Having faced increased clinical treatment failures with dihydroartemisinin-piperaquine(DHA-PPQ),Cambodia swapped the first line artemisinin-based combination therapy(ACT)from DHA-PPQ to artesunate-mefloquine given tha...Having faced increased clinical treatment failures with dihydroartemisinin-piperaquine(DHA-PPQ),Cambodia swapped the first line artemisinin-based combination therapy(ACT)from DHA-PPQ to artesunate-mefloquine given that parasites resistant to piperaquine are susceptible to mefloquine.However,triple mutants have now emerged,suggesting that drug rotations may not be adequate to keep resistance at bay.There is,therefore,an urgent need for alternative treatment strategies to tackle resistance and prevent its spread.A proper understanding of all contributors to artemisinin resistance may help us identify novel strategies to keep artemisinins effective until new drugs become available for their replacement.This review highlights the role of the key players in artemisinin resistance,the current strategies to deal with it and suggests ways of protecting future antimalarial drugs from bowing to resistance as their predecessors did.展开更多
This study evaluated and compared the efficacy of five brands of Artemisinin Combination Therapies (ACTs);Dihydroartemisinin plus Piperaquine, Artesunate plus Amodiaquine, Artesunate plus Sulphadoxine/Pyrimethamine, A...This study evaluated and compared the efficacy of five brands of Artemisinin Combination Therapies (ACTs);Dihydroartemisinin plus Piperaquine, Artesunate plus Amodiaquine, Artesunate plus Sulphadoxine/Pyrimethamine, Artemether plus lumefantrine and Artesunate plus mefloquine combinations in vivo in P.berghei infected swiss albino mice. The experimental animals were pre-screened to rule out infection. All drugs were administered as clinical doses for the curative test and the Mean Percentage Parasitemia level assessed daily for seven days and on day 60. The results showed that all the drugs were effective with artesunate plus amodiaquine combination being the most efficacious followed by dihydroartemisinin plus piperaquine and artesunate plus sulphadoxine plus pyrimethamine combinations followed by artesunate plus mefloquine combination and artemether plus lumefantrine combination which was the least efficacious. Results on day 60 showed increasing parasitemia levels in mice which received Artemether plus lumefantrine and Artesunate plus mefloquine combinations which is indicative of recrudescence. The results of this study showed that the ACT’s used in the experiment were all efficacious. The possible development of resistance to some of the drugs was shown by the increasing parasitemia levels following treatment with artesunate plus lumefantrine and artesunate plus mefloquine combinations on day 60.展开更多
Background: The World Health Organization adopted Artenisinin based combination therapy (ACT) for the treatment of uncomplicated malaria in endemic regions. The efficacy of ACT in malaria treatment must have prompted ...Background: The World Health Organization adopted Artenisinin based combination therapy (ACT) for the treatment of uncomplicated malaria in endemic regions. The efficacy of ACT in malaria treatment must have prompted this choice. There’s need to protect the ACT from plasmodial resistance. Hence, clinical scaling up of ACT program is needed. This entails continued assessment, monitoring and evaluation of the effectiveness of component drugs in endemic areas. Purpose: This study revisited the evaluation of the effectiveness of artemether-lumefantrine combination (ALC) in the treatment of uncomplicated malaria in Elele, Nigeria. Method: The study was conducted in Elele, a malaria endemic area in Rivers State, Nigeria. This was a facility based descriptive, cross sectional study at Madonna University Teaching Hospital (MUTH) Elele using simple sampling technique. Qualitative and quantitative data were collected. 100 patients who consented to the study were recruited in the outpatient clinic using semi structured questionnaires as part of study instrument. Inclusion criteria were having a body temperature of ≥37.5°C, symptoms of malaria, positive parasitemia, non ingestion of antimalarial in the past 2 weeks, etc. MUTH ethics committee gave ethical clearance. Patient recruitment following consent commenced with their symptoms and signs recorded at presentation while disappearance of the same was determined following drug ingestion on days 2/4/6/8/10 and 14. The data gotten was analyzed by tallying the responses to get the frequencies using SPSS 16.0 version and Microsoft excel tools. The student t-test was used to calculate the P-value, values < 0.05 was considered statistically significant. Results: Most of the patients knew mosquitoes as the mode of malaria transmission (70%). The ACT is known and used by these patients: artesunate/amodiaquine: 41 (41%);artesunate/lumefantrine: 40 (40%);artesunate/sulphadoxine-pyrimethamine: 38(38%);artesunate/mefloquine: 20 (20%). Fever was the predominant presenting symptom, 92% followed by body weakness (90%);headache (85%);malaise (80%);loss of appetite (80%);nausea (72%);vomiting (70%);abdominal pains (50%). Others were: pallor (30%);hepatomegally (20%);splenomegally (20%);chills (20%);rigor (20%). By day 10 of therapy, fever, vomiting and abdominal pains had disappeared in all patients, some patients still had mild: body weakness 40%;headache 2%;malaise 24%;loss of appetite 20% and nausea 10%. Day 14 recorded no symptoms in all patients. There was effective clinical response (ECR) by day 14. Conclusion: This study hereby reaffirms the efficacy and effectiveness of Artemether-lumefantrine Combination in the treatment of uncomplicated malaria in Elele, Nigeria. The need to fill the existing knowledge gap of monitoring and evaluation of ACT in rural endemic areas has been done by this study.展开更多
在国家"523"(防治疟疾新药项目代号)任务实施50周年之际,对广州中医药大学青蒿素抗疟研究科研团队采用青蒿素复方防治疟疾的历程与所取得的进展进行评述。广州中医药大学作为"523"项目研究小组之一,其青蒿素抗疟研...在国家"523"(防治疟疾新药项目代号)任务实施50周年之际,对广州中医药大学青蒿素抗疟研究科研团队采用青蒿素复方防治疟疾的历程与所取得的进展进行评述。广州中医药大学作为"523"项目研究小组之一,其青蒿素抗疟研究科研团队相继主持了采用青蒿素及其衍生物不同剂型、剂量、疗程治疗疟疾的临床研究(1974~1989)、青蒿素复方(Artekin及Artequick)治疗疟疾的临床研究(1984~2006),并于近10年中在东南亚地区及非洲全力推行快速消灭传染源清除疟疾(Fast Elimination of Malaria by Source Eradication,FEMSE)的抗疟项目。青蒿素抗疟研究科研团队所做的探索与获得的成就为青蒿素类药物走向世界做出了重要贡献,并为全球快速消灭疟疾创建了一种简单、易行、省钱的新方法。展开更多
百草枯（paraquat，PQ）是人类急性中毒病死率最高的除草剂，主要通过一系列的氧化还原反应产生多种自由基造成对机体严重的损害，尤其是对肺脏损害最重。循证医学（Evidence Based Medicine，EBM）提倡将临床医师个人的临床实践和经验...百草枯（paraquat，PQ）是人类急性中毒病死率最高的除草剂，主要通过一系列的氧化还原反应产生多种自由基造成对机体严重的损害，尤其是对肺脏损害最重。循证医学（Evidence Based Medicine，EBM）提倡将临床医师个人的临床实践和经验与当前所能获得的最客观科学的研究依据结合起来，制定出完美的治疗措施并服务于患者。由于目前对百草枯中毒还没有统一且有效的治疗方案，所以各家方法不一，目前治疗方法主要有大剂量糖皮质激素及免疫抑制剂、抗氧化及抗自由基、血液净化治疗及肺移植等。但何种治疗更有效，哪种综合治疗更合理，需要循证医学研究来调查，得出更为科学合理的结论。展开更多
文摘Having faced increased clinical treatment failures with dihydroartemisinin-piperaquine(DHA-PPQ),Cambodia swapped the first line artemisinin-based combination therapy(ACT)from DHA-PPQ to artesunate-mefloquine given that parasites resistant to piperaquine are susceptible to mefloquine.However,triple mutants have now emerged,suggesting that drug rotations may not be adequate to keep resistance at bay.There is,therefore,an urgent need for alternative treatment strategies to tackle resistance and prevent its spread.A proper understanding of all contributors to artemisinin resistance may help us identify novel strategies to keep artemisinins effective until new drugs become available for their replacement.This review highlights the role of the key players in artemisinin resistance,the current strategies to deal with it and suggests ways of protecting future antimalarial drugs from bowing to resistance as their predecessors did.
文摘This study evaluated and compared the efficacy of five brands of Artemisinin Combination Therapies (ACTs);Dihydroartemisinin plus Piperaquine, Artesunate plus Amodiaquine, Artesunate plus Sulphadoxine/Pyrimethamine, Artemether plus lumefantrine and Artesunate plus mefloquine combinations in vivo in P.berghei infected swiss albino mice. The experimental animals were pre-screened to rule out infection. All drugs were administered as clinical doses for the curative test and the Mean Percentage Parasitemia level assessed daily for seven days and on day 60. The results showed that all the drugs were effective with artesunate plus amodiaquine combination being the most efficacious followed by dihydroartemisinin plus piperaquine and artesunate plus sulphadoxine plus pyrimethamine combinations followed by artesunate plus mefloquine combination and artemether plus lumefantrine combination which was the least efficacious. Results on day 60 showed increasing parasitemia levels in mice which received Artemether plus lumefantrine and Artesunate plus mefloquine combinations which is indicative of recrudescence. The results of this study showed that the ACT’s used in the experiment were all efficacious. The possible development of resistance to some of the drugs was shown by the increasing parasitemia levels following treatment with artesunate plus lumefantrine and artesunate plus mefloquine combinations on day 60.
文摘Background: The World Health Organization adopted Artenisinin based combination therapy (ACT) for the treatment of uncomplicated malaria in endemic regions. The efficacy of ACT in malaria treatment must have prompted this choice. There’s need to protect the ACT from plasmodial resistance. Hence, clinical scaling up of ACT program is needed. This entails continued assessment, monitoring and evaluation of the effectiveness of component drugs in endemic areas. Purpose: This study revisited the evaluation of the effectiveness of artemether-lumefantrine combination (ALC) in the treatment of uncomplicated malaria in Elele, Nigeria. Method: The study was conducted in Elele, a malaria endemic area in Rivers State, Nigeria. This was a facility based descriptive, cross sectional study at Madonna University Teaching Hospital (MUTH) Elele using simple sampling technique. Qualitative and quantitative data were collected. 100 patients who consented to the study were recruited in the outpatient clinic using semi structured questionnaires as part of study instrument. Inclusion criteria were having a body temperature of ≥37.5°C, symptoms of malaria, positive parasitemia, non ingestion of antimalarial in the past 2 weeks, etc. MUTH ethics committee gave ethical clearance. Patient recruitment following consent commenced with their symptoms and signs recorded at presentation while disappearance of the same was determined following drug ingestion on days 2/4/6/8/10 and 14. The data gotten was analyzed by tallying the responses to get the frequencies using SPSS 16.0 version and Microsoft excel tools. The student t-test was used to calculate the P-value, values < 0.05 was considered statistically significant. Results: Most of the patients knew mosquitoes as the mode of malaria transmission (70%). The ACT is known and used by these patients: artesunate/amodiaquine: 41 (41%);artesunate/lumefantrine: 40 (40%);artesunate/sulphadoxine-pyrimethamine: 38(38%);artesunate/mefloquine: 20 (20%). Fever was the predominant presenting symptom, 92% followed by body weakness (90%);headache (85%);malaise (80%);loss of appetite (80%);nausea (72%);vomiting (70%);abdominal pains (50%). Others were: pallor (30%);hepatomegally (20%);splenomegally (20%);chills (20%);rigor (20%). By day 10 of therapy, fever, vomiting and abdominal pains had disappeared in all patients, some patients still had mild: body weakness 40%;headache 2%;malaise 24%;loss of appetite 20% and nausea 10%. Day 14 recorded no symptoms in all patients. There was effective clinical response (ECR) by day 14. Conclusion: This study hereby reaffirms the efficacy and effectiveness of Artemether-lumefantrine Combination in the treatment of uncomplicated malaria in Elele, Nigeria. The need to fill the existing knowledge gap of monitoring and evaluation of ACT in rural endemic areas has been done by this study.
文摘在国家"523"(防治疟疾新药项目代号)任务实施50周年之际,对广州中医药大学青蒿素抗疟研究科研团队采用青蒿素复方防治疟疾的历程与所取得的进展进行评述。广州中医药大学作为"523"项目研究小组之一,其青蒿素抗疟研究科研团队相继主持了采用青蒿素及其衍生物不同剂型、剂量、疗程治疗疟疾的临床研究(1974~1989)、青蒿素复方(Artekin及Artequick)治疗疟疾的临床研究(1984~2006),并于近10年中在东南亚地区及非洲全力推行快速消灭传染源清除疟疾(Fast Elimination of Malaria by Source Eradication,FEMSE)的抗疟项目。青蒿素抗疟研究科研团队所做的探索与获得的成就为青蒿素类药物走向世界做出了重要贡献,并为全球快速消灭疟疾创建了一种简单、易行、省钱的新方法。
文摘百草枯（paraquat，PQ）是人类急性中毒病死率最高的除草剂，主要通过一系列的氧化还原反应产生多种自由基造成对机体严重的损害，尤其是对肺脏损害最重。循证医学（Evidence Based Medicine，EBM）提倡将临床医师个人的临床实践和经验与当前所能获得的最客观科学的研究依据结合起来，制定出完美的治疗措施并服务于患者。由于目前对百草枯中毒还没有统一且有效的治疗方案，所以各家方法不一，目前治疗方法主要有大剂量糖皮质激素及免疫抑制剂、抗氧化及抗自由基、血液净化治疗及肺移植等。但何种治疗更有效，哪种综合治疗更合理，需要循证医学研究来调查，得出更为科学合理的结论。
