RESUMO
In this study, we have synthesized a series of ZSM-11 zeolite catalysts using tetrapropyl ammonium hydroxide as a structure-directing agent through a highly efficient hydrothermal method. The series of catalysts were studied by different techniques such as FT-IR spectroscopy, XRD, FE-SEM, HR-TEM, EDS, pyridine-FT-IR spectroscopy, and BET analysis. We focused on varying reaction time intervals from 18 to 48 hours to investigate the effect on catalytic activities of the synthesized series of catalysts. The percentages of aluminum increased in the framework of zeolites with increasing crystallinity, surface area, external surface area, and acidity in the series of ZSM-11 zeolites by increasing the time from 18 to 48 h. Then, we studied the catalytic activity of a series of ZSM-11 zeolites and found that the ZSM-11 zeolite (48 h) possesses higher catalytic activity towards the synthesis of 1,2,4,5-tetrasubstituted imidazoles under solvent-free conditions. The present protocol scored well with excellent yield, short reaction time, clean reaction profiles, low catalyst loading, and no tedious workup. The catalyst (ZSM-11 zeolite 48 h) was recycled and reused in five runs without any considerable loss of activity and product yield.
RESUMO
BACKGROUND: Blood transfusions can reduce mortality among children with severe malarial anaemia, but there is limited evidence quantifying the relationship between paediatric malaria and blood transfusions. This study explores the extent to which the use of paediatric blood transfusions is affected by the number of paediatric malaria visits and admissions. It assesses whether the scale-up of malaria control interventions in a facility catchment area explains the use of paediatric blood transfusions. METHODS: The study was conducted at a referral hospital for 13 rural health centres in rural Zambia. Data were used from facility and patient records covering all paediatric malaria admissions from 2000 to 2008. An interrupted time series analysis using an autoregression-moving-average model was conducted to assess the relationship between paediatric malaria outpatient visits and admissions and the use of paediatric blood transfusions. Further investigation explored whether the use of paediatric blood transfusions over time was consistent with the roll out of malaria control interventions in the hospital catchment area. RESULTS: For each additional paediatric malaria outpatient visit, there were 0.07 additional paediatric blood transfusions (95% CI 0.01-0.13; p < 0.05). For each additional paediatric admission for severe malarial anaemia, there were 1.09 additional paediatric blood transfusions (95% CI 0.95-1.23; p < 0.01). There were 19.1 fewer paediatric blood transfusions per month during the 2004-2006 malaria control period (95% CI 12.1-26.0; p < 0.01), a 50% reduction compared to the preceding period when malaria control was relatively limited. During the 2007-2008 malaria control period, there were 27.5 fewer paediatric blood transfusions per month (95% CI 14.6-40.3; p < 0.01), representing a 72% decline compared to the period with limited malaria control. CONCLUSIONS: Paediatric admissions for severe malarial anaemia largely explain total use of paediatric blood transfusions. The reduction in paediatric blood transfusions is consistent with the timing of the malaria control interventions. Malaria control seems to influence the use of paediatric blood transfusions by reducing the number of paediatric admissions for severe malarial anaemia. Reduced use of blood transfusions could benefit other areas of the health system through greater blood availability, particularly where supply is limited.
Assuntos
Transfusão de Sangue/estatística & dados numéricos , Malária/epidemiologia , Malária/prevenção & controle , Anemia/parasitologia , Anemia/terapia , Transfusão de Sangue/tendências , Pré-Escolar , Hospitalização/estatística & dados numéricos , Hospitalização/tendências , Humanos , Lactente , Recém-Nascido , Análise de Séries Temporais Interrompida , Malária/sangue , Malária/parasitologia , Zâmbia/epidemiologiaRESUMO
There is little evidence on the impact of malaria control on the health system, particularly at the facility level. Using retrospective, longitudinal facility-level and patient record data from two hospitals in Zambia, we report a pre-post comparison of hospital admissions and outpatient visits for malaria and estimated costs incurred for malaria admissions before and after malaria control scale-up. The results show a substantial reduction in inpatient admissions and outpatient visits for malaria at both hospitals after the scale-up, and malaria cases accounted for a smaller proportion of total hospital visits over time. Hospital spending on malaria admissions also decreased. In one hospital, malaria accounted for 11% of total hospital spending before large-scale malaria control compared with < 1% after malaria control. The findings demonstrate that facility-level resources are freed up as malaria is controlled, potentially making these resources available for other diseases and conditions.