Current Status of Malaria Control and Elimination in Africa: Epidemiology, Diagnosis, Treatment, Progress and Challenges.

The African continent carries the greatest malaria burden in the world. Falciparum malaria especially has long been the leading cause of death in Africa. Climate, economic factors, geographical location, human intervention and unstable security are factors influencing malaria transmission. Due to repeated infections and early interventions, the proportion of clinically atypical malaria or asymptomatic plasmodium carriers has increased significantly, which easily lead to misdiagnosis and missed diagnosis. African countries have made certain progress in malaria control and elimination, including rapid diagnosis of malaria, promotion of mosquito nets and insecticides, intermittent prophylactic treatment in high-risk groups, artemisinin based combination therapies, and the development of vaccines. Between 2000 and 2022, there has been a 40% decrease in malaria incidence and a 60% reduction in mortality rate in the WHO African Region. However, many challenges are emerging in the fight against malaria in Africa, such as climate change, poverty, substandard health services and coverage, increased outdoor transmission and the emergence of new vectors, and the growing threat of resistance to antimalarial drugs and insecticides. Joint prevention and treatment, identifying molecular determinants of resistance, new drug development, expanding seasonal malaria chemo-prevention intervention population, and promoting the vaccination of RTS, S/AS01 and R21/Matrix-M may help to solve the dilemma. China's experience in eliminating malaria is conducive to Africa's malaria prevention and control, and China-Africa cooperation needs to be constantly deepened and advanced. Our review aims to help the global public develop a comprehensive understanding of malaria in Africa, thereby contributing to malaria control and elimination.

The History of Controlling and Treating Infectious Diseases in Ancient China.

Infectious diseases are the common enemies of mankind. In the course of historical development, they persistently threaten human health and safety. Even today, despite the developments in medical science, we cannot escape the fear and suffering caused by infectious diseases. Whether in ancient or modern times, the source of infection, route of transmission, and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases. All factors closely related to these three conditions can affect the prevalence of infectious diseases. China is one of the cradles of world civilization. The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases. In the face of the current threat posed by widespread infectious disease, it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease. The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights, especially for impoverished and medically underserved regions.

Agent in Urgent Need of Clinical Practice: Corilagin.

Corilagin is a naturally occurring water-soluble retrogallic acid tannin, which can be extracted from many kinds of plants. Known at present, it is the main effective ingredient of Phyllanthus urinaria L., Geranium wilfordii Maxim., Phyllanthus matsumurae Hayata, and Trifolium repens L. It also exists in Phyllanthus emblica L., Dimocarpus longan Lour., Canarium album (Lour.) Raeusch., and Terminalia chebula Retz. It can participate in a variety of signaling pathways in vivo and has multiple biological activities, including antitumor, anti-microbial, anti-oxidation, anti-inflammation, hepatoprotective, anti-allergy, anti-proliferation and so on. Given the limited efficacy of first-line treatments for many diseases such as oncology, chronic liver disease, and rheumatic immune system diseases, and the potential for adverse effects to outweigh the therapeutic effects, attention is being focused on alternative treatments, and natural plant extracts are a natural target for alternative treatments, as natural substances tend to have low toxicity to normal tissues. Some proprietary Chinese medicines containing corilagin have been used in clinical applications, being clinically applied to treat chronic liver disease, viral hepatitis B, rheumatoid arthritis and other diseases. This paper reviews the extraction, determination, distribution and harvesting, pharmacokinetics, biological activity, safety assessment of corilagin and its application in clinical practice.

LUNG ULTRASOUND DURING COVID-19 PANDEMICS: WHY, HOW AND WHEN?

OBJECTIVE: The aim: To optimize diagnostic of pathological processes in lungs af f ected by COVID-19, dynamic monitoring and clinical decision making using lung ultrasound in limited resources settings. PATIENTS AND METHODS: Materials and methods: Between the onset of pandemics and January 2021, approximately 9000 patients have been treated for conf i rmed COVID-19 in the Olexandrivska Clinical Hospital. Assessment of all hospitalized patients included hematology, chemistries and proinf l ammatory cytokines - IL-6, CRP, procalcitonin, ferritin. Diagnosis was conf i rmed by PCR for SARS-CoV-2 RNA. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. Lung ultrasound was proactively utilized to assess the type and extent of lung damage and to monitor the progress of disease in patients hospitalized into the ICU and Infection Unit (n=135). Ultrasound fi ndings were recorded numerically based on scales. RESULTS: Results: In the setting of СOVID-19, bedside lung ultrasound has been promptly recognized as a tool to diagnose and monitor the nature and extent of lung injury. Lung ultrasound is a real time assessment, which helps determine the nature of a pathologic process af f ecting lungs. In this paper the accuracy of bedside LUS, chest X-ray and computer tomography are compared based on clinical cases, typical for COVID-19 lung ultrasound appearance is evaluated. Described in article data is collected in one of the biggest facility that deals with COVID-19. Chest X-ray was performed in all hospitalized cases, while CT was available approximately in 30% of cases during hospital stay. The cases presented in the paper indicate potential advantages to the use of ultrasound in limited resource healthcare settings, especially when the risk of transportation to CT outweighs the value of information obtained. CONCLUSION: Conclusions: Grading of ultrasonographic findings in the lungs was suf f i cient for both initial assessment with identif ication of high risk patients, and routine daily monitoring. Hence, lung ultrsound may be used to predict deterioration, stratify risks and make clinical decisions.