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Søgeord (malaria) valgt.
30 emner vises.
Camila Marques-da-Silva, Clyde Schmidt-Silva, Samarchith P. Kurup
Trends in Parasitology, 7.05.2024
Tilføjet 7.05.2024
The Plasmodium parasites that cause malaria undergo asymptomatic development in the parenchymal cells of the liver, the hepatocytes, prior to infecting erythrocytes and causing clinical disease. Traditionally, hepatocytes have been perceived as passive bystanders that allow hepatotropic pathogens such as Plasmodium to develop relatively unchallenged. However, now there is emerging evidence suggesting that hepatocytes can mount robust cell-autonomous immune responses that target Plasmodium, limiting its progression to the blood and reducing the incidence and severity of clinical malaria. Here we discuss our current understanding of hepatocyte cell-intrinsic immune responses that target Plasmodium and how these pathways impact malaria.
Læs mere Tjek på PubMedMichal Juraska, Angela M Early, Li Li, Stephen F Schaffner, Marc Lievens, Akanksha Khorgade, Brian Simpkins, Nima S Hejazi, David Benkeser, Qi Wang, Laina D Mercer, Samuel Adjei, Tsiri Agbenyega, Scott Anderson, Daniel Ansong, Dennis K Bii, Patrick B Y Buabeng, Sean English, Nicholas Fitzgerald, Jonna Grimsby, Simon K Kariuki, Kephas Otieno, François Roman, Aaron M Samuels, Nelli Westercamp, Christian F Ockenhouse, Opokua Ofori-Anyinam, Cynthia K Lee, Bronwyn L MacInnis, Dyann F Wirth, Peter B Gilbert, Daniel E Neafsey
Lancet Infectious Diseases, 7.05.2024
Tilføjet 7.05.2024
All tested dosing regimens blocked some infections to a similar degree. Improved vaccine efficacy in participants infected during vaccination could suggest new strategies for highly efficacious malaria vaccine development and implementation.
Læs mere Tjek på PubMedReina Engle-Stone, K Ryan Wessells, Marjorie J. Haskell, Sika M. Kumordzie, Charles D. Arnold, Jennie N. Davis, Emily R. Becher, Ahmed D. Fuseini, Kania W. Nyaaba, Xiuping Tan, Katherine P. Adams, Georg Lietz, Stephen A. Vosti, Seth Adu-Afarwuah
PLoS One Infectious Diseases, 6.05.2024
Tilføjet 6.05.2024
by Reina Engle-Stone, K Ryan Wessells, Marjorie J. Haskell, Sika M. Kumordzie, Charles D. Arnold, Jennie N. Davis, Emily R. Becher, Ahmed D. Fuseini, Kania W. Nyaaba, Xiuping Tan, Katherine P. Adams, Georg Lietz, Stephen A. Vosti, Seth Adu-Afarwuah Introduction Micronutrient deficiencies are prevalent in West Africa, particularly among women of reproductive age (WRA) and young children. Bouillon is a promising food fortification vehicle due to its widespread consumption. This study aims to evaluate the impact of multiple micronutrient-fortified bouillon cubes, compared to control bouillon cubes (fortified with iodine only), on micronutrient status and hemoglobin concentrations among lactating and non-lactating WRA and young children in northern Ghana. Methods This randomized, controlled doubly-masked trial will be conducted in the Kumbungu and Tolon districts in the Northern Region of Ghana, where prior data indicate multiple micronutrient deficiencies are common. Participants will be: 1) non-pregnant non-lactating WRA (15–49 y), 2) children 2–5 y, and 3) non-pregnant lactating women 4–18 months postpartum. Eligible participants will be randomly assigned to receive household rations of one of two types of bouillon cubes: 1) a multiple micronutrient-fortified bouillon cube containing vitamin A, folic acid, vitamin B12, iron, zinc, and iodine, or 2) a control cube containing iodine only.Each participant’s household will receive a ration of bouillon cubes every 2 weeks, and households will be advised to prepare meals as usual, using the study-provided cubes. The trial duration will be 9 months for non-pregnant non-lactating WRA and children, and 3 months for lactating women. The primary outcomes will be changes in biomarkers of micronutrient status and hemoglobin among WRA and children and milk micronutrient concentrations among lactating women. Secondary outcomes will include change in prevalence of micronutrient deficiency and anemia; dietary intake of bouillon and micronutrients; inflammation, malaria, and morbidity symptoms; and child growth and development. Discussion Evidence from this study will inform discussions about bouillon fortification in Ghana and West Africa. Trial registration The trial was registered on ClinicalTrials.gov (NCT05178407) and the Pan-African Clinical Trial Registry (PACTR202206868437931). This manuscript reflects protocol version 4 (August 29, 2022).
Læs mere Tjek på PubMedShirin TaheriMikel Alexander GonzálezMaría José Ruiz-LópezSergio MagallanesSarah Delacour-EstrellaJavier LucientesRubén Bueno-MaríJosué Martínez-de la PuenteDaniel Bravo-BarrigaEva FronteraAlejandro PolinaYasmina Martinez-BarcielaJosé Manuel PereiraJosefina GarridoCarles ArandaAlfonso MarzalIgnacio Ruiz-ArrondoJosé Antonio OteoMartina FerragutiRafael Gutíerrez-LópezRosa EstradaMiguel Ángel MirandaCarlos BarcelóRodrigo MorchónTomas MontalvoLaura GangosoFátima GoiriAna L. García-PérezSantiago RuizBeatriz Fernandez-MartinezDiana Gómez-BarrosoJordi Figuerolaa Departamento de Biología de la Conservación y Cambio Global, Estación Biológica de Doñana (EBD), CSIC, Sevilla, Spainb CIBER de Epidemiología y Salud Pública (CIBERESP), Madrid, Spainc The Agrifood Institute of Aragón (IA2), Faculty of Veterinary Medicine, University of Zaragoza, Zaragoza, Spaind Center of Excellence in Vector Control, Rentokil Initial, València, Spaine Grupo de Investigación Parásitos y Salud, Universitat de València, València, Spainf Departamento de Parasitología, Universidad de Granada, Granada, Spaing Departamento de Salud Animal, Grupo de Investigación en Salud Animal y Zoonosis (GISAZ), Facultad de Veterinaria, Universidad de Córdoba, Córdoba, Spainh Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de Extremadura (UEx), Cáceres, Spaini Departamento de Ecoloxía e Bioloxía Animal, Universidade de Vigo, Pontevedra, Spainj Departamento de Zooloxía, Xenética e Antropoloxía Física, Universidade de Santiago de Compostela, A Coruña, Spaink Servei de Control de Mosquits del Baix Llobregat, Sant Feliu del Llobregat, Barcelona, Spainl IRTA, Centre de Recerca en Sanitat Animal (CReSA, IRTA-UAB), Campus Universitat Autònoma de Barcelona, Bellaterra, Spainm Facultad de Biología, Universidad de Extremadura, Badajoz, Spainn Grupo de Investigaciones en Fauna Silvestre, Universidad Nacional de San Martín, Tarapoto, Perúo Centre of Rickettsiosis and Arthropod-Borne Diseases, Hospital Universitario San Pedro-CIBIR, La Rioja, Logroño, Spainp Centro Nacional de Microbiología (CNM-ISCIII), Madrid, Spainq CIBER de Enfermedades Infecciosas (CIBERINFEC), Madrid, Spainr Universitat de les Illes Balears (UIB), Zoología Aplicada y de la Conservación, Palma, Spains Zoonotic Diseases and One Health Group, Faculty of Pharmacy, Universidad de Salamanca, Salamanca, Spaint Agencia de Salut Publica de Barcelona, Barcelona, Spainu Universidad Complutense de Madrid, Madrid, Spainv NEIKER-Instituto Vasco de Investigación y Desarrollo Agrario, Derio, Spainw Servicio de Control de Mosquitos de la Diputación de Huelva, Huelva, Spainx Centro Nacional de Epidemiologia (CNE-ISCIII), Madrid, Spain
Emerg Microbes Infect, 3.05.2024
Tilføjet 3.05.2024
Jane M. Carlton and Aubrey J. Cunnington
Science, 3.05.2024
Tilføjet 3.05.2024
Harun K. Aremu, Christianah A. Dare, Idris A. Adekale, Bukunmi D. Adetunji, Dickson A. Musa, Luqmon A. Azeez, Olu I. Oyewole
PLoS One Infectious Diseases, 3.05.2024
Tilføjet 3.05.2024
by Harun K. Aremu, Christianah A. Dare, Idris A. Adekale, Bukunmi D. Adetunji, Dickson A. Musa, Luqmon A. Azeez, Olu I. Oyewole The incorporation of phytoactive compounds in the management of malarial vectors holds promise for the development of innovative and efficient alternatives. Nevertheless, the molecular and physiological responses that these bioactive substances induce remain underexplored. This present study investigated the toxicity of different concentrations of aqueous and methanol extracts of Ocimum tenuiflorum against larvae of Anopheles gambiae (sensu stricto) and unraveled the possible underlying molecular pathways responsible for the observed physiological effects. FTIR and GCMS analyses of phytoactive compounds in aqueous and methanol crude extracts of O. tenuiflorum showed the presence of OH stretching vibration, C = C stretching modes of aromatics and methylene rocking vibration; ring deformation mode with high levels of trans-β-ocimene, 3,7-dimethyl-1,3,6-octatriene in aqueous extract and 4-methoxy-benzaldehyde, 1,3,5-trimethyl-cyclohexane and o-cymene in methanol extract. The percentage mortality upon exposure to methanol and aqueous extracts of O. tenuiflorum were 21.1% and 26.1% at 24 h, 27.8% and 36.1% at 48 h and 36.1% and 45% at 72 h respectively. Using reverse transcription quantitative polymerase chain reaction (RT-qPCR), down-regulation of ABC transporter, overexpression of CYP6M2, Hsp70, and α-esterase, coupled with significantly increased levels of SOD, CAT, and GSH, were observed in An. gambiae (s.s.) exposed to aqueous and methanol extracts of O. tenuiflorum as compared to the control. Findings from this study have significant implications for our understanding of how An. gambiae (s.s.) larvae detoxify phytoactive compounds.
Læs mere Tjek på PubMedOmale, U. I., Ogbonnaya, L. U., Iyare, O., Nnachi, O. O.
BMJ Open, 2.05.2024
Tilføjet 2.05.2024
ObjectivesThe burden of malaria has persistently been high in Ebonyi state and Nigeria despite long-standing collaborations with international partners with huge and increased amounts of financial investments. We explored the system-wide governance challenges of the Ebonyi State Malaria Elimination Programme (SMEP) and the factors responsible in order to make recommendations for malaria health system strengthening. DesignWe did a qualitative study informed by the health system governance framework by Mikkelsen-Lopez et al and Savedoff’s concept of governance. Setting and participantsBetween 18 October 2022 and 8 November 2022, 25 semistructured face-to-face in-depth interviews were conducted in English with purposively selected key stakeholders in the Ebonyi SMEP aged 18 years or older with at least 2 years of involvement in the SMEP and who gave consent. AnalysisData were analysed deductively and the analytical strategy was informed by the framework method for the analysis of qualitative data by Gale et al. ResultsMany system-wide governance challenges of the SMEP were identified including the absence of state’s strategic vision and plans for malaria elimination; very weak primary and secondary healthcare systems; inadequate financial allocation and untimely release of budgeted funds by the state government; lack of human resources for health and very poor mosquito net distribution system. Other challenges were inadequate stakeholders’ participation; poor accountability culture; impaired transparency and corruption and impaired ability to address corruption. The fundamental responsible factors were the lack of state government’s concern for people’s welfare and lack of interest and commitment to the malaria elimination effort, chronic non-employment of staff and lack of human resources in the entire health sector including SMEP, and nepotism and godfatherism. ConclusionsThe system-wide governance challenges and the responsible factors call for changing the ‘business as usual’ and refocusing on strengthening malaria health system governance in addressing the persisting malaria health problems in Ebonyi state (and Nigeria).
Læs mere Tjek på PubMedMalaria Journal, 2.05.2024
Tilføjet 2.05.2024
Abstract Background The sequestration of Plasmodium falciparum infected erythrocytes in the placenta, and the resulting inflammatory response affects maternal and child health. Despite existing information, little is known about the direct impact of P. falciparum on the placental barrier formed by trophoblast and villous stroma. This study aimed to assess placental tissue damage caused by P. falciparum in human placental explants (HPEs). Methods HPEs from chorionic villi obtained of human term placentas (n = 9) from normal pregnancies were exposed to P. falciparum-infected erythrocytes (IE) for 24 h. HPEs were embedded in paraffin blocks and used to study tissue damage through histopathological and histochemical analysis and apoptosis using TUNEL staining. Culture supernatants were collected to measure cytokine and angiogenic factors and to determine LDH activity as a marker of cytotoxicity. A subset of archived human term placenta paraffin-embedded blocks from pregnant women with malaria were used to confirm ex vivo findings. Results Plasmodium falciparum-IE significantly damages the trophoblast layer and the villous stroma of the chorionic villi. The increased LDH activity and pathological findings such as syncytial knots, fibrin deposits, infarction, trophoblast detachment, and collagen disorganization supported these findings. The specific damage to the trophoblast and the thickening of the subjacent basal lamina were more pronounced in the ex vivo infection. In contrast, apoptosis was higher in the in vivo infection. This disparity could be attributed to the duration of exposure to the infection, which significantly varied between individuals naturally exposed over time and the 24-h exposure in the ex vivo HPE model. Conclusion Exposure to P. falciparum-IE induces a detachment of the syncytiotrophoblast, disorganization of the stroma villi, and an increase in apoptosis, alterations that may be associated with adverse results such as intrauterine growth restriction and low birth weight.
Læs mere Tjek på PubMedMalaria Journal, 2.05.2024
Tilføjet 2.05.2024
Abstract Background Malaria has remained a persistent global health problem. Despite multiple government and donor initiatives to eradicate malaria and its detrimental effects on Uganda\'s health outcomes, the incidence of malaria is worrying as it appears higher than the average of 219 cases per 1000 for sub-Saharan Africa for the period 2017–2018. This study investigated the effect of public and private healthcare spending on the incidence of malaria in Uganda. Methods Employing time series data spanning over 20 years from the first quarter of 2000 to the last quarter of 2019, the study builds a model based on the Grossman framework for analysing demand for health. The estimation technique used was the ARDL approach that takes into account reverse causality and incidental relationships. Prior to the adoption of the technique, a bounds test was performed to determine whether the variables contained in the model have a long-term relationship. Several diagnostic tests for serial correlation, functional normality, and heteroskedastic specification error were carried out to verify the ARDL model\'s goodness of fit. Additionally, the cumulative sum of recursive (CUSUM) and cumulative sum of squares of recursive residuals (CUSUMSQ) were used to test model stability. Results The results indicate that in the long run, an increase in public spending of one percent significantly reduces malaria incidence by 0.196 at the 10 percent level of significance. On the other hand, there is no significant evidence of private health expenditure\'s effect on malaria incidence. However, in the short run, public spending reduces malaria incidence by a smaller magnitude of 0.158 percent relative to the long-run. Still, private expenditure is found to exhibit no significant effect. Additional findings point to the importance of GDP per capita and urban population growth in reducing malaria incidence, whereas female unemployment, income inequality, as well as female-headed household. In the short run, however, the female-headed households and urban population growth are found to significantly reduce malaria incidence while an improvement in regulatory quality decreases malaria incidence by 0.129 percent. Conclusions There is need for further government interventions to reduce malaria incidence in the country via budget allocation, as well as the strengthening of programmes to raise household income to support private health spending, in addition to the development of strategies to promote well-planned and organized urban centres.
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.05.2024
Tilføjet 2.05.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 5 Pages: 887-891
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.05.2024
Tilføjet 2.05.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 5 Pages: 892-901
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.05.2024
Tilføjet 2.05.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 5 Pages: 902-909
Læs mere Tjek på PubMedAmerican Journal of Tropical Medicine and Hygiene, 2.05.2024
Tilføjet 2.05.2024
Journal Name: The American Journal of Tropical Medicine and Hygiene Volume: 110 Issue: 5 Pages: 921-924
Læs mere Tjek på PubMedMalaria Journal, 30.04.2024
Tilføjet 30.04.2024
Abstract Background Malaria treatment in sub-Saharan Africa is faced with challenges including unreliable supply of efficacious agents, substandard medicines coupled with high price of artemisinin-based combinations. This affects access to effective treatment increasing risk of malaria parasite resistance development and adverse drug events. This study investigated access to quality-assured artemisinin-based combination therapy (QAACT) medicines among clients of selected private drug-outlets in Uganda. Methods This was a cross sectional study where exit interviews were conducted among clients of private drug outlets in low and high malaria transmission settings in Uganda. This study adapted the World Health Organization/Health Action International (WHO/HAI) standardized criteria. Data was collected using a validated questionnaire. Data entry screen with checks was created in Epi-data ver 4.2 software and data entered in duplicate. Data was transferred to STATA ver 14.0 and cleaned prior to analysis. The analysis was done at 95% level of significance. Results A total of 1114 exit interviews were conducted among systematically sampled drug outlet clients. Over half, 54.9% (611/1114) of the participants were males. Majority, 97.2% (1083/1114) purchased an artemisinin-based combination anti-malarial. Most, 55.5% (618/1114) of the participants had a laboratory diagnosis of malaria. Majority, 77.9% (868/1114) of the participants obtained anti-malarial agents without a prescription. Less than a third, 27.7% (309/1114) of the participants obtained a QAACT. Of the participants who obtained QAACT, more than half 56.9% (173/309) reported finding the medicine expensive. The predictors of accessing a QAACT anti-malarial among drug outlet clients include type of drug outlet visited (aPR = 0.74; 95%CI 0.6, 0.91), not obtaining full dose (3-day treatment) of ACT (aPR = 0.49; 95%CI 0.33, 0.73), not finding the ACT expensive (aPR = 1.24; 95%CI 1.03, 1.49), post-primary education (aPR = 1.29; 95%CI 1.07,1.56), business occupation (aPR = 1.24; 95%CI 1.02,1.50) and not having a prescription (aPR = 0.76; 95%CI 0.63, 0.92). Conclusion Less than a third of the private drug outlet clients obtained a QAACT for management of malaria symptoms. Individuals who did not find artemisinin-based combinations to be expensive were more likely to obtain a QAACT anti-malarial. The Ministry of Health needs to conduct regular surveillance to monitor accessibility of QAACT anti-malarial agents under the current private sector copayment mechanism.
Læs mere Tjek på PubMedMalaria Journal, 30.04.2024
Tilføjet 30.04.2024
Abstract Background The decreasing residual efficacy of insecticides is an important factor when making decisions on insecticide choice for national malaria control programmes. The major challenge to using chemicals for vector control is the selection for the development of insecticide resistance. Since insecticide resistance has been recorded for most of the existing insecticides used for indoor residual spraying, namely, DDT, pyrethroids, organophosphates and carbamates, and new chemicals are necessary for the continued success of indoor residual spraying. The aim of this study was to assess the residual efficacy of Actellic 300CS, SumiShield™ 50WG and Fludora®Fusion by spraying on different wall surfaces. Methods One hundred and sixty-eight houses with different wall surface types (mud, cement, painted cement, and tin) which represented the rural house wall surface types in KwaZulu-Natal, South Africa were used to evaluate the residual efficacy of Actellic 300CS, SumiShield 50WG and Fludora®Fusion with DDT as the positive control. All houses were sprayed by experienced spray operators from the Malaria Control Programme. Efficacy of these insecticides were evaluated by contact bioassays against Anopheles arabiensis, a vector species. The residual efficacy of the insecticide formulations was evaluated against a susceptible insectary-reared population of An. arabiensis using WHO cone bioassays. Results Effectiveness of the three insecticides was observed up to 12 months post-spray. When assessing the achievement of 100% mortality over time, SumiShield performed significantly better than DDT on mud (OR 2.28, 95% CI 1.72–3.04) and painted cement wall types (OR 3.52, 95% CI 2.36–5.26). On cement wall types, Actellic was found to be less effective than DDT (OR 0.55, 95% CI 0.37–0.82) while Fludora®Fusion was less effective on tin wall types (OR 0.67, 95% CI 0.47–0.95). When compared to the combined efficacy of DDT on mud surfaces, SumiShield applied to each of the mud, cement and painted cement wall types and DDT applied to the cement wall types was found to be significantly more effective. These insecticides usually resulted in 100% mortality for up to 12 months with a delayed mortality period of 96–144 h, depending on the insecticide evaluated and the surface type sprayed. Conclusion Field evaluation of these insecticides have shown that Actellic, SumiShield and Fludora®Fusion are suitable replacements for DDT. Each of these insecticides can be used for malaria vector control, requiring just one spray round. These insecticides can be used in rotation or as mosaic spraying.
Læs mere Tjek på PubMedMalaria Journal, 30.04.2024
Tilføjet 30.04.2024
Abstract Introduction Introduction: Malaria continues to be the leading cause of hospitalization and death in Angola, a country in sub- Saharan Africa. In 2023, in the first quarter, 2,744,682 cases were registered, and of these 2,673 patients died due to malaria disease. Previous studies have shown that the ABO blood group can affect the progression of malaria to severe conditions after P. falciparum infection, while the sickle cell gene offers relative protection. Objective We investigated changes in the blood count according to blood groups (ABO/Rh) and sickle cell trait in patients with malaria in Luanda, capital of Angola. Methodology This was a longitudinal, prospective and observational study with 198 patients hospitalized for malaria. Results Of the 198 patients studied, 13(6.6%) were ABRh(+), 4(2.0%) were ARh(-), 49(24.7%) were ARh(+), 42(21, 2%) were BRh (+), 5(2.5%) were ORh(-) and 85(42.9%) were ORh(+). For sickle cell trait, 145(73.2%) were AA, 37(18.7%) were AS and 16(8.1%) were SS. No statistical relationship was observed between age group, sex, parasitemia, clinical picture, hematocrit, MCV, HCM, MCHC, leukocytes, NEUT, LINF and PTL values with blood groups (p0.05). There was no relationship between age, parasitemia, clinical condition, MCV, HCM and MCHC values, leukocytes, NEUT and LINF with sickle cell trait (p0.05). Conclusion It is imperative to differentiate patients with malaria based on blood groups and sickle cell trait, taking into account mainly the blood count parameters that demonstrate that there are patients who, depending on blood group or sickle cell trait, may react weakly to malaria infection regardless of the degree of parasitemia and medical prognosis.
Læs mere Tjek på PubMedMalaria Journal, 29.04.2024
Tilføjet 29.04.2024
Abstract Background Despite efforts made to reduce morbidity and mortality associated with malaria, especially in sub-Saharan Africa, malaria continues to be a public health concern that requires innovative efforts to reach the WHO-set zero malaria agenda. Among the innovations is the use of artemisinin-based combination therapy (ACT) that is effective against Plasmodium falciparum. Generic artemether–lumefantrine (AL) is used to treat uncomplicated malaria after appropriate diagnosis. AL is metabolized by the cytochrome P450 family of enzymes, such as CYP2B6, CYP3A4 and CYP3A5, which can be under pharmacogenetic influence. Pharmacogenetics affecting AL metabolism, significantly influence the overall anti-malarial activity leading to variable therapeutic efficacy. This study focused on generic AL drugs used in malarial treatment as prescribed at health facilities and evaluated pharmacogenomic influences on their efficacy. Methods Patients who have been diagnosed with malaria and confirmed through RDT and microscopy were recruited in this study. Blood samples were taken on days 1, 2, 3 and 7 for parasite count and blood levels of lumefantrine, artemisinin, desbutyl-lumefantrine (DBL), and dihydroartemisinin (DHA), the active metabolites of lumefantrine and artemether, respectively, were analysed using established methods. Pharmacogene variation analysis was undertaken using iPLEX microarray and PCR–RFLP. Results A total of 52 patients completed the study. Median parasite density from day 1 to 7 ranged from 0–2666/μL of blood, with days 3 and 7 recording 0 parasite density. Highest median plasma concentration for lumefantrine and desbutyl lumefantrine, which are the long-acting components of artemisinin-based combinations, was 4123.75 ng/mL and 35.87 ng/mL, respectively. Day 7 plasma lumefantrine concentration across all generic ACT brands was ≥ 200 ng/mL which potentially accounted for the parasitaemia profile observed. Monomorphism was observed for CYP3A4 variants, while there were observed variations in CYP2B6 and CYP3A5 alleles. Among the CYP3A5 genotypes, significant differences in genotypes and plasma concentration for DBL were seen on day 3 between 1/*1 versus *1/*6 (p = 0.002), *1/*3 versus *1/*6 (p = 0.006) and *1/*7 versus *1/*6 (p = 0.008). Day 7 plasma DBL concentrations showed a significant difference between *1/*6 and *1/*3 (p = 0.026) expressors. Conclusions The study findings show that CYP2B6 and CYP3A5 pharmacogenetic variations may lead to higher plasma exposure of AL metabolites.
Læs mere Tjek på PubMedMalaria Journal, 28.04.2024
Tilføjet 28.04.2024
Abstract Background Malaria is still a disease of global public health importance and children under-five years of age are the most vulnerable to the disease. Nigeria adopted the “test and treat” strategy in the national malaria guidelines as one of the ways to control malaria transmission. The level of adherence to the guidelines is an important indicator for the success or failure of the country’s roadmap to malaria elimination by 2030. This study aimed to assess the fidelity of implementation of the national guidelines on malaria diagnosis for children under-five years and examine its associated moderating factors in health care facilities in Rivers State, Nigeria. Methods This was a descriptive, cross-sectional study conducted in Port Harcourt metropolis. Data were collected from 147 public, formal private and informal private health care facilities. The study used a questionnaire developed based on Carroll’s Conceptual Framework for Implementation Fidelity. Frequency, mean and median scores for implementation fidelity and its associated factors were calculated. Associations between fidelity and the measured predictors were examined using Mann Whitney U test, Kruskal Wallis test, and multiple linear regression modelling using robust estimation of errors. Regression results are presented in adjusted coefficient (β) and 95% confidence intervals. Results The median (IQR) score fidelity score for all participants was 65% (43.3, 85). Informal private facilities (proprietary patent medicine vendors) had the lowest fidelity scores (47%) compared to formal private (69%) and public health facilities (79%). Intervention complexity had a statistically significant inverse relationship to implementation fidelity (β = − 1.89 [− 3.42, − 0.34]). Increase in participant responsiveness (β = 8.57 [4.83, 12.32]) and the type of malaria test offered at the facility (e.g., RDT vs. no test, β = 16.90 [6.78, 27.03]; microscopy vs. no test, β = 21.88 [13.60, 30.16]) were positively associated with fidelity score. Conclusions This study showed that core elements of the “test and treat” strategy, such as testing all suspected cases with approved diagnostic methods before treatment, are still not fully implemented by health facilities. There is a need for strategies to increase fidelity, especially in the informal private health sector, for malaria elimination programme outcomes to be achieved.
Læs mere Tjek på PubMedMalaria Journal, 28.04.2024
Tilføjet 28.04.2024
Abstract Background Malaria contributes to excess child mortality in The Gambia. Children under five are at risk of severe malaria and death if not treated promptly and appropriately. It is crucial that a child with fever receive appropriate care from a trained provider. The aim was to identify influences on child fever care-seeking in The Gambia to inform malaria control strategies. Methods This cross-sectional analysis of The Gambia 2019–20 Demographic and Health Survey used logistic regression analysis to identify associations between source of care for a child with fever (public or private healthcare provider, other, or no treatment) and mother, child, and household characteristics. Results Only 52.0% of mothers sought care from a trained healthcare provider for a child with fever—45.1% from a public facility and 7.0% from the private sector. 35.2% of mothers did not seek treatment. Mothers in urban households were 2.67 times as likely (aOR, 95% CI 1.504–4.736) as mothers in rural households to seek care from an informal source (e.g., pharmacy) versus not seeking treatment, and 0.29 times as likely (aOR, 95% CI 0.165–0.515) as mothers in rural households to seek care from a public provider versus informal source. Mothers in wealthier households were 2.30 times as likely (aOR, 95% CI 1.274–4.164) as mothers in poorer households to seek care from an informal source versus no treatment and half as likely as mothers in poorer households to seek care from a public provider versus informal source (aOR 0.53, 95% CI 0.291–0.959). Conclusions Maintaining The Gambia’s malaria control achievements will require the active engagement and oversight of private pharmacies along with continued integrated community case management to reach mothers who do not seek care for a child with fever, and remove challenges to seeking appropriate care from trained providers. Whether influenced by convenience, costs, perceived urgency, or other factors, given the likelihood of urban mothers and mothers in wealthier households to seek care from private pharmacies, it will be necessary to incorporate private pharmacies into malaria control strategies while building public sector capacity and workforce, and initiating more effective attitude and behavioural change among mothers and households.
Læs mere Tjek på PubMedKassoum Kayentao, Aissata Ongoiba, Anne C. Preston, Sara A. Healy, Zonghui Hu, Jeff Skinner, Safiatou Doumbo, Jing Wang, Hamidou Cisse, Didier Doumtabe, Abdrahamane Traore, Hamadi Traore, Adama Djiguiba, Shanping Li, Mary E. Peterson, Shinyi Telscher, Azza H. Idris, William C. Adams, Adrian B. McDermott, Sandeep Narpala, Bob C. Lin, Leonid Serebryannyy, Somia P. Hickman, Andrew J. McDougal, Sandra Vazquez, Matthew Reiber, Judy A. Stein, Jason G. Gall, Kevin Carlton, Philipp Schwabl, Siriman Traore, Mamadou Keita, Amatigué Zéguimé, Adama Ouattara, M’Bouye Doucoure, Amagana Dolo, Sean C. Murphy, Daniel E. Neafsey, Silvia Portugal, Abdoulaye Djimdé, Boubacar Traore, Robert A. Seder, and Peter D. Cromptonthe Mali Malaria mAb Trial Team*From the Malaria Research and Training Center, Mali International Center of Excellence in Research, University of Sciences, Techniques, and Technologies of Bamako, Bamako, Mali (K.K., A. Ongoiba, S.D., D.D., A.T., H.T., A. Djiguiba, S. Traore, M.K., A.Z., A. Ouattara, M.D., A. Dolo, A. Djimdé, B.T.); the Malaria Infection Biology and Immunity Section, Laboratory of Immunogenetics, Division of Intramural Research (A.C.P., S.A.H., J.S., H.C., S.L., M.E.P., P.D.C.), and the Biostatistics Research Branch, Division of Clinical Research (Z.H.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Rockville, the Vaccine Research Center (S. Telscher, A.H.I., W.C.A., A.B.M., S.N., B.C.L., L.S., S.P.H., A.J.M., S.V., M.R., J.A.S., J.G.G., K.C., R.A.S.), National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, and the Clinical Monitoring Research Program Directorate, Frederick National Laboratory for Cancer Research, Frederick (J.W.) — all in Maryland; the Department of Immunology and Infectious Diseases, Harvard T.H. Chan School of Public Health, Boston (P.S., D.E.N.); the Malaria Molecular Diagnostic Laboratory, Department of Laboratory Medicine and Pathology, and the Center for Emerging and Re-emerging Infectious Diseases, University of Washington, Seattle (S.C.M.); and the Max Planck Institute for Infection Biology, Berlin (S.P.).
New England Journal of Medicine, 27.04.2024
Tilføjet 27.04.2024
Trevor MundelFrom the Bill and Melinda Gates Foundation, Seattle.
New England Journal of Medicine, 27.04.2024
Tilføjet 27.04.2024
Malaria Journal, 27.04.2024
Tilføjet 27.04.2024
Abstract Background Anopheles coluzzii is a primary vector of malaria found in West and Central Africa, but its presence has hitherto never been documented in Kenya. A thorough understanding of vector bionomics is important as it enables the implementation of targeted and effective vector control interventions. Malaria vector surveillance efforts in the country have tended to focus on historically known primary vectors. The current study sought to determine the taxonomic status of samples collected from five different malaria epidemiological zones in Kenya as well as describe the population genetic structure and insecticide resistance profiles in relation to other An. coluzzii populations. Methods Mosquitoes were sampled as larvae from Busia, Kwale, Turkana, Kirinyaga and Kiambu counties, representing the range of malaria endemicities in Kenya, in 2019 and 2021 and emergent adults analysed using Whole Genome Sequencing (WGS) data processed in accordance with the Anopheles gambiae 1000 Genomes Project phase 3. Where available, historical samples from the same sites were included for WGS. Comparisons were made with An. coluzzii cohorts from West and Central Africa. Results This study reports the detection of An. coluzzii for the first time in Kenya. The species was detected in Turkana County across all three time points from which samples were analyzed and its presence confirmed through taxonomic analysis. Additionally, there was a lack of strong population genetic differentiation between An. coluzzii from Kenya and those from the more northerly regions of West and Central Africa, suggesting they represent a connected extension to the known species range. Mutations associated with target-site resistance to DDT and pyrethroids and metabolic resistance to DDT were found at high frequencies up to 64%. The profile and frequencies of the variants observed were similar to An. coluzzii from West and Central Africa but the ace-1 mutation linked to organophosphate and carbamate resistance present in An. coluzzii from coastal West Africa was absent in Kenya. Conclusions These findings emphasize the need for the incorporation of genomics in comprehensive and routine vector surveillance to inform on the range of malaria vector species, and their insecticide resistance status to inform the choice of effective vector control approaches.
Læs mere Tjek på PubMedMalaria Journal, 27.04.2024
Tilføjet 27.04.2024
Abstract Background In Madagascar, the districts of Antsirabe II, Faratsiho and Antsiranana I have relatively low malaria incidence rates and have been selected by the National Malaria Control Programme for pilot elimination strategies. The districts have residual transmission despite increasing coverage and quality of malaria services. This study sought to identify priority subpopulations at highest risk for malaria and collect information on intervention preferences and methods that will inform subnational tailoring of malaria service delivery. Methods This mixed methods study employed (i) a quantitative malaria risk factor assessment in Antsirabe II and Faratsiho comprising a test-negative frequency matched case–control study and a qualitative risk factor assessment in Antsiranana I; and (ii) a qualitative formative assessment in all three districts. For the case–control study, a mixed effects logistic regression was used with age, sex and district included as fixed effects and health facility included as a random effect. The qualitative risk factor assessment used semi-structured interview guides and key informant interviews. For the qualitative formative assessment in the three districts, a summary report was generated following semi-structured interviews and focus group discussions with high-risk populations (HRPs) and stakeholders. Results In Antsirabe II and Faratsiho districts, rice agriculture workers, outdoor/manual workers, particularly miners, and those with jobs that required travel or overnight stays, especially itinerant vendors, had higher odds of malaria infection compared to other (non-rice) agricultural workers. In Antsiranana I, respondents identified non-rice farmers, mobile vendors, and students as HRPs. Risk factors among these groups included overnight stays and travel patterns combined with a lack of malaria prevention tools. HRPs reported treatment cost and distance to the health facility as barriers to care and expressed interest in presumptive treatment and involvement of gatekeepers or people who have influence over intervention access or participation. Conclusions The study results illustrate the value of in-depth assessments of risk behaviours, access to services and prevention tools, surveillance and prevention strategies, and the involvement of gatekeepers in shaping subnational tailoring to reach previously unreached populations and address residual transmission in elimination settings.
Læs mere Tjek på PubMedMalaria Journal, 27.04.2024
Tilføjet 27.04.2024
Abstract Background The increased availability and use of malaria rapid diagnostic test (RDT) by primary healthcare (PHC) workers has made universal diagnostic testing before malaria treatment more feasible. However, to meaningfully resolve the problem of over-treatment with artemisinin-based combination therapy and the heightened risk of selection pressure and drug resistance, there should be appropriate response (non-prescription of anti-malarial drugs) following a negative RDT result by PHC workers. This study explored the determinants of the use of RDT and anti-malarial drug prescription practices by PHC workers in Ebonyi state, Nigeria. Methods Between March 2 and 10, 2020, three focus group discussions were conducted in English with 23 purposively-selected consenting PHC workers involved in the diagnosis and treatment of malaria. Data was analysed thematically as informed by the method by Braun and Clarke. Results The determinants of the use of RDT for malaria diagnosis were systemic (RDT availability and patient load), provider related (confidence in RDT and the desire to make correct diagnosis, PHC worker’s knowledge and training, and fear to prick a patient), client related (fear of needle prick and refusal to receive RDT, and self-diagnosis of malaria, based on symptoms, and insistence on not receiving RDT), and RDT-related (the ease of conducting and interpreting RDT). The determinants of anti-malarial drug prescription practices were systemic (drug availability and cost) and drug related (effectiveness and side-effects of the drugs). The determinants of the prescription of anti-malarial drugs following negative RDT were provider related (the desire to make more money and limited confidence in RDT) and clients’ demand while unnecessary co-prescription of antibiotics with anti-malarial drugs following positive RDT was determined by the desire to make more money. Conclusions This evidence highlights many systemic, provider, client, and RDT/drug related determinants of PHC workers’ use of RDT and anti-malarial drug prescription practices that should provide tailored guidance for relevant health policy actions in Ebonyi state, Nigeria, and similar settings.
Læs mere Tjek på PubMedKwaku Poku Asante, Don P Mathanga, Paul Milligan, Samuel Akech, Abraham Oduro, Victor Mwapasa, Kerryn A Moore, Titus K Kwambai, Mary J Hamel, Thomas Gyan, Nelli Westercamp, Atupele Kapito-Tembo, Patricia Njuguna, Daniel Ansong, Simon Kariuki, Tisungane Mvalo, Paul Snell, David Schellenberg, Paul Welega, Lucas Otieno, Alfred Chimala, Edwin A Afari, Philip Bejon, Kenneth Maleta, Tsiri Agbenyega, Robert W Snow, Madaliso Zulu, Jobiba Chinkhumba, Aaron M Samuels, Malaria Vaccine Programme Evaluation Partners
Lancet, 26.04.2024
Tilføjet 26.04.2024
In the first 2 years of implementation of RTS,S, the three primary doses were effectively deployed through national immunisation programmes. There was no evidence of the safety signals that had been observed in the phase 3 trial, and introduction of the vaccine was associated with substantial reductions in hospital admission with severe malaria. Evaluation continues to assess the impact of four doses of RTS,S.
Læs mere Tjek på PubMedMalaria Journal, 26.04.2024
Tilføjet 26.04.2024
Malaria Journal, 26.04.2024
Tilføjet 26.04.2024
Abstract Background There are giant steps taken in the introduction of the novel malaria vaccine poised towards reducing mortality and morbidity associated with malaria. Objectives This study aimed to determine the knowledge of malaria vaccine and factors militating against willingness to accept the vaccine among mothers presenting in nine hospitals in Enugu metropolis. Methods This was a cross-sectional study carried out among 491 mothers who presented with their children in nine hospitals in Enugu metropolis, South-East Nigeria. A pre-tested and interviewer-administered questionnaire was used in this study. Results A majority of the respondents, 72.1% were aware of malaria vaccine. A majority of the respondents, 83.1% were willing to receive malaria vaccine. Similarly, a majority of the mothers, 92.9%, were willing to vaccinate baby with the malaria vaccine, while 81.1% were willing to vaccinate self and baby with the malaria vaccine. The subjects who belong to the low socio-economic class were five times less likely to vaccinate self and baby with malaria vaccine when compared with those who were in the high socio-economic class (AOR = 0.2, 95% CI 0.1–0.5). Mothers who had good knowledge of malaria vaccination were 3.3 times more likely to vaccinate self and baby with malaria vaccine when compared with those who had poor knowledge of malaria vaccination (AOR = 3.3, 95% CI 1–6–6.8). Conclusion Although the study documented a high vaccine acceptance among the mothers, there exists a poor knowledge of the malaria vaccine among them.
Læs mere Tjek på PubMedMalaria Journal, 26.04.2024
Tilføjet 26.04.2024
Abstract Background Pregnancy Associated Malaria (PAM) include malaria in pregnancy (MiP), placental malaria (PM), and congenital malaria (CM). The evidence available in Colombia on PAM focuses on one of the presentations (MiP, PM or CM), and no study longitudinally analyses the infection from the pregnant woman, passing through the placenta, until culminating in the newborn. This study determined the frequency of MiP, PM, and CM caused by Plasmodium vivax, Plasmodium falciparum, or mixed infections, according to Thick Blood Smear (TBS) and quantitative Polymerase Chain Reaction (qPCR). Identifying associated factors of PAM and clinical-epidemiological outcomes in northwestern Colombia. Methods Prospective study of 431 pregnant women, their placenta, and newborns registered in the data bank of the research Group “Salud y Comunidad César Uribe Piedrahíta” which collected information between 2014 and 2020 in endemic municipalities of the departments of Córdoba and Antioquia. The frequency of infection was determined with 95% confidence intervals. Comparisons were made with the Chi-square test, Student t-test, prevalence ratios, and control for confounding variables by log-binomial regression. Results The frequency of MiP was 22.3% (4.6% using TBS), PM 24.8% (1.4% using TBS), and CM 11.8% (0% using TBS). Using TBS predominated P. vivax. Using qPCR the proportions of P. vivax and P. falciparum were similar for MiP and PM, but P. falciparum predominated in CM. The frequency was higher in nulliparous, and women with previous malaria. The main clinical effects of PAM were anaemia, low birth weight, and abnormal APGAR score. Conclusions The magnitude of infections was not detected with TBS because most cases were submicroscopic (TBS-negative, qPCR-positive). This confirmed the importance of improving the molecular detection of cases. PAM continue being underestimated in the country due to that in Colombia the control programme is based on TBS, despite its outcomes on maternal, and congenital health.
Læs mere Tjek på PubMedMalaria Journal, 26.04.2024
Tilføjet 26.04.2024
Abstract Background The residual activity of a clothianidin + deltamethrin mixture and clothianidin alone in IRS covered more than the period of malaria transmission in northern Benin. The aim of this study was to show whether the prolonged residual efficacy of clothianidin-based products resulted in a greater reduction in vector populations and subsequent malaria transmission compared with the shorter residual efficacy of pirimiphos-methyl. Methods Human bait mosquito collections by local volunteers and pyrethrum spray collections were used in 6 communes under IRS monitoring and evaluation from 2019 to 2021. ELISA/CSP and species PCR tests were performed on Anopheles gambiae sensu lato (s.l.) to determine the infectivity rate and subspecies by commune and year. The decrease in biting rate, entomological inoculation rate, incidence, inhibition of blood feeding, resting density of An. gambiae s.l. were studied and compared between insecticides per commune. Results The An. gambiae complex was the major vector throughout the study area, acounting for 98.71% (19,660/19,917) of all Anopheles mosquitoes collected. Anopheles gambiae s.l. collected was lower inside treated houses (45.19%: 4,630/10,245) than outside (54.73%: 5,607/10,245) after IRS (p
Læs mere Tjek på PubMedDeus S. Ishengoma, Roly Gosling, Rosario Martinez-Vega, Khalid B. Beshir, Jeffrey A. Bailey, John Chimumbwa, Colin Sutherland, Melissa D. Conrad, Fitsum G. Tadesse, Jonathan J. Juliano, Moses R. Kamya, Wilfred F. Mbacham, Didier Ménard, Philip J. Rosenthal, Jaishree Raman, Allison Tatarsky, Sofonias K. Tessema, David A. Fidock, Abdoulaye A. Djimde
Nature, 25.04.2024
Tilføjet 25.04.2024