Objective:To observe and assess the compliance to sulfadoxine-pyrimethamine(SP) one and a half years after phasing out chloroquine(CQ) in Mkuranga District,Coast region,Tanzania. Methods:A randomly controlled baseline...Objective:To observe and assess the compliance to sulfadoxine-pyrimethamine(SP) one and a half years after phasing out chloroquine(CQ) in Mkuranga District,Coast region,Tanzania. Methods:A randomly controlled baseline community study was conducted in rural areas of Mkuranga district,Tanzania.Semi-structured questionnaire consisted of open-and closed -ended questions including home stocking,home use,last fever episodes and treatment of underfives with malaria using CQ or SP.Results:The prevalence of fever or reported fever rate during the last 48 hours by their mothers or guardians was high(70%).Of all 117 blood samples,only 8 children after drug analysis were found to have CQ and 13 had SP concentrations within their blood respectively.None of these blood drug levels were above therapeutic ranges. Conclusions:Community interventions are urgently needed in rural communities and should specifically target households nucleus on early malaria fever recognition and provision of recommended antimalarials for the sick underfive children.However,sadly,there was an increase in underweight and undernourishment in the study areas,probably because of malaria in the area and poverty which are associated with poor nutrition in these youngsters.展开更多
Over 90 percent of illness and death attributable to malaria occurs in Sub-Saharan Africa, frequently among pregnant women and young children. Infection with P. falciparum results in high parasitemia percentages and i...Over 90 percent of illness and death attributable to malaria occurs in Sub-Saharan Africa, frequently among pregnant women and young children. Infection with P. falciparum results in high parasitemia percentages and it is the most frequent cause of malaria that results in illness and death in Africa. In areas with holoendemic transmission, such as in most of the Democratic Republic of the Congo (DRC), adults are exposed to malaria every few days or weeks throughout life and, if surviving, have relatively mild bouts of illness because of acquired immunity.展开更多
The spread of resistance to antimalarials is a major public health problem worldwide and especially in sub-Saharan Africa where the highest morbidity and mortality rates are found with a critical scarcity of data on r...The spread of resistance to antimalarials is a major public health problem worldwide and especially in sub-Saharan Africa where the highest morbidity and mortality rates are found with a critical scarcity of data on resistance. The objective of this review is to describe the mutations in the pfdhfr, pfdhps and k13 genes associated with resistance to artemisinin and Sulfadoxine-Pyrimethamine reported in West Africa during the decade 2007 to 2017 followed by a meta-analysis of their prevalence. A bibliographic search on the MEDLINE, PubMed, EMBASE and Sciences Direct databases made it possible to find 405 scientific papers relating to resistance to artemisinin and to Sulfadoxine-Pyrimethamine during the period 2007-2017. The analysis has concerned 217 scientific articles after the elimination of duplicates with 57 articles included in this review after the examination of titles and abstracts. The results of the present review show that the dhfr and dhps mutants are widespread in sub-Saharan Africa. Although, Kelch 13 mutants from Southeast Asia associated with artemisinin resistance are still absent in West Africa, studies have reported the presence of synonymous or non-K13 mutations correlated with a delay in parasite clearance in Burkina Faso (2.26%), Senegal (5.5%) and Togo (1.8%). The increased prevalence of dhfr and dhps mutants in West Africa could jeopardize its use for intermittent preventive treatment in the near future. Despite the absence of strains resistant to artemisinin-based combination therapy in the West African region, increased surveillance is necessary to prevent the rapid occurrence of possible resistance, especially in the context of synonymous or non-K13 mutations correlated with a delay in parasitic clearance.展开更多
基金the European Union(EU), for granting us financial support to undertake this study
文摘Objective:To observe and assess the compliance to sulfadoxine-pyrimethamine(SP) one and a half years after phasing out chloroquine(CQ) in Mkuranga District,Coast region,Tanzania. Methods:A randomly controlled baseline community study was conducted in rural areas of Mkuranga district,Tanzania.Semi-structured questionnaire consisted of open-and closed -ended questions including home stocking,home use,last fever episodes and treatment of underfives with malaria using CQ or SP.Results:The prevalence of fever or reported fever rate during the last 48 hours by their mothers or guardians was high(70%).Of all 117 blood samples,only 8 children after drug analysis were found to have CQ and 13 had SP concentrations within their blood respectively.None of these blood drug levels were above therapeutic ranges. Conclusions:Community interventions are urgently needed in rural communities and should specifically target households nucleus on early malaria fever recognition and provision of recommended antimalarials for the sick underfive children.However,sadly,there was an increase in underweight and undernourishment in the study areas,probably because of malaria in the area and poverty which are associated with poor nutrition in these youngsters.
文摘Over 90 percent of illness and death attributable to malaria occurs in Sub-Saharan Africa, frequently among pregnant women and young children. Infection with P. falciparum results in high parasitemia percentages and it is the most frequent cause of malaria that results in illness and death in Africa. In areas with holoendemic transmission, such as in most of the Democratic Republic of the Congo (DRC), adults are exposed to malaria every few days or weeks throughout life and, if surviving, have relatively mild bouts of illness because of acquired immunity.
文摘The spread of resistance to antimalarials is a major public health problem worldwide and especially in sub-Saharan Africa where the highest morbidity and mortality rates are found with a critical scarcity of data on resistance. The objective of this review is to describe the mutations in the pfdhfr, pfdhps and k13 genes associated with resistance to artemisinin and Sulfadoxine-Pyrimethamine reported in West Africa during the decade 2007 to 2017 followed by a meta-analysis of their prevalence. A bibliographic search on the MEDLINE, PubMed, EMBASE and Sciences Direct databases made it possible to find 405 scientific papers relating to resistance to artemisinin and to Sulfadoxine-Pyrimethamine during the period 2007-2017. The analysis has concerned 217 scientific articles after the elimination of duplicates with 57 articles included in this review after the examination of titles and abstracts. The results of the present review show that the dhfr and dhps mutants are widespread in sub-Saharan Africa. Although, Kelch 13 mutants from Southeast Asia associated with artemisinin resistance are still absent in West Africa, studies have reported the presence of synonymous or non-K13 mutations correlated with a delay in parasite clearance in Burkina Faso (2.26%), Senegal (5.5%) and Togo (1.8%). The increased prevalence of dhfr and dhps mutants in West Africa could jeopardize its use for intermittent preventive treatment in the near future. Despite the absence of strains resistant to artemisinin-based combination therapy in the West African region, increased surveillance is necessary to prevent the rapid occurrence of possible resistance, especially in the context of synonymous or non-K13 mutations correlated with a delay in parasitic clearance.
