Your browser doesn't support javascript.
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 8.750
Filtrar
1.
Rev Med Suisse ; 16(693): 978-983, 2020 May 13.
Artículo en Francés | MEDLINE | ID: mdl-32401437

RESUMEN

Long-term travelers are particularly exposed to malaria. It is essential to inform them about this risk, the recognition of the symptoms of the disease and the need for prompt treatment. Addressing any fears of travelers and answering their questions improve therapeutic adherence. Personal protective measures (repellents, mosquito nets) are fundamental and safe to reduce exposure to the vector of the disease. Depending on the individual risk of malaria and the special vulnerability of the traveler, short-term or prolonged chemoprophylaxis and/or emergency self-treatment and a rapid diagnostic test for malaria may be offered.


Asunto(s)
Antimaláricos/administración & dosificación , Educación en Salud , Malaria/prevención & control , Enfermedad Relacionada con los Viajes , Animales , Antimaláricos/uso terapéutico , Quimioprevención , Diagnóstico Precoz , Humanos , Malaria/diagnóstico , Malaria/tratamiento farmacológico , Mosquiteros , Mosquitos Vectores , Prevención Secundaria
4.
New Microbiol ; 43(1): 28-33, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-32118282

RESUMEN

In Italy, malaria continues to be one of the most common imported parasitoses; therefore, continuous surveillance of epidemiological data and clinical management is needed. In 2016, the National Institute for Infectious Diseases 'Lazzaro Spallanzani' in Rome promoted a retrospective questionnaire-based survey to assess the clinical management of imported malaria cases in Italy in 2015. The questionnaire was sent to 104 Tropical and/or Infectious Diseases Units in the country, and 37 of them filled out and returned the questionnaires. A total of 399 malaria cases were reported in 2015, mostly caused by Plasmodium falciparum and imported from Africa. Malaria chemoprophylaxis was correctly used by a minority of patients. Most patients presented with uncomplicated malaria and were treated orally. In severe cases, intravenous artesunate or quinine alone or in combination were administered, although one third of these severe cases received oral treatment. This retrospective survey reveals a lack of homogeneity in management of malaria-imported cases in Italy. Improvement of malaria chemoprophylaxis, standardization of clinical management of malaria cases and harmonization of oral and intravenous drug availability are needed throughout the country.


Asunto(s)
Antimaláricos , Malaria , Viaje , Antimaláricos/uso terapéutico , Estudios Transversales , Humanos , Italia , Malaria/tratamiento farmacológico , Malaria/prevención & control , Plasmodium , Estudios Retrospectivos , Encuestas y Cuestionarios
5.
PLoS Comput Biol ; 16(2): e1007025, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-32069285

RESUMEN

Malaria is an infectious disease that affects over 216 million people worldwide, killing over 445,000 patients annually. Due to the constant emergence of parasitic resistance to the current antimalarial drugs, the discovery of new drug candidates is a major global health priority. Aiming to make the drug discovery processes faster and less expensive, we developed binary and continuous Quantitative Structure-Activity Relationships (QSAR) models implementing deep learning for predicting antiplasmodial activity and cytotoxicity of untested compounds. Then, we applied the best models for a virtual screening of a large database of chemical compounds. The top computational predictions were evaluated experimentally against asexual blood stages of both sensitive and multi-drug-resistant Plasmodium falciparum strains. Among them, two compounds, LabMol-149 and LabMol-152, showed potent antiplasmodial activity at low nanomolar concentrations (EC50 <500 nM) and low cytotoxicity in mammalian cells. Therefore, the computational approach employing deep learning developed here allowed us to discover two new families of potential next generation antimalarial agents, which are in compliance with the guidelines and criteria for antimalarial target candidates.


Asunto(s)
Antimaláricos/química , Antimaláricos/uso terapéutico , Aprendizaje Profundo , Descubrimiento de Drogas/métodos , Malaria/tratamiento farmacológico , Humanos , Relación Estructura-Actividad Cuantitativa , Reproducibilidad de los Resultados , Relación Estructura-Actividad
7.
An. pediatr. (2003. Ed. impr.) ; 92(1): 21-27, ene. 2020. tab
Artículo en Español | IBECS | ID: ibc-186814

RESUMEN

Introducción: La malaria es considerada la cuarta causa de mortalidad infantil después de la neumonía, las complicaciones por parto prematuro y la asfixia perinatal. Material y métodos: Estudio retrospectivo y descriptivo de los casos de paludismo confirmados y tratados en la Unidad de Enfermedades Infecciosas Pediátricas (edad inferior a 15 años) del Hospital La Fe (Valencia) en el período comprendido entre 1993 y 2015. Resultados: Durante el período 1993-2015 se diagnosticaron 54 casos de malaria infantil, el 51,8% en varones. El 46,2% eran menores de 5 años. La mayoría de los niños procedían de Guinea Ecuatorial (68,5%). Solo en el 5,6% de los pacientes se pudo constatar que recibieran profilaxis antimalárica. Se evidenció que Plasmodium falciparum fue la especie causal del 81,4% de los episodios. Siete casos (13%) presentaron malaria complicada. El tratamiento más empleado fue la quinina, sola o en combinación con otros fármacos: atovacuona-proguanil fue empleada a partir del año 2010 y estuvo indicada en el 20,3% de los pacientes. A partir del año 2013 se inició la utilización de: artesunato, piperaquina y dihidroartemisina. No hubo mortalidad ni efectos adversos relevantes, siendo la respuesta clínica favorable en el 100% de los niños. Conclusiones: La malaria sigue siendo una enfermedad vigente en nuestra población, consecuencia de la inmigración y del turismo a países endémicos. Debe ser considerada como diagnóstico probable ante un niño febril que procede o ha viajado a un área endémica en el último año


Introduction: Malaria is considered to be the fourth leading cause of infant mortality after pneumonia, complications related to premature birth, and perinatal asphyxia. Material and methods: A retrospective and descriptive study of cases of malaria confirmed and treated by the Paediatric Infectious Diseases Unit (age lower than 15 years) at the La Fe Hospital, Valencia, over the period 1993 to 2015. Results: A total of 54 cases of paediatric malaria were diagnosed in the period 1993-2015, with 51.8% of these occurring in males, and 46.2% of patients were aged below 5 years. The majority of children came from Equatorial Guinea (68.5%). Only 5.6% had received antimalarial prophylaxis. Plasmodium falciparum was found to be the causal species in 81.4% of cases. Seven patients (13%) presented with complicated malaria. The most widely used treatment was quinine, either alone or in combination with other drugs. Atovaquone/proguanil was used from 2010 onwards and was indicated in 20.3% of the patients. The combination of artesunate/piperaquine/dihydroartemisinin began to be used in 2013. No deaths or relevant side effects were reported, and the clinical response was favourable in all children (100%). Conclusions: Malaria is still a prevalent disease in this population, a consequence of immigration, and tourism to endemic countries. Malaria should be considered as a likely diagnosis in a febrile child who comes from, or has travelled to, an endemic region in the past year


Asunto(s)
Humanos , Masculino , Femenino , Preescolar , Niño , Malaria/epidemiología , Malaria/microbiología , España/epidemiología , Estudios Retrospectivos , Epidemiología Descriptiva , Malaria/etiología , Malaria/tratamiento farmacológico
8.
BMC Med ; 18(1): 17, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-31996199

RESUMEN

BACKGROUND: There has been a successful push towards parasitological diagnosis of malaria in Africa, mainly with rapid diagnostic tests (mRDTs), which has reduced over-prescribing of artemisinin-based combination therapies (ACT) to malaria test-negative patients. The effect on prescribing for test-positive patients has received much less attention. Malaria infection in endemic Africa is often most dangerous for young children and those in low-transmission settings. This study examined non-prescription of antimalarials for patients with malaria infection demonstrated by positive mRDT results, and in particular these groups who are most vulnerable to poor outcomes if antimalarials are not given. METHODS: Analysis of data from 562,762 patients in 8 studies co-designed as part of the ACT Consortium, conducted 2007-2013 in children and adults, in Cameroon, Ghana, Nigeria, Tanzania, and Uganda, in a variety of public and private health care sector settings, and across a range of malaria endemic zones. RESULTS: Of 106,039 patients with positive mRDT results (median age 6 years), 7426 (7.0%) were not prescribed an ACT antimalarial. The proportion of mRDT-positive patients not prescribed ACT ranged across sites from 1.3 to 37.1%. For patients under age 5 years, 3473/44,539 (7.8%) were not prescribed an ACT, compared with 3833/60,043 (6.4%) of those aged ≥ 5 years. The proportion of < 5-year-olds not prescribed ACT ranged up to 41.8% across sites. The odds of not being prescribed an ACT were 2-32 times higher for patients in settings with lower-transmission intensity (using test positivity as a proxy) compared to areas of higher transmission. mRDT-positive children in low-transmission settings were especially likely not to be prescribed ACT, with proportions untreated up to 70%. Of the 7426 mRDT-positive patients not prescribed an ACT, 4121 (55.5%) were prescribed other, non-recommended non-ACT antimalarial medications, and the remainder (44.5%) were prescribed no antimalarial. CONCLUSIONS: In eight studies of mRDT implementation in five African countries, substantial proportions of patients testing mRDT-positive were not prescribed an ACT antimalarial, and many were not prescribed an antimalarial at all. Patients most vulnerable to serious outcomes, children < 5 years and those in low-transmission settings, were most likely to not be prescribed antimalarials, and young children in low-transmission settings were least likely to be treated for malaria. This major public health risk must be addressed in training and practice. TRIAL REGISTRATION: Reported in individual primary studies.


Asunto(s)
Antimaláricos/uso terapéutico , Artemisininas/uso terapéutico , Malaria/tratamiento farmacológico , Pautas de la Práctica en Medicina , Adolescente , Adulto , Niño , Preescolar , Prestación de Atención de Salud/normas , Femenino , Ghana , Humanos , Malaria/diagnóstico , Masculino , Persona de Mediana Edad , Nigeria , Prescripciones , Sector Privado , Tanzanía , Uganda , Adulto Joven
9.
PLoS One ; 15(1): e0216260, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31967991

RESUMEN

The circumsporozoite protein (CSP) and thrombospondin-related adhesion protein (TRAP) are major targets for pre-erythrocytic malaria vaccine development. However, the CSP-based vaccine RTS,S provides only marginal protection, highlighting the need for innovative vaccine design and development. Here we design and characterize expression and folding of P. berghei (Pb) and P. falciparum (Pf) TRAP-CSP fusion proteins, and evaluate immunogenicity and sterilizing immunity in mice. TRAP N-terminal domains were fused to the CSP C-terminal αTSR domain with or without the CSP repeat region, expressed in mammalian cells, and evaluated with or without N-glycan shaving. Pb and Pf fusions were each expressed substantially better than the TRAP or CSP components alone; furthermore, the fusions but not the CSP component could be purified to homogeneity and were well folded and monomeric. As yields of TRAP and CSP fragments were insufficient, we immunized BALB/c mice with Pb TRAP-CSP fusions in AddaVax adjuvant and tested the effects of absence or presence of the CSP repeats and absence or presence of high mannose N-glycans on total antibody titer and protection from infection by mosquito bite both 2.5 months and 6 months after the last immunization. Fusions containing the repeats were completely protective against challenge and re-challenge, while those lacking repeats were significantly less effective. These results correlated with higher total antibody titers when repeats were present. Our results show that TRAP-CSP fusions increase protein antigen production, have the potential to yield effective vaccines, and also guide design of effective proteins that can be encoded by nucleic acid-based and virally vectored vaccines.


Asunto(s)
Vacunas contra la Malaria/farmacología , Malaria/tratamiento farmacológico , Proteínas Protozoarias/genética , Animales , Anticuerpos/genética , Anticuerpos/inmunología , Antígenos/genética , Antígenos/inmunología , Modelos Animales de Enfermedad , Regulación de la Expresión Génica/inmunología , Humanos , Inmunización , Malaria/inmunología , Malaria/parasitología , Vacunas contra la Malaria/inmunología , Ratones , Plasmodium berghei/efectos de los fármacos , Plasmodium berghei/inmunología , Plasmodium berghei/patogenicidad , Plasmodium falciparum/efectos de los fármacos , Plasmodium falciparum/inmunología , Plasmodium falciparum/patogenicidad , Polisacáridos/genética , Polisacáridos/inmunología , Pliegue de Proteína , Proteínas Protozoarias/inmunología , Proteínas Recombinantes de Fusión/genética , Proteínas Recombinantes de Fusión/inmunología
11.
Am J Trop Med Hyg ; 102(2s): 3-24, 2020 02.
Artículo en Inglés | MEDLINE | ID: mdl-31971144

RESUMEN

In the context of stalling progress against malaria, resistance of mosquitoes to insecticides, and residual transmission, mass drug administration (MDA) of ivermectin, an endectocide used for neglected tropical diseases (NTDs), has emerged as a promising complementary vector control method. Ivermectin reduces the life span of Anopheles mosquitoes that feed on treated humans and/or livestock, potentially decreasing malaria parasite transmission when administered at the community level. Following the publication by WHO of the preferred product characteristics for endectocides as vector control tools, this roadmap provides a comprehensive view of processes needed to make ivermectin available as a vector control tool by 2024 with a completely novel mechanism of action. The roadmap covers various aspects, which include 1) the definition of optimal dosage/regimens for ivermectin MDA in both humans and livestock, 2) the risk of resistance to the drug and environmental impact, 3) ethical issues, 4) political and community engagement, 5) translation of evidence into policy, and 6) operational aspects of large-scale deployment of the drug, all in the context of a drug given as a prevention tool acting at the community level. The roadmap reflects the insights of a multidisciplinary group of global health experts who worked together to elucidate the path to inclusion of ivermectin in the toolbox against malaria, to address residual transmission, counteract insecticide resistance, and contribute to the end of this deadly disease.


Asunto(s)
Antiparasitarios/farmacología , Insecticidas/farmacología , Ivermectina/farmacología , Malaria/prevención & control , Mosquitos Vectores/efectos de los fármacos , África , Animales , Antiparasitarios/uso terapéutico , Enfermedades Endémicas/prevención & control , Humanos , Insecticidas/uso terapéutico , Ivermectina/uso terapéutico , Dosificación Letal Mediana , Malaria/tratamiento farmacológico , Malaria/transmisión , Administración Masiva de Medicamentos , Seguridad , España , Organización Mundial de la Salud
12.
PLoS One ; 15(1): e0227341, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-31923258

RESUMEN

Clan CA cysteine proteases, also known as papain-like proteases, play important roles throughout the malaria parasite life cycle and are therefore potential drug targets to treat this disease and prevent its transmission. In order to study the biological function of these proteases and to chemically validate some of them as viable drug targets, highly specific inhibitors need to be developed. This is especially challenging given the large number of clan CA proteases present in Plasmodium species (ten in Plasmodium falciparum), and the difficulty of designing selective inhibitors that do not cross-react with other members of the same family. Additionally, any efforts to develop antimalarial drugs targeting these proteases will also have to take into account potential off-target effects against the 11 human cysteine cathepsins. Activity-based protein profiling has been a very useful tool to determine the specificity of inhibitors against all members of an enzyme family. However, current clan CA proteases broad-spectrum activity-based probes either target endopeptidases or dipeptidyl aminopeptidases, but not both subfamilies efficiently. In this study, we present a new series of dipeptydic vinyl sulfone probes containing a free N-terminal tryptophan and a fluorophore at the P1 position that are able to label both subfamilies efficiently, both in Plasmodium falciparum and in mammalian cells, thus making them better broad-spectrum activity-based probes. We also show that some of these probes are cell permeable and can therefore be used to determine the specificity of inhibitors in living cells. Interestingly, we show that the choice of fluorophore greatly influences the specificity of the probes as well as their cell permeability.


Asunto(s)
Proteasas de Cisteína/metabolismo , Inhibidores de Cisteína Proteinasa/química , Malaria/enzimología , Animales , Antimaláricos/química , Permeabilidad de la Membrana Celular , Humanos , Malaria/diagnóstico por imagen , Malaria/tratamiento farmacológico , Sondas Moleculares/química , Plasmodium falciparum/efectos de los fármacos , Plasmodium falciparum/enzimología , Sulfonas , Triptófano
13.
Eur J Med Chem ; 187: 111963, 2020 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-31865015

RESUMEN

The tropical disease malaria is responsible for more than 400,000 deaths annually, especially in Southeast Asia and Africa. Although the number of malaria cases is declining, there still is an urgent need for novel antimalarial agents. The emergence of hybrid antimalarial agents and the precedence set by the antimalarial drug ferroquine (FQ) prompted us to design new ferrocene-containing quinoline structures. Herein, we report the efficient synthesis of three different series of ferrocene-quinoline conjugates and a class of ferrocene-containing heterotricycles in good to high yields. For all twenty novel ferrocenyl derivatives, electrochemical properties were investigated using cyclic voltammetry and antiplasmodium evaluation against a chloroquine-susceptible NF54 strain of the human malaria parasite Plasmodium falciparum was conducted, pointing to three compounds showing submicromolar potency. Subsequently, cytotoxicity assays against a Chinese Hamster Ovarian cell line and evaluation against a chloroquine-resistant strain of Plasmodium falciparum for these three compounds revealed selective and promising antiplasmodium activity.


Asunto(s)
Antimaláricos/farmacología , Diseño de Fármacos , Técnicas Electroquímicas , Compuestos Ferrosos/farmacología , Malaria/tratamiento farmacológico , Metalocenos/farmacología , Plasmodium falciparum/efectos de los fármacos , Quinolinas/farmacología , Antimaláricos/síntesis química , Antimaláricos/química , Relación Dosis-Respuesta a Droga , Compuestos Ferrosos/química , Humanos , Metalocenos/química , Modelos Moleculares , Estructura Molecular , Pruebas de Sensibilidad Parasitaria , Quinolinas/química , Relación Estructura-Actividad
14.
J Ethnopharmacol ; 247: 112203, 2020 Jan 30.
Artículo en Inglés | MEDLINE | ID: mdl-31472271

RESUMEN

ETHNOPHARMACOLOGICAL RELEVANCE: Combretum racemosum showed activity in previous ethnopharmacological investigations of some Combretum species used in malaria treatment in parts of West Africa. AIM OF THE STUDY: This study aimed at confirming the antimalarial potential of this plant by an activity-guided isolation of its active principles. MATERIALS AND METHODS: A crude methanolic leaf extract of Combretum racemosum and fractions thereof obtained by partition with chloroform and n-butanol were investigated for antiplasmodial activity against chloroquine-sensitive (D10) and chloroquine-resistant (W2) strains of Plasmodium falciparum. Repeated chromatographic separations were conducted on the chloroform fraction to isolate bioactive compounds for further tests on antiplasmodial activity. The characterization of the isolated substances was performed by applying NMR- and MS-techniques (ESI-MS, HR-ESIMS, 1D and 2D NMR). RESULTS: The chloroform fraction (D10: IC50 = 33.8 ±â€¯1.5 µg/mL and W2: IC50 = 27.8 ±â€¯2.9 µg/mL) exhibited better antiplasmodial activity than the n-butanol fraction (D10: IC50 = 78.1 ±â€¯7.3 µg/mL and W2: IC50 = 78 ±â€¯15 µg/mL) as well as the methanolic raw extract (D10: IC50 = 64.2 ±â€¯2.7 µg/mL and W2: IC50 = 65.8 ±â€¯14.9 µg/mL). Thus, the focus of the phytochemical investigation was laid on the chloroform fraction, which led to the identification of four ursane-type (19α-hydroxyasiatic acid (1), 6ß,23-dihydroxytormentic acid (4), madecassic acid (8), nigaichigoside F1 (10)) and four oleanane-type (arjungenin (2), combregenin (5), terminolic acid (7), arjunglucoside I (11)) triterpenes, as well as abscisic acid (9). Compounds 1 and 2, 4 and 5, 7 and 8 as well as 10 and 11 were isolated as isomeric mixtures in fractions CR-A, CR-C, CR-E and CR-H, respectively. All isolated compounds and mixtures exhibited moderate to low activity, with madecassic acid being most active (D10: IC50 = 28 ±â€¯12 µg/mL and W2: IC50 = 17.2 ±â€¯4.3 µg/mL). CONCLUSION: This paper reports for the first time antiplasmodial principles from C. racemosum and thereby gives reason to the traditional use of the plant.


Asunto(s)
Antimaláricos/farmacología , Combretum/química , Extractos Vegetales/farmacología , Plasmodium falciparum/efectos de los fármacos , Triterpenos/farmacología , África Occidental , Animales , Antimaláricos/aislamiento & purificación , Antimaláricos/uso terapéutico , Etnofarmacología , Humanos , Malaria/tratamiento farmacológico , Malaria/parasitología , Medicina Tradicional Africana/métodos , Metanol/química , Pruebas de Sensibilidad Parasitaria , Extractos Vegetales/aislamiento & purificación , Extractos Vegetales/uso terapéutico , Triterpenos/aislamiento & purificación , Triterpenos/uso terapéutico
15.
Parasitol Int ; 74: 101994, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31634628

RESUMEN

IL-27, a regulatory cytokine, plays critical roles in the prevention of immunopathology during Plasmodium infection. We examined these roles in the immune responses against Plasmodium chabaudi infection using the Il-27ra-/- mice. While IL-27 was expressed at high levels during the early phase of the infection, enhanced CD4+ T cell function and reduction in parasitemia were observed mainly during the chronic phase in the mutant mice. In mice infected with P. chabaudi and cured with drug, CD4+ T cells in the Il-27ra-/- mice exhibited enhanced CD4+ T-cell responses, indicating the inhibitory role of IL-27 on the protective immune responses. To determine the role of IL-27 in detail, we performed CD4+ T-cell transfer experiments. The Il-27ra-/- and Il27p28-/- mice were first infected with P. chabaudi and then cured using drug treatment. Plasmodium-antigen primed CD4+ T cells were prepared from these mice and transferred into the recipient mice, followed by infection with the heterologous parasite P. berghei ANKA. Il-27ra-/- CD4+ T cells in the infected recipient mice did not produce IL-10, indicating that IL-10 production by primed CD4+ T cells is IL-27 dependent. Il27p28-/- CD4+ T cells that were primed in the absence of IL-27 exhibited enhanced recall responses during the challenge infection with P. berghei ANKA, implying that IL-27 receptor signaling during the primary infection affects recall responses in the long-term via the regulation of the memory CD4+ T cell generation. These features highlighted direct and time-transcending roles of IL-27 in the regulation of immune responses against chronic infection with Plasmodium parasites.


Asunto(s)
Linfocitos T CD4-Positivos/inmunología , Regulación de la Expresión Génica/inmunología , Memoria Inmunológica , Interleucina-10/inmunología , Interleucina-27/genética , Malaria/inmunología , Animales , Enfermedad Crónica , Interleucina-27/inmunología , Malaria/tratamiento farmacológico , Ratones Endogámicos BALB C , Ratones Endogámicos C57BL , Ratones Noqueados , Plasmodium chabaudi
16.
J Matern Fetal Neonatal Med ; 33(1): 92-95, 2020 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29886762

RESUMEN

Background: Malaria in pregnancy carries a proven huge health burden; however, the economic challenges have not been properly evaluated in Nigeria.Methodology: The study was a descriptive cross-sectional hospital-based approach. A structured questionnaire was used to collect microeconomic data from pregnant women, on the medical and nonmedical cost of malaria to them.Results: A total of 371 questionnaires were analyzed (93%; 371/400), of 400 respondents interviewed. The average direct medical cost was N3581.78 naira (N) (US$11.86) with SD of N177.9 and mean direct nonmedical cost of N5741.5 (US$18.97). Of the patients, 86.8% received artemisinin-based combination therapy (ACTs) for the treatment of malaria. Nigeria has an estimated population of women of child-bearing age of 40 million and, the fertility rate of 124 per 1000. On the basis of estimation of 56.5% of pregnant women receiving at least one intermittent preventive therapy (IPT), will approximate to 22.8 billion naira (US$75.5 million) national annual expenditure for malaria in pregnancy. This approximates to 0.016% of the Nigerian gross domestic product of 481 billion USD of 2015. The major mechanism that was used to pay for treatment was out-of-pocket (OOP).Conclusions: Malaria carries high-economic burden both on individual and national levels, especially in Nigeria where OOPs is the major payment mechanism. Scaling up malaria control measures will not only improve the lives of pregnant women but will also improve the economy of the nation.


Asunto(s)
Antimaláricos/economía , Malaria/tratamiento farmacológico , Malaria/economía , Complicaciones Parasitarias del Embarazo/tratamiento farmacológico , Complicaciones Parasitarias del Embarazo/economía , Adulto , Antimaláricos/uso terapéutico , Artemisininas/administración & dosificación , Artemisininas/economía , Costo de Enfermedad , Estudios Transversales , Quimioterapia Combinada/economía , Quimioterapia Combinada/estadística & datos numéricos , Femenino , Costos de la Atención en Salud , Humanos , Recién Nacido , Malaria/epidemiología , Nigeria/epidemiología , Embarazo , Complicaciones Parasitarias del Embarazo/epidemiología , Encuestas y Cuestionarios , Adulto Joven
17.
Eur J Med Chem ; 185: 111791, 2020 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-31669852

RESUMEN

Hybrid molecules have the potential to enhance the efficacy against both drug-sensitive and drug-resistant organisms, and Ferroquine, a ferrocene hybrid, has demonstrated great potency in clinical trials against both drug-sensitive and drug-resistant malaria. Accordingly, hybridization of ferrocene with other antimalarial pharmacophores represents a promising strategy to develop novel antimalarial candidates. This work attempts to systematically review the recent study of ferrocene hybrids in the design and development of antimalarial agents, and the structure-activity relationship (SAR) is also discussed to provide an insight for rational design of more effective antibacterial candidates.


Asunto(s)
Antimaláricos/farmacología , Compuestos Ferrosos/farmacología , Malaria/tratamiento farmacológico , Metalocenos/farmacología , Plasmodium falciparum/efectos de los fármacos , Antimaláricos/química , Artemisininas/química , Artemisininas/farmacología , Compuestos Ferrosos/química , Humanos , Metalocenos/química , Estructura Molecular , Pruebas de Sensibilidad Parasitaria , Peróxidos/química , Peróxidos/farmacología , Quinolinas/química , Quinolinas/farmacología
18.
Phytochemistry ; 170: 112225, 2020 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-31855780

RESUMEN

Sixteen previously undescribed lanostane-type triterpenoids (1-16), together with fourteen known compounds, were isolated from cultivated fruiting bodies of the basidiomycete Ganoderma casuarinicola, a recently described species. The structures were elucidated on the basis of NMR spectroscopic and mass spectrometry data. Two of these compounds, 9 and 10, showed antimalarial activity with IC50 values of 9.7 and 9.2 µg/ml, respectively.


Asunto(s)
Antimaláricos/farmacología , Antituberculosos/farmacología , Ganoderma/química , Lanosterol/farmacología , Malaria/tratamiento farmacológico , Fitoquímicos/farmacología , Triterpenos/farmacología , Animales , Antimaláricos/química , Antimaláricos/metabolismo , Antituberculosos/química , Antituberculosos/metabolismo , Supervivencia Celular/efectos de los fármacos , Chlorocebus aethiops , Relación Dosis-Respuesta a Droga , Cuerpos Fructíferos de los Hongos/química , Cuerpos Fructíferos de los Hongos/metabolismo , Ganoderma/metabolismo , Lanosterol/análogos & derivados , Lanosterol/química , Lanosterol/metabolismo , Pruebas de Sensibilidad Microbiana , Conformación Molecular , Mycobacterium tuberculosis/efectos de los fármacos , Fitoquímicos/química , Fitoquímicos/metabolismo , Triterpenos/química , Triterpenos/metabolismo , Células Vero , Madera/química , Madera/metabolismo
19.
BMC Complement Altern Med ; 19(1): 353, 2019 Dec 05.
Artículo en Inglés | MEDLINE | ID: mdl-31806007

RESUMEN

BACKGROUND: Plants have been used as a primary source of medicine since ancient times and about 80% of the world's population use herbal medicine to treat different ailments. Plant use knowledge differs in space and time and thus requires documentation to avoid its loss from one generation to another. METHODS: In order to accomplish the survey, semi-structured questionnaires were used. The data collected included names of plant species, parts used, ailments treated, growth habit, methods of preparation and mode of administration of the herbal remedies. Descriptive statistics were used to present the data in form of tables and a graph. RESULTS: Results showed that 50 plant species belonging to 26 families were utilized in the treatment of paediatric diseases of which Asteraceae and Lamiaceae were the most common. Leaves (80%) were the most commonly used and decoctions were the main method of preparation. Twenty nine health conditions were treated out of which digestive disorders, malaria and respiratory tract infections were predominant. Herbs and shrubs were equally dominant. CONCLUSION: Herbal remedies are an important source of treatment for paediatric diseases in Buhunga Parish. However, there is need for collaboration between herbal medicine users and scientific institutions to help in the discovery of new drugs based on indigenous knowledge. Scientists ought to explore suitable methods of preparation and dosage formulations in order to achieve the best benefits from herbal remedies.


Asunto(s)
Etnofarmacología , Medicina Tradicional Africana , Preparaciones de Plantas/uso terapéutico , Plantas Medicinales , Niño , Enfermedades del Sistema Digestivo/tratamiento farmacológico , Femenino , Humanos , Malaria/tratamiento farmacológico , Masculino , Infecciones del Sistema Respiratorio/tratamiento farmacológico , Uganda/etnología
20.
PLoS Med ; 16(12): e1002992, 2019 12.
Artículo en Inglés | MEDLINE | ID: mdl-31834890

RESUMEN

BACKGROUND: To reduce the risk of drug-induced haemolysis, all patients should be tested for glucose-6-phosphate dehydrogenase (G6PD) deficiency (G6PDd) prior to prescribing primaquine (PQ)-based radical cure for the treatment of vivax malaria. This systematic review and individual patient meta-analysis assessed the utility of a qualitative lateral flow assay from Access Bio/CareStart (Somerset, NJ) (CareStart Screening test for G6PD deficiency) for the diagnosis of G6PDd compared to the gold standard spectrophotometry (International Prospective Register of Systematic Reviews [PROSPERO]: CRD42019110994). METHODS AND FINDINGS: Articles published on PubMed between 1 January 2011 and 27 September 2019 were screened. Articles reporting performance of the standard CSG from venous or capillary blood samples collected prospectively and considering spectrophotometry as gold standard (using kits from Trinity Biotech PLC, Wicklow, Ireland) were included. Authors of articles fulfilling the inclusion criteria were contacted to contribute anonymized individual data. Minimal data requested were sex of the participant, CSG result, spectrophotometry result in U/gHb, and haemoglobin (Hb) reading. The adjusted male median (AMM) was calculated per site and defined as 100% G6PD activity. G6PDd was defined as an enzyme activity of less than 30%. Pooled estimates for sensitivity and specificity, unconditional negative predictive value (NPV), positive likelihood ratio (LR+), and negative likelihood ratio (LR-) were calculated comparing CSG results to spectrophotometry using a random-effects bivariate model. Of 11 eligible published articles, individual data were available from 8 studies, 6 from Southeast Asia, 1 from Africa, and 1 from the Americas. A total of 5,815 individual participant data (IPD) were available, of which 5,777 results (99.3%) were considered for analysis, including data from 3,095 (53.6%) females. Overall, the CSG had a pooled sensitivity of 0.96 (95% CI 0.90-0.99) and a specificity of 0.95 (95% CI 0.92-0.96). When the prevalence of G6PDd was varied from 5% to 30%, the unconditional NPV was 0.99 (95% CI 0.94-1.00), with an LR+ and an LR- of 18.23 (95% CI 13.04-25.48) and 0.05 (95% CI 0.02-0.12), respectively. Performance was significantly better in males compared to females (p = 0.027) but did not differ significantly between samples collected from capillary or venous blood (p = 0.547). Limitations of the study include the lack of wide geographical representation of the included data and that the CSG results were generated under research conditions, and therefore may not reflect performance in routine settings. CONCLUSIONS: The CSG performed well at the 30% threshold. Its high NPV suggests that the test is suitable to guide PQ treatment, and the high LR+ and low LR- render the test suitable to confirm and exclude G6PDd. Further operational studies are needed to confirm the utility of the test in remote endemic settings.


Asunto(s)
Pruebas Diagnósticas de Rutina , Deficiencia de Glucosafosfato Deshidrogenasa/diagnóstico , Glucosafosfato Deshidrogenasa/genética , Primaquina/uso terapéutico , Pruebas Diagnósticas de Rutina/métodos , Enfermedades Endémicas , Femenino , Deficiencia de Glucosafosfato Deshidrogenasa/tratamiento farmacológico , Humanos , Malaria/tratamiento farmacológico , Malaria/epidemiología , Malaria Vivax/epidemiología , Masculino , Sistemas de Atención de Punto , Primaquina/efectos adversos , Sensibilidad y Especificidad
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA