Malaria Preventive Practices among Under-five Children in Rivers State, Nigeria

Background:Malaria is a life threatening protozoan infection and children under 5 years are one of the most vulnerable group. Good malaria preventive practices among these group is key to reducing malaria burden and its associated mortality Objective:The aim of the study was to assess malaria preventive practices among under-five children in Rivers State, Nigeria. Materials and Methods:This was a cross sectional study carried out in public and private health facilities in Rivers state. Ethical approval for the study was obtained from the Research and Ethics committee of the University of Port Harcourt Teaching Hospital, while an informed written consent was obtained from the parents or caregivers of the participants. Stratified sampling method was used to select the health facilities and the subjects for the study. A pretested interviewer administered questionnaire was used to harvest relevant information on socio demographic characteristics of the subjects and informants and malaria preventive practices. Obtaineddata was analysed using SPSS version 22 and results are presented in prose and tables. Results:A total of 1138 children participated in the study constituting of 613 (53.9%) male and 525(46.1%) female giving a male: female ratio of 1.2:1. Mean age of participants was 1.74±1.08 years. Mothers, accounted for majority 1012 (88.9%) of the informants. Most of the informants had tertiary degree; 605 (53.4%) and 697 (61.8%) among mothers and fathers respectively. Among the occupations of fathers, public servants, civil servants and the self-employed were more represented, constituting 242 (21.4%), 200 (17.7%) and 149 (13.2%) respectively. Traders/business women, the self-employed and civil servants were most represented among the occupations of mothers in the study and these accounted for 444 (39.7%), 181 (16.2%) and 137 (12.3%) respectively. Malaria preventive practices included use of Insecticide-treated bed nets (ITNs), Indoor spraying of insecticide (modified IRS), use of antimalarial drugs, clearing of bushes/ disposal of containers where mosquitoes breed and use of mosquito repellent creams which constituted 605 (53.2%), 483 (42.4%), 133 (11.7%), 4 (0.4%) and 2 (0.2%) respectively; there were 512 (45.0%) children who slept under ITNs the previous night. Also, 970 (85.2%) had window nets installed in their homes. Protective window nets was also in place in the homes of 970 (85.2%) of the study participants. Among families that practiced use of ITNs, 110 (61.8%) were from the middle social class and 62 (34.8%) were from the upper social class, while 316 (52.2%) and 276 (45.6%) were from the upper and middle social class respectively among those that practised Indoor spraying of insecticide (IRS). Conclusion:Use of ITNs, modified IRS and use of anti malarials were the common malaria preventive practices among under-fives in Rivers state and these methods were more practiced among the middle and upper social class. Education on the integrated approach to malaria prevention which advocates the use of several malaria prevention methods in a holistic manner should be intensified

Promising Novel Applications of Heparin / 中国药学杂志

Heparin has been used as first-line anticoagulant clinically for 80 years. Heparin mainly exerts its anticoagulant activity through interaction with ATIII. It has been found there are more than one hundred heparin-dependent functional proteins which demonstrates promising novel application beyond anticoagulant, such as anti-tumor, anti-malaria anti-inflammation, anti-viral, anti-malaria anti-anemia, etc. Heparin is also hopeful to be used as tool for drug delivery vehicle and functionalized implants material. In addition, heparin oligosaccharides are expected to be produced by chemical/enzymatic and bioengineering synthesis. Above mentioned new developments of heparin are covered in this review.

Achieving the 6th MDG: An Evaluation Drug Treatment of Malaria in Selected PHC in Osun State.

Introduction: The burden of malaria in Nigeria and Africa is well documented. The current Nigeria anti-malaria drug policy has recommended artemisinin-based combination therapy (ACT) as the first-line drug treatment for uncomplicated malaria since 2005. It is now 8 years since the adoption of ACT and two years to the set time for the achievement of the MDGs. Objective: To assess the adherence of the PHC to the new policy on drug treatment for uncomplicated malaria. Methods: Using a pro-forma, relevant information about drug prescription of malaria cases between January 2008 and December 2009 was extracted from patients’ folders in the 3 comprehensive health centres being used by LAUTECH Teaching Hospital, Osogbo. Additional data were also collected through the use of in-depth interviews. Data were analyzed with Epi-Info software 3.4.2. Results: A total of 8881 episodes of malaria were analyzed of which male children (0-5years) constituted the highest number. The commonest prescribed anti-malaria was oral Chloroquine (21.6%) for the 3 CHC combined. However, for each CHC, CQ was the commonest drug prescribed for Ilie and Atelewo CHC (41.6% and 25.5% respectively), while for Akogun CHC alone, it was Artesunate + SP. Akogun CHC was found to have the highest prescribed pre-packaged ACT. Factors responsible for inappropriate prescription were non-availability and perceived patients' nonaffordability and unwillingness to buy drugs. Conclusion: Prescription of CQ and SP as mono-therapy continues to prevail in the CHC. There is urgent need for ensuring compliance to the current and acceptable treatment for malaria. Other means of sustaining availability of anti-malaria drugs should be considered.

U.S. Military Administration's Malaria Control Activities (1945-1948) / 의사학

To prevent and control infectious diseases was one of the major concerns of U.S. military government when they stationed in Korea in 1945. It was because the spread of various infectious diseases can cause social unrest and they can also affect the U.S. military. Malaria was one of the most important infectious diseases to which the U.S. military had been paying special attention. The U.S. military received a severe damage during the Pacific war with Japan due to malaria. It was said that more soldiers were lost by malaria than by battle itself. The bitter experience they had during the war made them accumulate more systematic and practical knowledge against malaria. As a result, by the end of the war, the U.S. military could run more than hundreds of units specialized in controlling malaria. Thanks to such a preparation, they could immediately begin their anti-malaria activities in Korea soon after the World War II. Although the vivax malaria, which is the dominant type in Korea, is not as much a fatal type as that in the Pacific areas, it was damaging enough to the infected. The 207th Malaria Survey Detachment carried out collecting and identifying the kinds of mosquitos in Korea. In addition, they also surveyed the prevalence of malaria among school children in Seoul. In terms of controlling malaria, DDT played a decisive role. Vector control is the most effective and ideal measurements against malaria. Before the development of DDT, it was practically impossible to eradicate mosquitos which arise from extremely broad areas. However, DDT could not be used as it had been expected in the rural area, because spraying DDT in the rice paddies which is the breeding place of mosquitos kills rice. Despite such a limitation in anti-malaria activities of the US military government, it should be noted that a significant turn in controlling malaria was possible thanks to the development of DDT.

In vivo antioxidant assessment of two antimalarial plants-Allamamda cathartica and Bixa orellana

<p><b>OBJECTIVE</b>To determine the free radical scavenging potentials pytochemical constituents of ethanol leaves extracts of Allamanda cathartica (A. cathartica) and Bixa orellana (B. orellana) and thus their effects in antimalarial activities.</p><p><b>METHODS</b>Both ethanol extracted plant samples were administered at 50 mg/mL, 100 mg/mL and 200 mg/mL to Albino rats and then administered with CCl4 at 1 mL/kg body weight, in liquid paraffin (1:1, v/v) for 2 days (negative control) and compared with 5% Tween 80 (placebo) and vitamin E (positive control) pretreatments. Thiobarbituric acid reactive substances (TBARS), glutathione (GSH) and catalase (CAT) activities in blood and liver tissues were assessed.</p><p><b>RESULTS</b>In CCl4 treated rats, TBARS levels significantly increased, while decreased GSH and CAT levels were recorded for both plant extracts. Generally, higher TBARS and GSH values were recorded for blood than for liver homogenates; with reverse trend observed for CAT level. Increased concentrations of A. cathartica extract recorded significant antioxidant levels similar to tocopherol (vitamin E). Reducing sugars, saponins, flavonoids were recorded for both species; alkaloids in A. cathartica and terpenoids in B. orellana.</p><p><b>CONCLUSIONS</b>A. cathartica, possess phytochemicals that recorded significant antioxidative defense activities for blood and liver tissues with increasing concentration. However B. orellana did not record similar results.</p>

In vivo antioxidant assessment of two antimalarial plants-Allamamda cathartica and Bixa orellana

Objective: To determine the free radical scavenging potentials pytochemical constituents of ethanol leaves extracts of Allamanda cathartica (A. cathartica) and Bixa orellana (B. orellana) and thus their effects in antimalarial activities. Methods: Both ethanol extracted plant samples were administered at 50 mg/mL, 100 mg/mL and 200 mg/mL to Albino rats and then administered with CCl4 at 1 mL/kg body weight, in liquid paraffin (1:1, v/v) for 2 days (negative control) and compared with 5% Tween 80 (placebo) and vitamin E (positive control) pretreatments. Thiobarbituric acid reactive substances (TBARS), glutathione (GSH) and catalase (CAT) activities in blood and liver tissues were assessed. Results: In CCl4 treated rats, TBARS levels significantly increased, while decreased GSH and CAT levels were recorded for both plant extracts. Generally, higher TBARS and GSH values were recorded for blood than for liver homogenates; with reverse trend observed for CAT level. Increased concentrations of A. cathartica extract recorded significant antioxidant levels similar to tocopherol (vitamin E). Reducing sugars, saponins, flavonoids were recorded for both species; alkaloids in A. cathartica and terpenoids in B. orellana. Conclusions: A.cathartica, possess phytochemicals that recorded significant antioxidative defense activities for blood and liver tissues with increasing concentration. However B. orellana did not record similar results.

Natural products drug discovery research in India: Status and appraisal.

Discovery of a new drug is time consuming and laborious process. Natural products have long been a thriving source for the discovery of new drugs due to their chemical diversity and ability to act on various biological targets. The phytochemical exploration of indigeneous flora has contributed to some extent in this race for the discovery of new drugs. The traditional Indian systems of medicine has been a part of our lifestyle since ages and the classical texts like Ayurveda and Charak Samhita have served as materia medica for this purpose. This review focuses on the contributions made from India in the drug discovery and development process and provides future directions in the area.

Malária grave importada: relato de caso / Severe imported malaria: case report

JUSTIFICATIVA E OBJETIVOS: A malária ainda representa um problema de saúde global. A forma grave da doença é causada principalmente por P. falciparum e pode cursar com complicações cerebrais, renais, pulmonares, hematológicas, circulatórias e hepáticas. O objetivo deste estudo foi relatar um caso de paciente portador de malária grave importada. RELATO DO CASO: Paciente do sexo masculino, 30 anos, pardo, filipino, marinheiro, proveniente de embarcação vinda da Nigéria, com história de dor abdominal no hipocôndrio direito, icterícia, febre e rebaixamento do nível de consciência. Os exames laboratoriais de admissão mostraram hiperbilirrubinemia de 50 mg/dL, acidose metabólica grave, trombocitopenia, creatinina de 5,6 mg/dL, leucocitose com desvio até metamielócitos. O escore APACHE II foi de 37, com risco de óbito de 88 por cento. Durante a internação foi diagnosticada malária por P. falciparum pelo teste de gota espessa. Mesmo com tratamento antimalárico adequado, o paciente evoluiu com insuficiência renal aguda necessitando de hemodiálise e síndrome de angústia respiratória aguda (SARA), necessitando de ventilação mecânica (VM), choque refratário tratado com aminas vasoativas, além de quadro hematológico, configurando um caso grave de disfunção de múltiplos de órgãos. Ainda apresentou pneumonia associada à VM e sepse relacionada ao uso de cateteres. Após a alta hospitalar, o paciente não apresentou seqüelas cerebral, pulmonar ou renal. CONCLUSÕES: Dos critérios definidores de malária grave descritos na literatura, o paciente preenchia: insuficiência renal aguda, síndrome da angústia respiratória aguda (SARA), acidose metabólica, alteração do nível de consciência, hemoglobinúria macroscópica, hiperparasitemia e hiperbilirrubinemia, que se relaciona a uma mortalidade maior que 10 por cento, na dependência do tratamento precoce e dos recursos disponíveis. A malária grave exige diagnóstico e tratamento intensivo rápidos, pois o atraso aumenta...

BACKGROUND AND OBJECTIVES: Malaria is still considered a major global health problem. The severity form of the disease is caused, mainly by P. falciparum and may occur together with cerebral, kidney, pulmonary, hematologic, circulatory and hepatic complications. This report is about a patient with a case of severe imported malaria. CASE REPORT: A 30-years-old man, mulatto, Philippine, sailor, coming from a ship arriving from Nigeria, with a history of abdominal pain on the right hypochondrium, jaundice, fever, decreased in the consciousness. Lab tests made upon his admission showed hyperbilirubinemia at a level of 50 mg/dL, severe metabolic acidosis, thrombocytopenia, creatinine levels of 5.6 mg/dL and leukocytosis with deviation through metamyelocytes. The APACHE II score was 37, with death estimated risk of 88 percent. During his stay at the hospital, P. Falciparum Malaria was diagnosed through the thick drop test. And, even with the adequate anti-malaria therapy, the patientÆs condition evolved to an acute renal failure requiring hemodialis; acute respiratory distress syndrome (ARDS); septic shock, and hematological disorders, forming a multiple organ dysfunction syndrome (MODS). After being discharged from the hospital, the patient did not present any cerebral, pulmonary or kidney sequel. CONCLUSIONS: From the criteria described in medical literature to define critical malaria, the patient fulfilled the following: acute renal failure, ARDS, metabolic acidosis, altered level of consciousness, macroscopic hemoglobinuria, hyperparasitism and hyperbilirubinemia, related to a lethality rate of over 10 percent, depending on early treatment and available resources. Severe malaria requires fast diagnosis allied to a quick access to an intensive care treatment, since any delay increases the morbid-mortality of the disease.

La Malaria en el Nuevo Mundo: de los Origenes al Siglo XXI / Malaria in the New World: From its Origin to the XXI Century

A partir de una revisión histórico-epidemiológica de la información disponible sobre el Paludismo en nuestro continente, después de la llegada de los Conquistadores, se comentan las relaciones parásito-vectores y hospederos naturales, dejando abierta la gran incógnita del origen de los parásitos maláricos en el Nuevo Mundo. Se traza una visión de salud y enfermedad como producto de la conquista y de la limitada experiencia de nuestros aborígenes frente a las patologías importadas de Eurasia. Un resumen sobre la lucha antipalúdica organizada permite algunas consideraciones sobre su presente y futuro. Se concluye sugiriendo un esfuerzo multidisciplinario y pluriinstitucional basado en una estrategia de participación comunitaria para superar el estancamiento o los retrocesos presentes en los inicios del Siglo XXI.

Starting from a historic-epidemiological review of the available information concerning malaria in our continent after the arrival of the "conquistadores", the authors discuss the relations between parasites, vectors and natural hosts, leaving unsolved the question concerning the origin of malaria parasites in the New World. An outlook of health-disease process as a product of the conquest and the limited experience of our ancestors in front of exotic pathologies arrived from Eurasia is given. A summary of the organized struggle against malaria allows some considerations on its present and future perspectives. Finally, a suggestion for a joint professional and institutional effort with a community based strategy is made, aimed to overcome the blockage and setbacks recorded at the beginning of the XXI century.