The economic burden of malaria: a systematic review.

BACKGROUND: Quantifying disease costs is critical for policymakers to set priorities, allocate resources, select control and prevention strategies, and evaluate the cost-effectiveness of interventions. Although malaria carries a very large disease burden, the availability of comprehensive and comparable estimates of malaria costs across endemic countries is scarce. METHODS: A literature review to summarize methodologies utilized to estimate malaria treatment costs was conducted to identify gaps in knowledge. RESULTS: Only 45 publications met the inclusion criteria. They utilize different methods, include distinct cost components, have varied geographical coverage (a country vs a city), include different periods in the analysis, and focus on specific parasite types or population groups (e.g., pregnant women). CONCLUSIONS: Cost estimates currently available are not comparable, hindering broad statements on the costs of malaria, and constraining advocacy efforts towards investment in malaria control and elimination, particularly with the finance and development sectors of the government.

Implications of Zika virus and congenital Zika syndrome for the number of live births in Brazil.

An increase in microcephaly, associated with an epidemic of Zika virus (ZIKV) in Brazil, prompted the World Health Organization to declare a Public Health Emergency of International Concern in February 2016. While knowledge on biological and epidemiological aspects of ZIKV has advanced, demographic impacts remain poorly understood. This study uses time-series analysis to assess the impact of ZIKV on births. Data on births, fetal deaths, and hospitalizations due to abortion complications for Brazilian states, from 2010 to 2016, were used. Forecasts for September 2015 to December 2016 showed that 119,095 fewer births than expected were observed, particularly after April 2016 (a reduction significant at 0.05), demonstrating a link between publicity associated with the ZIKV epidemic and the decline in births. No significant changes were observed in fetal death rates. Although no significant increases in hospitalizations were forecasted, after the ZIKV outbreak hospitalizations happened earlier in the gestational period in most states. We argue that postponement of pregnancy and an increase in abortions may have contributed to the decline in births. Also, it is likely that an increase in safe abortions happened, albeit selective by socioeconomic status. Thus, the ZIKV epidemic resulted in a generation of congenital Zika syndrome (CZS) babies that reflect and exacerbate regional and social inequalities. Since ZIKV transmission has declined, it is unlikely that reductions in births will continue. However, the possibility of a new epidemic is real. There is a need to address gaps in reproductive health and rights, and to understand CZS risk to better inform conception decisions.

The new organic nitrate 2-nitrate-1,3-diocthanoxypropan (NDOP) induces nitric oxide production and vasorelaxation via activation of inward-rectifier potassium channels (KIR).

INTRODUCTION: Cardiovascular diseases are coupled to decreased nitric oxide (NO) bioavailability, and there is a constant search for novel and better NO-donors. Here we synthesized and characterized the cardiovascular effects of the new organic nitrate 2-nitrate-1,3-dioctanoxypropan (NDOP). METHODS: A combination of in vitro and in vivo experiments was performed in C57BL/6 mice and Wistar rats. Thus, the ability of NDOP in donating NO in a cell-free system and in vascular smooth muscles cells (VSMC) and its ability to induce vasorelaxation in aortic rings from mice were evaluated. In addition, changes in blood pressure and heart rate to different doses of NDOP were evaluated in conscious rats. Finally, acute pre-clinical toxicity to oral administration of NDOP was assessed in mice. RESULTS: In cell-free system, NDOP increased NO levels, which was dependent on xanthine oxidoreductase (XOR). NDOP also increased NO levels in VSMC, which was not influenced by endothelial NO synthase. Furthermore, incubation with the XOR inhibitor febuxostat blunted the vasorelaxation in aortic ring preparations. In conscious rats, NDOP elicited dose-dependent reduction in blood pressure accompanied with increased heart rate. In vessel preparations, NDOP (10-8-10-3 mol/L) induced endothelium-independent vasorelaxation, which was inhibited by the NO scavengers 2-phenyl-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide and hydroxocobalamin or by inhibition of soluble guanylyl cyclase using H- [1,2,4] oxadiazolo [4,3-a]quinoxalin-1-one. To investigate if NDOP acts through potassium channels, selective blockers were used. Inhibition of BKCa, Kv or KATP subtypes of potassium channels had no effect, but inhibition of inward-rectifier potassium channels (KIR) significantly reduced NDOP-mediated vasorelaxation. Lastly, NDOP showed low toxicity (LD50 ~5000 mg/kg). CONCLUSION: Bioactivation of NDOP involves functional XOR, and this new organic nitrate elicits vasorelaxation via NO-cGMP-PKG signaling and activation of KIR channels. Future studies should further characterize the underlying mechanism and evaluate the therapeutic benefits of chronic NDOP treatment in relevant cardiovascular disease models.

Avaliação da qualidade microbiológica dos caldos de cana comercializados no centro de Itabuna-BA e práticas de produção e higiene de seus manipuladores / Evaluation of the microbiological quality of sugarcane juice sold in Itabuna, BA and the handlers production and higiene practices

O caldo de cana, obtido da prensagem da cana-de-açúcar é comercializado, principalmente, por vendedores ambulantes que não possuem instalações compatíveis e conhecimento adequado sobre higiene na preparação do alimento. O objetivo deste trabalho foi avaliar a qualidade microbiológica dos caldos de cana que são comercializados por vendedores formais e ambulantes no centro da cidade de Itabuna, Bahia, pelo Método do Número mais Provável (NMP) para coliformes, bem como avaliar o perfil higiênico sanitário dos vendedores por meio da aplicação de formulário. Foram analisadas 20 amostras coletadas entre março e julho de 2006 para Coliformes Totais, Coliformes Termotolerantes e Escherichia coli. Noventa por cento das amostras mostraram altas contagens de Coliformes Totais (maior que 1100 NMP/mL), 75por cento estavam acima do estabelecido para Coliformes Termotolerantes, sendo que, destes, 65por cento era E. coli. Quarenta e cinco por cento dos entrevistados revelaram não saber o que são microrganismos e os riscos que eles causam à saúde humana e 25por cento não sabiam o que são boas práticas de fabricação e higiene. De fato, 55por cento nunca haviam recebido orientação da vigilância sanitária. Portanto, é necessário capacitar os vendedores da região, para que possam comercializar alimentos que não ofereçam risco aos consumidores.

Avaliação da qualidade microbiológica dos caldos de cana comercializados no centro de Itabuna-BA e práticas de produção e higiene de seus manipuladores / Evaluation of the microbiological quality of sugarcane juice sold in Itabuna, BA and the handlers production and higiene practices

O caldo de cana, obtido da prensagem da cana-de-açúcar é comercializado, principalmente, por vendedores ambulantes que não possuem instalações compatíveis e conhecimento adequado sobre higiene na preparação do alimento. O objetivo deste trabalho foi avaliar a qualidade microbiológica dos caldos de cana que são comercializados por vendedores formais e ambulantes no centro da cidade de Itabuna, Bahia, pelo Método do Número mais Provável (NMP) para coliformes, bem como avaliar o perfil higiênico sanitário dos vendedores por meio da aplicação de formulário. Foram analisadas 20 amostras coletadas entre março e julho de 2006 para Coliformes Totais, Coliformes Termotolerantes e Escherichia coli. Noventa por cento das amostras mostraram altas contagens de Coliformes Totais (maior que 1100 NMP/mL), 75por cento estavam acima do estabelecido para Coliformes Termotolerantes, sendo que, destes, 65por cento era E. coli. Quarenta e cinco por cento dos entrevistados revelaram não saber o que são microrganismos e os riscos que eles causam à saúde humana e 25por cento não sabiam o que são boas práticas de fabricação e higiene. De fato, 55por cento nunca haviam recebido orientação da vigilância sanitária. Portanto, é necessário capacitar os vendedores da região, para que possam comercializar alimentos que não ofereçam risco aos consumidores.(AU)