ABSTRACT
Background: Malaria is a public health problem, particularly in low- and middle-income countries. In Angola, it is the leading cause of death, morbidity, and absenteeism from work and school. Objective: To evaluate the social and clinical factors associated with resistance to in-hospital treatment. Methodology: A prospective analytical cross-sectional study with a quantitative approach was conducted including 220 patients with malaria. Results: Of the 220 patients enrolled, the majority were between 21 and 40 years old (72.7%), male (53.6%), of peri-urban areas (47.7%), employees (46.4%), and with high parasitemia levels (57.7%). Of the remaining hospitalized patients (61.4%), 20.9% were resistant to treatment. The resistance risk was higher in patients over 40 years [OR: 5.91 (95% CI: 0.76-45.7), P = .088], from rural regions [OR: 2.48 (95% CI: 0.95-6.48), P = .064], that were unemployed [OR: 1.06 (95% CI: 0.52-2.15), P = .859], presenting high parasitemia [OR: 1.95 (95% CI: 1.02-3.75), P = .043] and who remained hospitalized [OR: 5.28 (95% CI: 0.63-43.1), P = .121]. The risk to develop resistance was lower in patients that were students [OR: 0.04 (95% CI: 0.01-0.37), P = .004], patients who were treated with dipyrone [OR: 0.06 (95% CI: 0.01-0.24), P < .001], metoclopramide [OR: 0.25 (95% CI: 0.09-0.67), P = .006] and ciprofloxacin [OR: 0.22 (95% CI: 0.11-0.44), P < .001]. Conclusion: Treatment with antimalarial drugs as well as the use of adjuvants such as dipyrone, metoclopramide, ciprofloxacin, and diazepam can reduce the chances of developing resistance to malaria treatment, however, it is necessary to carry out further in-depth studies.
ABSTRACT
The global community is racing to slow down and eventually stop the spread of COVID-19, which is a pandemic that has killed thousands of lives and made tens of thousands sick. The new coronavirus has already reached Angola, with 25 confirmed cases, among them 2 died and 6 were cured. The government has decreed a state of emergency on 24 March 2020 for 15 days, which was extended twice for the same number of days that will make it possible to reduce clusters of people and keep them at home. This study reflected on the diverse ways of leadership. It is an article of theoretical, technical and scientific reflection, based on the experience of a new epidemiological situation, with a critical analysis based on technical, scientific and professional experience, with bibliographic input of data obtained from information published in scientific articles, newspapers, magazines and other official documents published in Angola and worldwide related to COVID-19. This article emerged from critical thinking based on the current situation of COVID-19 in Angola in the world and is reflected in this article, what Angola should learn and learned from the experience of other countries that also imported the disease, their history of investment in health, characteristics of their populations, their economies and other aspects.