In vitro Anti-malarial Activity Evaluation of Extracts from Plants often used in the East African Region

Biodiversity plays vital roles in maintaining human and animal health. A wide variety of plants, animals, and fungi are used as medicine, essential vitamins, painkillers. Natural products have been recognized and used as medicines by ancient cultures all around the world. About 119 pure chemicals are extracted from less than 90 species of higher plants and used as medicines throughout the world, for example, artemisinin and quinine for treatment of malaria. Malaria is the most important public health problem in tropical and sub-tropical Africa, and it is becoming more and more difficult to control. Although several attempts have been made on vaccine development, chemotherapy and vector control are currently the mainstays of malaria control. However, with increasing cases of drug-resistant strains of malaria parasites and expensive anti-malarial drugs coupled with the poor distribution of modern health facilities, there is a resurgence in use of herbal remedies to treat malaria and other infectious diseases, before seeking the conventional western remedies. Although the use of herbal preparations for malaria is widespread in the Lake Victoria basin, there has been no previous validation of their efficacy and safety. Furthermore, there are no standard practices for quality assurance in sourcing of the herbal anti-malarial drugs. In this paper, a survey of the plants used for treatment and management of malaria in the Lake Victoria was carried out. Organic and water extracts from these plants were subjected to in vitro anti-plasmodial assays using W2 (CQ resistant) and D6 (CQ sensitive) strains. The results obtained to authenticate the use of these plants as anti-malarial herbs. A set of compounds have been isolated and characterized from the plant species that exhibited high anti-plasmodial activity.

In vitro antiplasmodial activity and toxicity assessment of plant extracts used in traditional malaria therapy in the Lake Victoria Region

As part of our program screening the flora of the Lake Victoria Region, a total of 54 organic extracts from seven plant families (8 species) were individually tested for antiplasmodial activity against chloroquine-sensitive [Sierra Leone (D-6)] and chloroquine-resistant [Vietnam (W-2)] strains. Only 22 percent of these extracts exhibited very high in vitro antiplasmodial activity. Six methanol (MeOH) extracts and one chloroform extract showed in vitro antiplasmodial activity against the D-6 Plasmodium falciparum strain, while only three MeOH extracts were active against the W-2 strain. All of the ethyl acetate extracts proved to be inactive against both strains of P. falciparum. A brine shrimp cytotoxicity assay was used to predict the potential toxicity of the extracts. The cytotoxicity to antiplasmodial ratios for the MeOH extracts were found to be greater than 100, which could indicate that the extracts are of low toxicity.

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.

INFLUENCE OF ARTESUNATE ON INFECTIVITY OF GAMETOCYTES OF PLASMODIUM FALCIPARUM / 中药新药与临床药理

A study was carried out in south of Vietnam 15 Patients with Plasmodium falciparum gametocytes and asexual parasites were distributed into groups A, B and C. Artesunate was given orally at a total dose of 600 mg for 5 days in group A, 200 mg for 2 days in group B and intravenously at a total dose of 360 mg for 5 days in group C respectively. Gametocytes count was done before medication and daily after medication. Meanwhile, Anopheles dirus as a vector was employed to study the infectivity of gametocyte, The result showed that the mean gametocyte clearance time in three groups were respectively 15.4?5.0, 20.6?4.8 and 20.3?4.0 days. The mosquitoes were not infected from the blood in 2, 5 and 5 of 5 patients respectively on days 7, 14 and 21 in group A; 1 and 5 of 5 patients on day 14 and 21 in group B; 2 of 5 patients and 3 of 3 patients on days 14 and 21 in group C. It indicates that artesunate has remarkable effect on Plasmodium falciparum gametocytemia and its infectivity to mosquitoes.