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1.
PLoS One ; 14(4): e0214667, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30939179

RESUMEN

BACKGROUND: In Vietnam, a rapid decline of P. falciparum malaria cases has been documented in the past years, the number of Plasmodium falciparum malaria cases has rapidly decreased passing from 19.638 in 2012 to 4.073 cases in 2016. Concomitantly, the spread of artemisinin resistance markers is raising concern on the future efficacy of the ACTs. An evaluation of the clinical impact of the artemisinin resistance markers is therefore of interest. METHODS: The clinical effectiveness of dihydroartemisinin-piperaquine therapy (DHA-PPQ) has been evaluated in three districts characterized by different rates of ART resistance markers: K13(C580Y) mutation and delayed parasite clearance on day 3 (DPC3). Patients were stratified in 3 groups a) no markers, b) one marker (suspected resistance), c) co-presence of both markers (confirmed resistance). In the studied areas, the clinical effectiveness of DHA-PPQ has been estimated as malaria recrudescence within 60 days. RESULTS: The rate of K13(C580Y) ranged from 75.8% in Krong Pa to 1.2% in Huong Hoa district. DPC3 prevalence was higher in Krong Pa than in Huong Hoa (86.2% vs 39.3%). In the two districts, the prevalence of confirmed resistance was found in 69.0% and 1.2% of patients, respectively. In Thuan Bac district, we found intermediate prevalence of confirmed resistance. Treatment failure was not evidenced in any district. PPQ resistance was not evidenced. Confirmed resistance was associated to the persistence of parasites on day 28 and to 3.4-fold higher parasite density at diagnosis. The effectiveness of malaria control strategies was very high in the studied districts. CONCLUSION: No treatment failure has been observed in presence of high prevalence of ART resistance and in absence of PPQ resistance. K13(C580Y) was strongly associated to higher parasitemia at admission, on days 3 and 28. Slower parasite clearance was also observed in younger patients.


Asunto(s)
Antimaláricos/uso terapéutico , Resistencia a Medicamentos/genética , Malaria/tratamiento farmacológico , Proteínas Protozoarias/genética , Adolescente , Adulto , Artemisininas/uso terapéutico , Ácido Aspártico Endopeptidasas/genética , Niño , Preescolar , Femenino , Humanos , Malaria/etnología , Malaria/parasitología , Masculino , Mutación , Plasmodium falciparum/genética , Quinolinas/uso terapéutico , Vietnam/epidemiología , Adulto Joven
2.
Am J Trop Med Hyg ; 100(5): 1164-1169, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30793693

RESUMEN

Plasmodium malariae is a neglected malaria parasite. It has wide geographic distribution and, although often associated with mild malaria, is linked to a high burden of anemia and nephrotic syndromes. Here, we report a cohort study conducted in the Kanchanaburi Province of Thailand during May 2013-June 2014 in which P. malariae infection was detected. Of the 812 study participants, two were found to be infected with P. malariae. One had an infection that led to acute malaria, but the other was positive for P. malariae at multiple visits during the study and apparently had chronic asymptomatic infection. Such persistent infection may explain how P. malariae has been able to thrive at very low prevalence and represents a challenge for malaria elimination.


Asunto(s)
Malaria/etnología , Adulto , Infecciones Asintomáticas , Estudios de Cohortes , Enfermedades Endémicas , Femenino , Geografía , Humanos , Malaria/diagnóstico , Masculino , Persona de Mediana Edad , Mianmar , Plasmodium malariae , Prevalencia , Tailandia
3.
BMC Infect Dis ; 18(1): 644, 2018 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-30541456

RESUMEN

BACKGROUND: Although the incidence of dengue across Africa is high, severe dengue is reported infrequently. We describe the clinical features and the outcome of dengue according to raceduring an outbreak in Dar es Salaam, Tanzania that occurred in both native and expatriate populations. METHODS: Adults with confirmed dengue (NS1 and/or IgM on rapid diagnostic test and/or PCR positive) were included between December 2013 and July 2014 in outpatient clinics. Seven-day outcome was assessed by a visit or a call. Association between black race and clinical presentation, including warning signs, was assessed by logistic regression adjusted for age, malaria coinfection, secondary dengue and duration of symptoms at inclusion. The independent association between demographic and comorbidities characteristics of the patients and severe dengue was evaluated by multivariate logistic regression that included potential confounders. RESULTS: After exclusion of 3 patients of mixed race, 431 patients with dengue (serotype 2, genotype Cosmopolitan) were included: 241 of black and 190 of non-black race. Black patients were younger (median age 30 versus 41 years; p < 0.001) and attended care after a slightly longer duration of symptoms (median of 2.9 versus 2.7 days; p = 0.01). Malaria coinfection was not significantly different between black (5%) and non-black (1.6%) patients (p = 0.06). The same proportion of patients in both group had secondary dengue (13 and 14%; p = 0.78). Among warning signs, only mucosal bleed was associated with race, black race being protective (adjusted OR 0.44; 95% CI 0.21-0.92). Overall, 20 patients (4.7%) presented with severe dengue. Non-black race (adjusted OR 3.9; 95% CI 1.3-12) and previously known diabetes (adjusted OR 43; 95% CI 5.2-361) were independently associated with severe dengue. CONCLUSIONS: Although all patients were infected with the same dengue virus genotype, black race was independently protective against a severe course of dengue, suggesting the presence of protective genetic or environmental host factors among people of African ancestry. The milder clinical presentation of dengue in black patients might partly explain why dengue outbreaks are under-reported in Africa and often mistaken for malaria. These results highlight the need to introduce point-of-care tests, beside the one for malaria, to detect outbreaks and orientate diagnosis. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT01947075 , retrospectively registered on the 13 of September 2014.


Asunto(s)
Grupo de Ascendencia Continental Africana/estadística & datos numéricos , Grupos Étnicos/estadística & datos numéricos , Dengue Grave/epidemiología , Adulto , Coinfección/epidemiología , Virus del Dengue/genética , Virus del Dengue/aislamiento & purificación , Brotes de Enfermedades , Femenino , Humanos , Incidencia , Malaria/diagnóstico , Malaria/epidemiología , Malaria/etnología , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Serogrupo , Dengue Grave/diagnóstico , Dengue Grave/etnología , Tanzanía/epidemiología , Adulto Joven
4.
Infect Dis Health ; 23(1): 17-22, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-30479299

RESUMEN

BACKGROUND: Imported malaria cases continue to occur in non-endemic regions among travellers returning from tropical and subtropical countries. At particular risk of acquiring malaria is the group of travellers identified as immigrants who return to their home country with the specific intent of visiting friends or relatives (VFRs) and who commonly believe they are immune to malaria and fail to seek pre-travel advice. Our aim was to review the current trends of imported malaria in the three main hospitals of the Friuli-Venezia Giulia region (FVG), North Eastern Italy, focusing in particular on patient characteristics and laboratory findings. METHODS: In this retrospective study, we examined all malaria cases among patients admitted from January 2010 through December 2014 to the emergency department of the three main hospitals located in FVG. RESULTS: During the 5-year study period from 2010 to 2014, there were a total of 140 patients with a diagnosis of suspected malaria and who received microscopic confirmation of malaria. The most common species identified was P. falciparum, in 96 of 140 cases (69%), followed by P. vivax (13%), P. ovale (4%), P. malariae (4%), and mixed infection (4%). The most common reason for travel was VFRs (54%), followed by work (17%), and recent immigration (15%). Moreover, 78% of all patients took no chemoprophylaxis, 80 (79%) of whom were foreigners. Notably, the percentage of Italian travellers who took chemoprophylaxis was only 20% (8 of 39 Italian cases), and the regimen was appropriate in only four cases. Parasitaemia greater than 5% was observed in 11 cases (10%), all due to P. falciparum infection. CONCLUSIONS: We highlight that VFRs have the highest proportion of malaria morbidity and the importance of improving patient management in this category. These data are useful for establishing appropriate malaria prevention measures and recommendations for international travellers.


Asunto(s)
Malaria/epidemiología , Viaje , Adolescente , Adulto , Anciano , Quimioprevención , Niño , Femenino , Hospitales , Humanos , Italia/epidemiología , Malaria/etnología , Malaria/microbiología , Malaria/prevención & control , Masculino , Persona de Mediana Edad , Plasmodium falciparum/aislamiento & purificación , Plasmodium vivax/aislamiento & purificación , Estudios Retrospectivos , Medicina del Viajero , Adulto Joven
5.
BMC Public Health ; 18(1): 1206, 2018 Oct 26.
Artículo en Inglés | MEDLINE | ID: mdl-30367615

RESUMEN

BACKGROUND: Malaria incidence has been steadily declining in Cambodia, where the government is aiming to eliminate malaria by 2025. Successful malaria elimination requires active engagement and participation of communities to recognize malaria symptoms and the development of prompt treatment-seeking behavior for early diagnosis and appropriate treatment. This study examined malaria knowledge, preventive actions, and treatment-seeking behavior among different groups of ethnic minorities and Khmer in Ratanakiri Province, Cambodia. METHODS: Face-to-face interviews were conducted in December 2015, targeting 388 mothers with children under 2 years old, who belonged to ten ethnic minority groups or the Khmer group living in 62 rural villages in Ratanakiri. In addition to describing mothers' knowledge and actions for malaria prevention, logistic regression analysis was performed to identify determinants of fever during the most recent pregnancy and among children under two. RESULTS: Overall 388 mothers were identified for enrollment into the study of which 377 (97.2%) were included in analyses. The majority of mothers slept under bed nets at home (95.8%) and wore long-sleeved clothes (83.8%) for malaria prevention. However, knowledge of malaria was limited: 44.6% were aware of malaria symptoms, 40.6% knew the malaria transmission route precisely, and 29.2% knew of mosquito breeding places. Staying overnight at a farm hut was significantly associated with having fever during the most recent pregnancy (adjusted odds ratio [AOR] 2.008, 95% confidence interval [CI]: 1.215-3.321) and a child having fever (AOR 3.681, 95% CI 1.943-6.972). Mothers' partaking in a variety of malaria preventive actions was protective against fever in children (AOR 0.292, 95% CI: 0.136-0.650). Among those who had fever during pregnancy, 39.4% did not seek treatment. CONCLUSION: Although the majority of mothers took malaria preventive actions, knowledge of malaria epidemiology and vector ecology and treatment-seeking behavior for fever were limited. Staying overnight at farm huts, regardless of the differences in socio-demographic and socio-cultural characteristics, was strongly associated with fever episodes during pregnancy and childhood. This study indicates the necessity of spreading accurate malaria knowledge, raising awareness of health risks related to agricultural practices, and promoting treatment-seeking behavior among ethnic minorities to strengthen their engagement in malaria elimination.


Asunto(s)
Grupos Étnicos/psicología , Conocimientos, Actitudes y Práctica en Salud/etnología , Malaria/etnología , Malaria/prevención & control , Grupos Minoritarios/psicología , Aceptación de la Atención de Salud/etnología , Adulto , Cambodia/epidemiología , Estudios Transversales , Grupos Étnicos/estadística & datos numéricos , Femenino , Fiebre/etnología , Humanos , Incidencia , Lactante , Recién Nacido , Masculino , Grupos Minoritarios/estadística & datos numéricos , Madres/psicología , Madres/estadística & datos numéricos , Embarazo , Población Rural/estadística & datos numéricos , Encuestas y Cuestionarios , Adulto Joven
6.
PLoS One ; 13(9): e0203673, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-30208075

RESUMEN

Determining the distribution of disease prevalence among heterogeneous populations at the national scale is fundamental for epidemiology and public health. Here, we use a combination of methods (spatial scan statistic, topological data analysis and epidemic profile) to study measurable differences in malaria intensity by regions and populations of Colombia. This study explores three main questions: What are the regions of Colombia where malaria is epidemic? What are the regions and populations in Colombia where malaria is endemic? What associations exist between epidemic outbreaks between regions in Colombia? Plasmodium falciparum is most prevalent in the Pacific Coast, some regions of the Amazon Basin, and some regions of the Magdalena Basin. Plasmodium vivax is the most prevalent parasite in Colombia, particularly in the Northern Amazon Basin, the Caribbean, and municipalities of Sucre, Antioquia and Cordoba. We find an acute peak of malarial infection at 25 years of age. Indigenous and Afrocolombian populations experience endemic malaria (with household transmission). We find that Plasmodium vivax decreased in the most important hotspots, often with moderate urbanization rate, and was re-introduced to locations with moderate but sustained deforestation. Infection by Plasmodium falciparum, on the other hand, steadily increased in incidence in locations where it was introduced in the 2009-2010 generalized epidemic. Our findings suggest that Colombia is entering an unstable transmission state, where rapid decreases in one location of the country are interconnected with rapid increases in other parts of the country.


Asunto(s)
Malaria/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Niño , Preescolar , Análisis por Conglomerados , Colombia/epidemiología , Brotes de Enfermedades , Femenino , Humanos , Lactante , Malaria/etnología , Malaria/parasitología , Malaria/patología , Masculino , Persona de Mediana Edad , Plasmodium falciparum/aislamiento & purificación , Plasmodium vivax/aislamiento & purificación , Prevalencia , Factores Sexuales , Adulto Joven
7.
Mol Med ; 24(1): 24, 2018 06 01.
Artículo en Inglés | MEDLINE | ID: mdl-30134810

RESUMEN

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease with genetic, hormonal, and environmental influences. In Western Europe and North America, individuals of West African descent have a 3-4 fold greater incidence of SLE than Caucasians. Paradoxically, West Africans in sub-Saharan Africa appear to have a low incidence of SLE, and some studies suggest a milder disease with less nephritis. In this study, we analyzed sera from African American female SLE patients and four other cohorts, one with SLE and others with varying degrees of risk for SLE in order to identify serologic factors that might correlate with risk of or protection against SLE. METHODS: Our cohorts included West African women with previous malaria infection assumed to be protected from development of SLE, clinically unaffected sisters of SLE patients with high risk of developing SLE, healthy African American women with intermediate risk, healthy Caucasian women with low risk of developing SLE, and women with a diagnosis of SLE. We developed a lupus risk index (LRI) based on titers of IgM and IgG anti-double stranded DNA antibodies and levels of C1q. RESULTS: The risk index was highest in SLE patients; second highest in unaffected sisters of SLE patients; third highest in healthy African-American women and lowest in healthy Caucasian women and malaria-exposed West African women. CONCLUSION: This risk index may be useful in early interventions to prevent SLE. In addition, it suggests new therapeutic approaches for the treatment of SLE.


Asunto(s)
Predisposición Genética a la Enfermedad , Lupus Eritematoso Sistémico , Adolescente , Adulto , Grupo de Ascendencia Continental Africana , Anciano , Anticuerpos Antinucleares/sangre , Complemento C1q/análisis , Grupo de Ascendencia Continental Europea , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Lupus Eritematoso Sistémico/sangre , Lupus Eritematoso Sistémico/etnología , Lupus Eritematoso Sistémico/genética , Lupus Eritematoso Sistémico/inmunología , Malaria/sangre , Malaria/etnología , Malaria/genética , Malaria/inmunología , Persona de Mediana Edad , Adulto Joven
8.
Med Anthropol ; 37(4): 327-342, 2018.
Artículo en Inglés | MEDLINE | ID: mdl-29319338

RESUMEN

Global health security is increasingly reliant on vigilance to provide early warning of transnational health threats. In theory, this approach requires that sentinels, based in communities most affected by new or reemerging infectious diseases, deliver timely alerts of incipient risk. Medicalizing global safety also implies there are particular forms of insecurity that must be remedied to preempt disease spread. I examine vigilance in the context of spreading drug-resistant malaria in Southeast Asian border zones and argue that to act as sentinels, marginal groups vulnerable to infection must be able to articulate what social and behavioral factors prompt proliferating disease risks.


Asunto(s)
Enfermedades Transmisibles Emergentes , Emigrantes e Inmigrantes , Salud Global/etnología , Malaria , Antropología Médica , Asia Sudoriental/etnología , Enfermedades Transmisibles Emergentes/etnología , Enfermedades Transmisibles Emergentes/parasitología , Enfermedades Transmisibles Emergentes/prevención & control , Resistencia a Medicamentos , Humanos , Malaria/etnología , Malaria/parasitología , Malaria/prevención & control
9.
Hum Biol ; 90(4): 271-280, 2018 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-31714694

RESUMEN

Malaria is an endemic disease in a large part of Colombia, and the city of Buenaventura reports one of the highest malaria infection rates. Some genetic variants confer resistance to malaria, such as the heterozygote for hemoglobin S (HbS) and the homozygous variant FYBES/FYBES of the Duffy gene. The aim of this work was the molecular characterization of these genes in an Afrodescendant population from the urban area of Buenaventura. A total of 819 individuals from a stratified random sampling in each of the 12 communities of this city were analyzed. Molecular analysis was performed using PCR-RFLP, and data analysis was performed using Arlequin 3.5, SPSS 20.0, and R 3.4.1. Frequencies of 3.1% and 72.2% were obtained for the S and FYBES alleles, respectively, with 6.1% AS heterozygous and 55% FYBES/FYBES homozygous genotypes. The highest percentages of the resistant genotype (genotypic combination AA*FYBES/FYBES) were found for the 13-27-year age group (8.2%) and communities 1 and 3 (18% and 10.3%, respectively). Therefore, it would be pertinent to consider the remaining communities and age groups when performing epidemiological studies and preventive and health care campaigns on malaria in the urban areas of the city of Buenaventura.


Asunto(s)
Grupo de Ascendencia Continental Africana/genética , Sistema del Grupo Sanguíneo Duffy/genética , Hemoglobina Falciforme/genética , Malaria/sangre , Polimorfismo de Longitud del Fragmento de Restricción , Adolescente , Adulto , Colombia , Femenino , Genotipo , Heterocigoto , Homocigoto , Humanos , Malaria/etnología , Malaria/genética , Masculino , Reacción en Cadena de la Polimerasa , Población Urbana , Adulto Joven
10.
J Travel Med ; 25(1)2018 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-29232457

RESUMEN

Background: Even though malaria incidence is decreasing worldwide, travel-related cases reported in Europe have remained stable in recent years. In Italy, incidence had increased in the 1990s, reaching a peak in 1999; a slow decline was then reported over the subsequent decade. To our knowledge, few published data are available on imported malaria in Italy since 2010. In this article we aimed to analyse trends in imported malaria in the teaching hospital of Brescia, northern Italy, over the last 18 years. Methods: All malaria cases diagnosed from 1999 to 2016 in Spedali Civili Hospital, Brescia, were retrospectively identified. Demographic, clinical and travel-related data were described. Results: A total of 1200 cases of imported malaria were diagnosed in Brescia during the study period. Among them, 225 were children. A trend of increasing paediatric cases was identified over the study period, while cases in adults were stable. Most cases were diagnosed between August and October. Patients were most likely exposed in sub-Saharan Africa (87.2%). The main reported travel reason was travelling to visit friends and relatives (66.0%). A significantly higher risk of severe malaria was observed in non-immune patients and children visiting friend and relatives (P < 0.001 and P = 0.006, respectively). Conclusions: Our study reveals a relatively stable incidence in imported malaria cases with a peak during the summertime. A large and increasing paediatric burden of disease was identified. Imported malaria requires attention since in Italy a potential reappearance of autochthonous Plasmodium vivax malaria transmission cannot be excluded. Preventive action and physician awareness should be especially directed to children visiting friends and relatives in endemic countries and to non-immune patients since they both represent high-risk groups for severe malaria.


Asunto(s)
Malaria/epidemiología , Viaje , Adolescente , Adulto , África del Sur del Sahara/etnología , Anciano , Anciano de 80 o más Años , Antimaláricos , Niño , Preescolar , Femenino , Hospitales de Enseñanza , Humanos , Incidencia , India/etnología , Lactante , Recién Nacido , Italia/epidemiología , Malaria/sangre , Malaria/etnología , Malaria/prevención & control , Masculino , Persona de Mediana Edad , Pakistán/etnología , Estudios Retrospectivos , Adulto Joven
12.
São Paulo; s.n; s.n; 2018. 64 p. graf, ilus.
Tesis en Portugués | LILACS | ID: biblio-995988

RESUMEN

A identificação de focos de transmissão pode ser de grande utilidade no controle da malária. Por esse motivo, hospitais em regiões endêmicas buscam saber os locais que foram visitados anteriormente por pacientes. No entanto, tais informações, obtidas através de questionários fornecidos aos pacientes, são geralmente vagas e muitas vezes imprecisas. Isto torna o processo manual, lento e de pouca valia em estudos epidemiológicos de larga escala. Baseando-se no fato de que uma parcela significativa da população possui celulares com GPS, o objetivo deste projeto é melhorar a acurácia, organização e dinâmica do processo de coleta de dados de geolocalização de pacientes infectados. Um sistema (https://sipos.fcf.usp.br) foi desenvolvido para que pacientes que chegam aos hospitais possam, sob consentimento voluntário, fornecer os dados de GPS dos seus celulares. Os dados dos usuários, que são tratados de forma anônima, são automaticamente processados e armazenados de forma segura. Através do sistema SiPoS Explorer, epidemiologistas e especialistas em saúde pública podem explorar e analisar os dados de geolocalização, permitindo, desta forma, que regiões vulneráveis sejam priorizadas durante campanhas de controle


The identification of regions with high rates of infection can be of great use in the control of malaria. For this reason, hospitals in endemic regions seek to know the places previously visited by patients. However, such information, obtained through questionnaires provided to patients, is usually vague, inaccurate and not integrated into databases. This makes the process manual, slow and of little value in large-scale epidemiological studies. Based on the fact that a significant portion of the population has smartphones equipped with GPS, this project aims to improve the accuracy and organization of the process of collecting geolocation data from infected patients. The Sickness Positioning System (https://sipos.fcf.usp.br) was developed so that patients who arrive at hospitals can, with voluntary consent, provide the GPS data collected by their smartphones. User data, which is handled anonymously, is automatically processed and securely stored. Through the SiPoS Explorer system (https://sipos.fcf.usp.br/explorer), epidemiologists and public health experts can explore and analyze geolocation data, thereby allowing vulnerable regions to be prioritized during control campaigns


Asunto(s)
Pacientes , Mapeo Geográfico , Culicidae/clasificación , Medios de Comunicación Sociales , Nube Computacional/estadística & datos numéricos , Malaria/etnología
13.
Mil Med Res ; 4: 19, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28593051

RESUMEN

BACKGROUND: Sri Lanka has been free from indigenous malaria since November 2012 and received the WHO certificate for malaria-free status in September 2016. Due to increased global travel, imported malaria cases continue to be reported in the country. Military personnel returning home from international peace-keeping missions in malaria endemic countries represent a key risk group in terms of imported malaria. The present study intended to characterize the potential causes of a malaria outbreak among the Sri Lankan security forces personnel deployed in the Central African Republic (CAR). METHODS: Data were collected from a cross-sectional survey distributed among Sri Lankan Air Force personnel who had returned from United Nations peace-keeping missions in the CAR region. A pre-tested questionnaire was used for the data collection, and focus group discussions were also conducted. RESULTS: One hundred twenty male Air Force personnel were interviewed (out of a group of 122 officers and airmen). All participants were deployed in the CAR for 14 months and were aware of the existence of chemoprophylaxis against malaria. The majority of the subjects (92.5%, 111/120) also knew that prophylaxis should be started prior to departure. However, the regular use of chemoprophylaxis was reported by only 61.7% (74/120) of the sample. Overall, 30.8% of the participants (37/120) had 44 symptomatic episodes of malaria during deployment, and one person succumbed to severe malaria. All cases were associated with noncompliance with chemoprophylaxis. CONCLUSION: Better coordination with overseas healthcare services and the establishment of directly observed chemoprophylaxis may help to avoid similar outbreaks in the future.


Asunto(s)
Enfermedades Endémicas/prevención & control , Malaria/tratamiento farmacológico , Antimaláricos/uso terapéutico , Estudios de Casos y Controles , República Centroafricana , Quimioprevención/métodos , Estudios Transversales , Brotes de Enfermedades/prevención & control , Brotes de Enfermedades/estadística & datos numéricos , Grupos Focales , Humanos , Malaria/epidemiología , Malaria/etnología , Personal Militar/estadística & datos numéricos , Plasmodium falciparum/patogenicidad , Plasmodium vivax/patogenicidad , Factores de Riesgo , Sri Lanka/epidemiología , Sri Lanka/etnología , Encuestas y Cuestionarios
14.
Med Anthropol ; 36(5): 464-478, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28594568

RESUMEN

Today, malaria prevention hinges upon two domestic interventions: insecticide-treated bed nets and indoor residual spraying. As mosquitoes grow resistant to these tools, however, novel approaches to vector control have become a priority area of malaria research and development. Spatial repellency, a volumetric mode of action that seeks to reduce disease transmission by creating an atmosphere inimical to mosquitoes, represents one way forward. Drawing from research that sought to develop new repellent chemicals in conversation with users from sub-Saharan Africa and the United States, we consider the implications of a non-insecticidal paradigm of vector control for how we understand the political ecology of malaria.


Asunto(s)
Salud Global/etnología , Mosquiteros Tratados con Insecticida , Malaria , Control de Mosquitos/métodos , Animales , Antropología Médica , Humanos , Insecticidas/administración & dosificación , Insecticidas/uso terapéutico , Malaria/etnología , Malaria/prevención & control , Sudáfrica , Estados Unidos
15.
Malar J ; 16(1): 256, 2017 06 15.
Artículo en Inglés | MEDLINE | ID: mdl-28619033

RESUMEN

BACKGROUND: The purpose of the study was to recognize the social representation of the Guna indigenous population by identifying cultural elements related to malaria, in order to create an intercultural approach to any health intervention to control and prevent the disease. METHODS: This qualitative study has an anthropological focus that used participant observation, informal conversations, focus groups, interviews, in-depth interviews with key actors. Analyses included review, classification and categorization of interviews. RESULTS: Malaria within the Guna culture is in harmony with several cultural factors, such as magic, religion, beliefs, myths, and nature. The health system must include these factors in its intercultural approach to ensure the sustainability of anti-malarial intervention measures. Until this is not properly addressed, the Guna population of Madungandi will remain a permanent source of risk for malaria transmission in this region and for the rest of the country. CONCLUSION: The findings of this study contribute new variables that can facilitate an intercultural approach to improve the perception of malaria in the indigenous population of Comarca Guna de Madungandi, Panama.


Asunto(s)
Malaria/etnología , Cultura , Femenino , Grupos Focales , Humanos , Entrevistas como Asunto/métodos , Malaria/epidemiología , Malaria/prevención & control , Masculino , Observación , Panamá/epidemiología , Grupos de Población , Encuestas y Cuestionarios
16.
PLoS One ; 12(5): e0177917, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28531196

RESUMEN

Glucose-6-phosphate dehydrogenase (G6PD) deficiency and hemoglobin E (HbE, ß26 Glu-Lys) are two common red cell disorders in Southeast Asia. G6PD deficiency produces hemolytic anemia, which can be triggered by certain drugs or infections. HbE is asymptomatic or is manifested as microcytic, minimally hemolytic anemia. The association between G6PD deficiency and HbE is little understood. This study aimed to investigate G6PD deficiency and HbE in a Kachin ethnic group in the China-Myanmar border area. G6PD enzyme activity was measured using a quantitative G6PD assay, G6PD variants genotyped by the SNaPshot assay, and an HbE gene mutation identified by an amplification refractory mutation system and subsequently confirmed by using a reverse dot blot hybridization assay from 100 unrelated individuals in the study area. G6PD enzyme activity ranged from 0.4 to 24.7 U/g Hb, and six males had severe G6PD deficiency (<0.12-1.2 U/g Hb), while six males and 12 females had mild G6PD deficiency (>1.2-4.5 U/g Hb). Among the 24 G6PD-deficient subjects, 22 (92%) had the Mahidol 487G>A mutation (12 male hemizygotes, one female homozygote, and nine female heterozygotes), while the G6PD genotypes in two female subjects were unknown. HbE was identified in 39 subjects (20 males and 19 females), including 15 HbEE (seven males and eight females) and 24 HbAE (13 males and 11 females). Twenty-three subjects co-inherited both G6PD deficiency and HbE (22 with HbAE and one with HbEE). Whereas mean Hb levels were not significantly different between the HbA and HbE groups, G6PD-deficient males had significantly lower Hb levels than G6PD-normal males (P < 0.05, t-test). However, it is noteworthy that two G6PD-deficient hemizygous males with HbAE were severely anemic with Hb levels below 50 g/L. This study revealed high prevalence of co-inheritance of G6PD deficiency with HbAE in the Kachin ethnicity, and a potential interaction of the G6PD Mahidol 487G>A and HbAE in males leading to severe anemia. The presence of 6% males with severe G6PD deficiency raised a major concern in the use of primaquine for radical cure of vivax malaria.


Asunto(s)
Deficiencia de Glucosafosfato Deshidrogenasa/epidemiología , Glucosafosfato Deshidrogenasa/genética , Hemoglobina E/genética , Hemoglobinuria/epidemiología , Malaria/epidemiología , Adolescente , Adulto , Anciano , Niño , Preescolar , China/epidemiología , China/etnología , Comorbilidad , Enfermedades Endémicas , Femenino , Genotipo , Glucosafosfato Deshidrogenasa/metabolismo , Deficiencia de Glucosafosfato Deshidrogenasa/etnología , Hemoglobinuria/etnología , Humanos , Malaria/etnología , Masculino , Persona de Mediana Edad , Mutación , Mianmar/epidemiología , Mianmar/etnología , Adulto Joven
17.
Travel Med Infect Dis ; 17: 56-61, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28465184

RESUMEN

BACKGROUND: Malaria is not endemic in Italy, but it still represents an important threat to the travelers' health. With this study we wanted to compare the characteristics of imported malaria between adults and children. METHOD: This retrospective observational study includes all patients admitted to the Infectious Diseases Unit and in the Pediatric Department of Padua (Italy), and discharged with a diagnosis of malaria from 2005 to 2015. The variables considered are epidemiological and clinical. RESULTS: 172 cases of imported malaria were studied (124 adults and 48 children), P. falciparum was responsible for 90,7% of the cases, and was contracted mostly in Africa (96,5%), especially by foreigners visiting friends and relatives (VFR). Chemoprophylaxis was adopted only by few patients. 93% of all the patients developed the uncomplicated malaria, but pediatric patients had severe malaria significantly more often than adults (OR = 4,06, p = 0,015). Children also had significantly lower hemoglobin levels and higher parasitemia. The drugs used to treat the two groups were substantially different, but both had a good overall outcome. CONCLUSIONS: In order to reduce the risk of imported malaria, educational actions should target potential VFR travelers, and they should underline the different risk of severe malaria in adults and children. A further implementation of the recommended therapies could improve the patients' outcome.


Asunto(s)
Malaria/epidemiología , Viaje/estadística & datos numéricos , Adolescente , Adulto , Anciano , Antimaláricos/uso terapéutico , Quimioprevención/estadística & datos numéricos , Niño , Preescolar , Femenino , Hospitales de Enseñanza , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Malaria/tratamiento farmacológico , Malaria/etnología , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , Adulto Joven
18.
Travel Med Infect Dis ; 17: 35-42, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-28456684

RESUMEN

BACKGROUND: We describe trends of malaria in London (2000-2014) in order to identify preventive opportunities and we estimated the cost of malaria admissions (2009/2010-2014/2015). METHODS: We identified all cases of malaria, resident in London, reported to the reference laboratory and obtained hospital admissions from Hospital Episode Statistics. RESULTS: The rate of malaria decreased (19.4[2001]-9.1[2014] per 100,000). Males were over-represented (62%). Cases in older age groups increased overtime. The rate was highest amongst people of Black African ethnicity followed by Indian, Pakistani, Bangladeshi ethnicities combined (103.3 and 5.5 per 100,000, respectively). The primary reason for travel was visiting friends and relatives (VFR) in their country of origin (69%), mostly sub-Saharan Africa (92%). The proportion of cases in VFRs increased (32%[2000]-50%[2014]) and those taking chemoprophylaxis decreased (36%[2000]-14%[2014]). The overall case fatality rate was 0.3%. We estimated the average healthcare cost of malaria admissions to be just over £1 million per year. CONCLUSION: Our study highlighted that people of Black African ethnicity, travelling to sub-Saharan Africa to visit friends and relatives in their country of origin remain the most affected with also a decline in chemoprophylaxis use. Malaria awareness should focus on this group in order to have the biggest impact but may require new approaches.


Asunto(s)
Malaria , Viaje/estadística & datos numéricos , Adolescente , Adulto , África del Sur del Sahara/etnología , Antimaláricos/uso terapéutico , Quimioprevención/estadística & datos numéricos , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Londres/epidemiología , Malaria/tratamiento farmacológico , Malaria/economía , Malaria/epidemiología , Malaria/etnología , Masculino , Persona de Mediana Edad , Adulto Joven
19.
BMC Res Notes ; 10(1): 157, 2017 Apr 18.
Artículo en Inglés | MEDLINE | ID: mdl-28420410

RESUMEN

BACKGROUND: One of the services that plants provide for human beings is their wider medicinal application. Although it is not fully assessed, the practice and wider use of traditional medicine is frequent in Ethiopia. Studies conducted previously are confined to the perceptions of modern and traditional health practitioners about traditional medicine. A total of 45 informants were selected purposefully from the study area. For collecting the data, semi-structured interviewees, observation and field walks were employed from August 10 to September 30/2014. To summarize the information, descriptive statistical methods were applied. RESULTS: Sixty species of medicinal plants distributed in 42 families were collected and identified applied locally for the treatment of 55 human disorders. The most commonly treated ones were evil eye, malaria, wound, peptic ulcer disease and rabies. According to this study, leaves were the commonly used plant parts (36.5%) and 39% of the preparations were decoctions. Oral route, 43 (44%) was the commonly used route of application whereas most (54.8%) remedies were administered only once. Fourteen percent of preparations caused vomiting in addition most (40.4%) of the formulations was contraindicated for pregnant patients. Only seventeen percent of the formulations possessed drug food interactions. Most preparations were stored within clothes, 31 (29.8%). There exists a high (ICF = 0.8) evenness of plant use among healers for treating respiratory problems. Alliumsativum (FI = 0.75) for evil eye, Phytolacca dodecandra (FI = 0.8) for rabies and Croton macrostachyus (FI = 0.78) for treating malaria were medicinal plants with highest fidelity levels showing consistency of knowledge on species best treating power. This study also documented that drought, overgrazing and firewood collection are major threats. CONCLUSION: Dega Damot district is loaded in its medicinal plant diversity and indigenous knowledge though plants are highly affected by drought, overgrazing and firewood collection. Therefore awareness activities must be created among the district's population by concerned governmental and nongovernmental organizations about the value of medicinal plants and conservation of these plants. The healing potential and associated adverse issues of the claimed medicinal plants should be assessed before proposing for a broader utilization.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud/etnología , Medicina Tradicional Africana/métodos , Fitoterapia/métodos , Preparaciones de Plantas/administración & dosificación , Plantas Medicinales/clasificación , Adulto , Anciano , Anciano de 80 o más Años , Conservación de los Recursos Naturales , Contraindicaciones de los Medicamentos , Etiopía , Etnofarmacología , Femenino , Humanos , Malaria/tratamiento farmacológico , Malaria/etnología , Masculino , Persona de Mediana Edad , Úlcera Péptica/tratamiento farmacológico , Úlcera Péptica/etnología , Preparaciones de Plantas/efectos adversos , Plantas Medicinales/química , Plantas Medicinales/crecimiento & desarrollo , Embarazo , Rabia/tratamiento farmacológico , Rabia/etnología , Encuestas y Cuestionarios , Heridas y Traumatismos/tratamiento farmacológico , Heridas y Traumatismos/etnología
20.
Med Anthropol ; 36(5): 436-448, 2017 07.
Artículo en Inglés | MEDLINE | ID: mdl-28394640

RESUMEN

In this article, I investigate the ramifications of health data production in the health fight against malaria in and around Dakar, Senegal. Malaria health development funding at the community level is contingent on performativity; the Global Fund's "performance-based funding," for example, requires that local actors produce certain forms of evidence and that intermediaries synthesize this evidence into citable data. Analyzing the practices of diagnosis and approximation in health clinics and in global malaria documents, I argue that data production in Senegal is conditioned by and reifies preconceived notions of malaria as a problem addressable by the enumeration of technological fixes.


Asunto(s)
Salud Global/etnología , Personal de Salud , Malaria , Vigilancia en Salud Pública , Antropología Médica , Humanos , Malaria/diagnóstico , Malaria/etnología , Malaria/prevención & control , Senegal , Encuestas y Cuestionarios
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