmodium does not exist. Polymerase chain reaction (PCR) allows for the detection of parasites below the threshold of microscopic examination. OBJECTIVE Our aim was to develop a real-time PCR test to reduce diagnostic errors and increase efficacy. METHODS The lower limit of quantification and the linearity/analytical sensitivity to measure sensitivity or limit of detection (LoD) were determined. Intra-assay variations (repeatability) and alterations between assays, operators, and instruments (reproducibility) were also assessed to set precision. FINDINGS The linearity in SYBR™ Green and TaqMan™ systems was 106 and 102 copies and analytical sensitivity 1.13 and 1.17 copies/μL, respectively. Real-time PCR was more sensitive than conventional PCR, showing a LoD of 0.01 parasite (p)/μL. Reproducibility and repeatability (precision) were 100% for up to 0.1 p/μL in SYBR™ Green and 1 p/μL in TaqMan™ and conventional PCR. CONCLUSION Real-time PCR may replace conventional PCR in reference laboratories for P. vivax detection due to its rapidity. The TaqMan™ system is the most indicated when quantification assays are required. Performing tests in triplicate when diagnosing Plasmodium-infected-asymptomatic individuals is recommended to minimise diagnostic errors.


Subject(s)
Humans , Plasmodium vivax , Malaria/diagnosis , Malaria/prevention & control , Malaria/transmission
14.
Rev. Soc. Bras. Med. Trop ; 52: e20180542, 2019. graf
Article in English | LILACS | ID: biblio-990438

ABSTRACT

Abstract In Brazil, malaria is an important public health problem first reported in 1560. Historically, fluctuations in malaria cases in Brazil are attributed to waves of economic development; construction of railroads, highways, and hydroelectric dams; and population displacement and land occupation policies. Vector control measures have been widely used with an important role in reducing malaria cases. In this review article, we reviewed the vector control measures established in the Brazilian territory and aspects associated with such measures for malaria. Although some vector control measures are routinely used in Brazil, many entomological and effectiveness information still need better evidence in endemic areas where Plasmodium vivax predominates. Herein, we outlined some of the needs and priorities for future research: a) update of the cartography of malaria vectors in Brazil, adding molecular techniques for the correct identification of species and complexes of species; b) evaluation of vector competence of anophelines in Brazil; c) strengthening of local entomology teams to perform vector control measures and interpret results; d) evaluation of vector control measures, especially use of insecticide-treated nets and long-lasting insecticidal nets, estimating their effectiveness, cost-benefit, and population acceptance; e) establishment of colonies of malaria vectors in Brazil, i.e., Anopheles darlingi, to understand parasite-vector interactions better; f) study of new vector control strategies with impacts on non-endophilic vectors; g) estimation of the impact of insecticide resistance in different geographical areas; and h) identification of the relative contribution of natural and artificial breeding sites in different epidemiological contexts for transmission.


Subject(s)
Humans , Animals , Mosquito Control/methods , Mosquito Vectors , Malaria/prevention & control , Malaria/transmission , Brazil/epidemiology , Insecticide Resistance , Insecticides/pharmacology , Anopheles
15.
Thesis in French | AIM, AIM | ID: biblio-1278011

ABSTRACT

Face aux pratiques thérapeutiques inadaptées et à la couverture sanitaire insuffisante, le paludisme reste une maladie mortelle en Afrique sub-saharienne. Notre étude a concerné la communauté urbaine de Gamboma. Elle a été menée du 18 mai au 22 juin 2017. L'étude a eu pour objectif d'évaluer le niveau de prise en charge du paludisme dans les formations sanitaires de la localité. La population visée est constituée de mères d'enfants de 0 à 5 ans et de femmes enceintes. Pour ce faire, les entretiens individuels ont été réalisés à l'aide d'un questionnaire sur un échantillon de 200 mères d'enfants et femmes enceintes. L'étude a montré que le niveau de prise en charge n'est pas satisfaisant dans les différentes structures sanitaires de Gamboma. Plusieurs difficultés réduisent la prise en charge de cas de paludisme (manque de financement, de moustiquaires imprégnées d'insecticide). Faute de moyens financiers, 67% des mères ont recours à l'automédication (moderne et traditionnelle) pour traiter les cas de paludisme. Seulement 20% ont recours à un centre de santé, 7,6% à la prière et 4,8% aux guérisseurs. Ces résultats suggèrent qu'une intensification de la communication auprès des populations ainsi qu'une participation active de celles-ci seraient utiles pour atteindre les objectifs visés par les autorités au Congo. Des efforts restent à faire pour relever la qualité du traitement préventif du paludisme et augmenter la disponibilité et l'utilisation des moustiquaires imprégnées d'insecticide


Subject(s)
Africa South of the Sahara , Congo , Disease Management , Malaria/epidemiology , Malaria/prevention & control , Rural Population
16.
Ghana Med. J. (Online) ; 53(3): 237-247, 2019. ilus
Article in English | AIM, AIM | ID: biblio-1262308

ABSTRACT

Background: Patent medicine vendors (PMVs) are the most common source of antimalarial drugs and treatment for majority of Nigerians. The quality of their practice could have implications for malaria control. This study sought to explore the factors influencing the malaria treatment practices of PMVs for under-five children in Akwa Ibom State. Methods: A cross-sectional survey using an interviewer-administered questionnaire was conducted among 176 PMVs selected by simple random sampling from two local government areas (LGAs). In addition, four focus group discussions (FGD) were conducted to generate qualitative data. Quantitative data was analysed using SPSS version 20 while content analysis was done on the qualitative data. Results: Artemisinin Combination Therapy (ACT) was the most frequently recommended antimalarial treatment by PMVs (75.6%) for children as against chloroquine (17%) and Sulphadoxine/Pyrimethamine (2.8%). However, only 39.2% of PMVs recommended the appropriate antimalarial treatment (ACTs at the right dose for age), while 71% recommended referral for severe malaria. Factors found to be associated with appropriate management of malaria from quantitative analysis included Educational qualification, attending malaria training and their knowledge of malaria. The FGDs showed that severity of child's illness, parents/caregivers drug request and perceived ability of the parents/caregiver to afford the drugs influenced PMVs malaria treatment practices. Conclusion: Knowledge of malaria, severity of child's illness and parents' drug request influenced the treatment practices of PMVs. Training PMVs on appropriate malaria management and community health education/sensitization to leverage on the influence of client-demand on ACT use is recommended to improve PMVs treatment practice


Subject(s)
Child, Preschool , Malaria , Malaria/economics , Malaria/prevention & control , Malaria/therapy , Nigeria
17.
Article in English | AIM, AIM | ID: biblio-1264368

ABSTRACT

Background: The global malaria agenda has the ultimate goal of eliminating malaria in all countries of the world by 2030 through universal access to malaria prevention, diagnosis and treatment. Presumptive treatment of malaria with Artemisinin Combination Therapy (ACT) has been associated with the development of resistance, therefore parasitological confirmation of all fevers is crucial in the context of eliminating malaria. This study assessed physicians' compliance with the national guidelines in the treatment of malaria among under-five (U-5) children and their prescription pattern in a Maternal and Child Care (MCC) centre in Lagos State. Methods: This was a descriptive cross-sectional study conducted as an exit interview among 427 mothers/caregivers of febrile U-5 children who were consecutively sampled.The data was collected using a pre-tested interviewer-administered questionnaire and a proforma. Epi-info version 7.2.1 was used to analyze the data and the level of significance was set as p<0.05. Results: Malaria Rapid Diagnostic Test (mRDT) was done for 75 17.6%) of the children and 37 (49.3%) was positive. Anti-malarial drugs were prescribed at consultation to 400 (93.7%) of the febrile children. Artemisinin Combination Therapy (ACT) was prescribed for 364 (91.0%) of the children. The most prescribed ACT was Artemether-Lumefantrine (AL) in 222 (60.9%). Conclusion: The physician's compliance with malaria treatment guidelines for febrile illnesses in U-5 children was poor with regards to parasitological confirmation before treatment. However, the use of ACTs was adhered to in almost all cases. Regular training workshops are recommended for health workers to improve adherence to parasitological confirmation before treatment


Subject(s)
Child Day Care Centers , Compliance , Lakes , Malaria , Malaria/diagnosis , Malaria/prevention & control , Nigeria
18.
Bogotá; Instituto Nacional de Salud; [2019]. 4 p.
Monography in Spanish | PIE, LILACS, PIE | ID: biblio-1047552

ABSTRACT

La minería de oro a cielo abierto se ha asociado a diversos problemas de salud en la población, entre esos la proliferación de enfermedades infecciosas como la malaria. El departamento del Chocó, uno de los más importantes productores de oro del país, ha venido siendo afectado por un aumento en el número de casos y muertes por Malaria. Con el fin de poner a prueba si estos dos eventos se encuentran relacionados el ONS llevó a cabo un estudio para evaluar la asociación entre los niveles de producción de oro en los municipios del Chocó y los casos de malaria. El estudio encontró que los municipios con mayor producción de oro también presentan en promedio el mayor número de casos de malaria anualmente. De acuerdo con los hallazgos de este y otros estudios es importante para el control de la malaria abrir los espacios necesarios para discutir la minería de oro como un factor determinante en la propagación de la malaria en el departamento del Chocó y probablemente otras regiones mineras de Colombia.


Subject(s)
Gold , Malaria/epidemiology , Mining , Epidemiologic Factors , Risk Factors , Colombia , Malaria/etiology , Malaria/prevention & control
19.
Rev. Soc. Bras. Med. Trop ; 52: e20190014, 2019. tab
Article in English | LILACS | ID: biblio-1041595

ABSTRACT

Abstract INTRODUCTION: Malaria is the main cause of death by infection among travelers and is preventable through a combination of chemoprophylaxis and personal protective measures. METHODS: Travelers were interviewed by phone 28-90 days after returning, to assess adherence to pre-travel advice for malaria prevention. RESULTS: A total 57 travelers were included. Adherence to chemoprophylaxis was significantly higher among participants prescribed mefloquine (n=18; 75%) than doxycycline (n=14; 45%). Adherence to mosquito repellent and bed net use was 65% and 67%, respectively. CONCLUSIONS: Adherence to malaria prophylaxis was lower than expected. Further studies testing innovative approaches to motivate travelers' compliance are required.


Subject(s)
Humans , Male , Female , Adult , Mefloquine/therapeutic use , Doxycycline/therapeutic use , Medication Adherence/statistics & numerical data , Pre-Exposure Prophylaxis/statistics & numerical data , Malaria/prevention & control , Malaria/drug therapy , Antimalarials/therapeutic use , Travel , Middle Aged
20.
Buenos Aires; GCBA. Gerencia Operativa de Epidemiología; 9 nov. 2018. a) f: 13 l:17 p. graf, mapas.(Boletín Epidemiológico Semanal: Ciudad Autónoma de Buenos Aires, 3, 116).
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1116593

ABSTRACT

El paludismo o malaria es una enfermedad potencialmente mortal causada por la infección de una o más de cinco especies de parásitos protozoarios intracelulares: Plasmodium vivax, Plasmodium falciparum, Plasmodium ovale, Plasmodium malariae, y Plasmodium knowlesi, que se transmiten al ser humano por la picadura de mosquitos hembra infectados del género Anopheles. Se describen antecedentes, situación actual, casos notificados en Argentina, estratificación de riesgo de reintroducción de paludismo en el país, definición de casos sospechosos y confirmados, y acciones epidemiológicas realizadas


Subject(s)
Protozoan Infections/prevention & control , Protozoan Infections/epidemiology , Health Surveillance , Disease Notification/methods , Disease Notification/statistics & numerical data , Risk Map , Malaria/pathology , Malaria/prevention & control , Malaria/transmission , Malaria/epidemiology
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