Malaria

2017 ◽  
Author(s):  
Kiran Thakur
Keyword(s):  
Malaria Infection ◽  
Vaccine Development ◽  
Sub Saharan Africa ◽  
Neurological Manifestations ◽  
Significant Morbidity ◽  
Related Factors ◽  
Major Life ◽  
Life Threatening ◽  
Sub Saharan ◽  
Global Eradication

Malaria persists despite efforts for global eradication and vaccine development, and continues to prove lethal in endemic regions. The neurological manifestations of malaria are often devastating, with a high mortality rate and significant morbidity in survivors. A major life threatening complication of malaria infection is cerebral malaria (CM), most commonly occurring in children in sub-Saharan Africa and adults in Southeast Asia. There should be a high suspicion for CM in patients who present in coma residing in or having recently traveled to malaria endemic regions. Other neurological manifestations posing significant morbidity include postmalaria neurological syndrome and side effects due to antimalarial medications. Discussions in this chapter are focused around the neurobiology of malaria infection, and the host- and pathogen-related factors that contribute to neurological manifestations of the mosquito-borne illness.

scholarly journals A GMMA-CPS-Based Vaccine for Non-Typhoidal Salmonella

Vaccines ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 165
Author(s):  
Akosiererem S. Sokaribo ◽  
Sumudu R. Perera ◽  
Zoe Sereggela ◽  
Ryan Krochak ◽  
Lindsay R. Balezantis ◽  
...  
Keyword(s):  
Vaccine Development ◽  
Random Mutagenesis ◽  
Bloodstream Infections ◽  
Sub Saharan Africa ◽  
Colanic Acid ◽  
High Fatality Rate ◽  
Current Vaccine ◽  
Membrane Antigens ◽  
Human Use ◽  
Sub Saharan

Non-typhoidal Salmonella are a major cause of gastroenteritis worldwide, as well as causing bloodstream infections in sub-Saharan Africa with a high fatality rate. No vaccine is currently available for human use. Current vaccine development strategies are focused on capsular polysaccharides (CPS) present on the surface of non-typhoidal Salmonella. This study aimed to boost the amount of CPS purified from S. Typhimurium for immunization trials. Random mutagenesis with Tn10 transposon increased the production of CPS colanic acid, by 10-fold compared to wildtype. Immunization with colanic acid or colanic acid conjugated to truncated glycoprotein D or inactivated diphtheria toxin did not induce a protective immune response in mice. However, immunization with Generalized Modules for Membrane Antigens (GMMAs) isolated from colanic acid overproducing isolates reduced Salmonella colonization in mice. Our results support the development of a GMMA-CPS-based vaccine against non-typhoidal Salmonella.

scholarly journals Attitudes towards early marriage and related factors among adolescent girls in Ethiopia

2019 ◽  
Author(s):  
Hanna Gulema ◽  
Ayah Hamdan ◽  
Jessica Gingles ◽  
Lauren E. Friedman ◽  
Bizu Gelaye ◽  
...  
Keyword(s):  
Adolescent Girls ◽  
Cross Sectional Study ◽  
Sub Saharan Africa ◽  
Early Marriage ◽  
Final Decision ◽  
Related Factors ◽  
Cross Sectional ◽  
Decision Making Processes ◽  
Sub Saharan ◽  
Structured Questionnaire

Abstract Background Early marriage, although it remains a common practice in sub-Saharan Africa, has detrimental effects on women’s sexual and reproductive health, social networks, and educational attainment. We sought to investigate the association between attitudes towards early marriage and marital status among adolescent girls in Ethiopia. Methods A cross-sectional study was conducted among 3,013 adolescent girls aged 13-17 years of age, living in four districts of the Oromia region of Ethiopia. Sociodemographic characteristics and were participants’ attitudes towards early marriage were measured using a pre-tested structured questionnaire. Results The prevalence of early marriage among adolescent girls was 8.3% and approximately 87.0% of girls had an overall positive attitude towards early marriage. Compared to adolescent girls who were unmarried, those who were married or living with a partner were less likely to believe they should have a say whether they want to marry or not (OR=0.32; 95%CI: 0.18-0.57), believe they should get to decide when to marry (OR=0.52; 0.31-0.88), and believe they should have the final decision over the decision to marry (OR=0.48; 0.32-0.73). Conclusions Interventions to prevent early marriage should strengthen women decision-making processes and promote women’s agency.

scholarly journals Rates and predictors of adherence and retention for antiretroviral therapy among HIV-positive adults in Enugu, Nigeria

2019 ◽  
Vol 31 (3) ◽  
pp. 202-211
Author(s):  
Onyinye Hope Chime
Keyword(s):  
Sub Saharan Africa ◽  
People Living With Hiv ◽  
Related Factors ◽  
Art Programs ◽  
Adherence To Medication ◽  
Behavioural Modification ◽  
Resource Limited ◽  
Sub Saharan ◽  
Living With Hiv ◽  
Predictors Of Adherence

BackgroundHIV infection and AIDS are majorpublic health challenges in Nigeria, a country with one of the highest rates of new infection in sub-Saharan Africa and the second largest HIV epidemic in the world.Non-adherence to medication and defaulting from treatment are the two major challenges faced by anti-retroviral therapy (ART) programs in resource-constrained settings. This study was undertaken to determine the rate and predictors of adherence to medication and retention among people living with HIVin Enugu State, Nigeria.MethodsThis was a cross-sectionalretrospective study conducted among adults living with HIV(PLHIV) receiving ARTs in eightcomprehensive health facilities in Enugu, Nigeria. We used self-reported adherence and recorded clinic visits to assess adherence and retention, respectively. Descriptive statistics (frequencies, proportions, mean and standard deviation) and regression analysis were then conducted to identify the association between adherence, retention and demographic and health-related factors. ResultsThe mean age of respondents was 38.5±9.8 years. Predictors of good adherence to medication includedbeing male(adjusted odds ratio [AOR]:2.08; 95% confidence interval [CI]:1.12–3.85), having been on anti-retroviral medications for more than 5 years (AOR:1.92; 95% CI: 1.17–3.16), the non-consumption of alcohol(AOR: 3.67; 95% CI: 2.01–6.70),not usingtraditional medicine (AOR: 2.76; 95% CI:1.33–5.73) and having a baseline CD4count exceeding 500 cells/μl (AOR: 5.67; 95% CI: 1.32–24.32).Adequate retention was predicted by being resident in the urban area (AOR: 1.90; 95% CI: 1.17–3.06). Being away from home (41.8%) and forgetfulness (35.0%) were reported as the major reasons for missing medication.ConclusionThe rates of adherence and retention found in this study were similar to those reported forother resource-limited settings. Health education and behavioural modification interventions should be intensified to reduce the consumption of alcohol and the use of traditional medicine by people living with HIV. Identifying other factors may help to design effective strategies to ensure that people living with HIV adhere to their medications and remain in care.

scholarly journals Management of chronic respiratory complications in children and adolescents with sickle cell disease

2020 ◽  
Vol 29 (157) ◽  
pp. 200054
Author(s):  
Michele Arigliani ◽  
Atul Gupta
Keyword(s):  
Sickle Cell Disease ◽  
Sickle Cell ◽  
Current Knowledge ◽  
Sub Saharan Africa ◽  
Cell Disease ◽  
Respiratory Complications ◽  
Progressive Decline ◽  
Blood Disorder ◽  
Life Threatening ◽  
Sub Saharan

Sickle cell disease (SCD) is a life-threatening hereditary blood disorder that affects millions of people worldwide, especially in sub-Saharan Africa. This condition has a multi-organ involvement and highly vascularised organs, such as the lungs, are particularly affected. Chronic respiratory complications of SCD involve pulmonary vascular, parenchymal and airways alterations. A progressive decline of lung function often begins in childhood. Asthma, sleep-disordered breathing and chronic hypoxaemia are common and associated with increased morbidity. Pulmonary hypertension is a serious complication, more common in adults than in children. Although there is a growing attention towards respiratory care of patients with SCD, evidence regarding the prognostic meaning and optimal management of pulmonary issues in children with this condition is limited.This narrative review presents state-of-the-art evidence regarding the epidemiology, pathophysiology and therapeutic options for chronic respiratory complications commonly seen in paediatric patients with SCD. Furthermore, it highlights the gaps in the current knowledge and indicates future directions for studies that aim to improve our understanding of chronic respiratory complications in children with SCD.

scholarly journals Reduced Parasite Burden in Children with Falciparum Malaria and Bacteremia Coinfections: Role of Mediators of Inflammation

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Gregory C. Davenport ◽  
James B. Hittner ◽  
Vincent Otieno ◽  
Zachary Karim ◽  
Harshini Mukundan ◽  
...  
Keyword(s):  
Geometric Mean ◽  
Parasite Burden ◽  
Sub Saharan Africa ◽  
Mediation Model ◽  
Multiple Mediation ◽  
Mediators Of Inflammation ◽  
Threatening Condition ◽  
Life Threatening ◽  
Sub Saharan

Bacteremia and malaria coinfection is a common and life-threatening condition in children residing in sub-Saharan Africa. We previously showed that coinfection with Gram negative (G[−]) enteric Bacilli andPlasmodium falciparum(Pf[+]) was associated with reduced high-density parasitemia (HDP, >10,000 parasites/μL), enhanced respiratory distress, and severe anemia. Since inflammatory mediators are largely unexplored in such coinfections, circulating cytokines were determined in four groups of children (n=206, aged <3 yrs): healthy;Pf[+] alone; G[−] coinfected; and G[+] coinfected.Staphylococcus aureusand non-TyphiSalmonellawere the most frequently isolated G[+] and G[−] organisms, respectively. Coinfected children, particularly those with G[−] pathogens, had lower parasite burden (peripheral and geometric mean parasitemia and HDP). In addition, both coinfected groups had increased IL-4, IL-5, IL-7, IL-12, IL-15, IL-17, IFN-γ, and IFN-αand decreased TNF-αrelative to malaria alone. Children with G[−] coinfection had higher IL-1βand IL-1Ra and lower IL-10 than thePf[+] group and higher IFN-γthan the G[+] group. To determine how the immune response to malaria regulates parasitemia, cytokine production was investigated with a multiple mediation model. Cytokines with the greatest mediational impact on parasitemia were IL-4, IL-10, IL-12, and IFN-γ. Results here suggest that enhanced immune activation, especially in G[−] coinfected children, acts to reduce malaria parasite burden.

scholarly journals How Eliminating Malaria May Also Prevent Iron Deficiency in African Children

2018 ◽  
Vol 11 (4) ◽  
pp. 96 ◽  
Author(s):  
John Muriuki ◽  
Sarah Atkinson
Keyword(s):  
Iron Deficiency ◽  
Malaria Infection ◽  
Iron Status ◽  
Causal Link ◽  
Sub Saharan Africa ◽  
African Children ◽  
Sub Saharan ◽  
Factor Α ◽  
Epidemiology Studies ◽  
Necrosis Factor

Malaria and iron deficiency are common among children living in sub-Saharan Africa. Several studies have linked a child’s iron status to their future risk of malaria infection; however, few have examined whether malaria might be a cause of iron deficiency. Approximately a quarter of African children at any one time are infected by malaria and malaria increases hepcidin and tumor necrosis factor-α concentrations leading to poor iron absorption and recycling. In support of a hypothetical link between malaria and iron deficiency, studies indicate that the prevalence of iron deficiency in children increases over a malaria season and decreases when malaria transmission is interrupted. The link between malaria and iron deficiency can be tested through the use of observational studies, randomized controlled trials and genetic epidemiology studies, each of which has its own strengths and limitations. Confirming the existence of a causal link between malaria infection and iron deficiency would readjust priorities for programs to prevent and treat iron deficiency and would demonstrate a further benefit of malaria control.

scholarly journals Malaria in Tunisian Military Personnel after Returning from External Operation

2013 ◽  
Vol 2013 ◽  
pp. 1-3
Author(s):  
Faïda Ajili ◽  
Riadh Battikh ◽  
Janet Laabidi ◽  
Rim Abid ◽  
Najeh Bousetta ◽  
...  
Keyword(s):  
Military Personnel ◽  
Malaria Infection ◽  
Imported Malaria ◽  
Sub Saharan Africa ◽  
Military Hospital ◽  
Imported Cases ◽  
Male Patients ◽  
Sub Saharan ◽  
The Military

Introduction. Malaria had been eliminated in Tunisia since 1979, but there are currently 40 to 50 imported cases annually. Soldiers are no exception as the incidence of imported malaria is increasing in Tunisian military personnel after returning from malaria-endemic area, often in Sub-Saharan Africa. Methods. We retrospectively analyzed the clinical and biological presentations, treatment, and outcomes of 37 Tunisian military personnel hospitalized at the Department of Internal Medicine, the Military Hospital of Tunis, between January 1993 and January 2011, for imported malaria. The clinical and laboratory features were obtained from the medical records and a questionnaire was filled by the patients about the compliance of malaria prophylaxis. Results. Thirty-seven male patients, with a mean age of 41 years, were treated for malaria infection. Twenty-two were due to Plasmodium falciparum. The outcome was favourable for all patients, despite two severe access. The long-term use of chemoprophylaxis has been adopted by only 21 (51%) of expatriate military for daily stresses. Moreover, poor adherence was found in 32 patients. Conclusion. The risk of acquiring malaria infection in Tunisian military personnel can largely be prevented by the regular use of chemoprophylactic drugs combined with protective measures against mosquito bites.

scholarly journals A Concept Mapping Study of Physicians’ Perceptions of Factors Influencing Management and Control of Hypertension in Sub-Saharan Africa

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Juliet Iwelunmor ◽  
Sarah Blackstone ◽  
Joyce Gyamfi ◽  
Collins Airhihenbuwa ◽  
Jacob Plange-Rhule ◽  
...  
Keyword(s):  
Concept Mapping ◽  
Research Training ◽  
Sub Saharan Africa ◽  
Future Research ◽  
Hypertension Management ◽  
Optimal Management ◽  
Related Factors ◽  
Factors Influencing ◽  
Sub Saharan ◽  
And Control

Hypertension, once a rare problem in Sub-Saharan Africa (SSA), is predicted to be a major cause of death by 2020 with mortality rates as high as 75%. However, comprehensive knowledge of provider-level factors that influence optimal management is limited. The objective of the current study was to discover physicians’ perceptions of factors influencing optimal management and control of hypertension in SSA. Twelve physicians attending the Cardiovascular Research Training (CaRT) Institute at the University of Ghana, College of Health Sciences, were invited to complete a concept mapping process that included brainstorming the factors influencing optimal management and control of hypertension in patients, sorting and organizing the factors into similar domains, and rating the importance and feasibility of efforts to address these factors. The highest ranked important and feasible factors include helping patients accept their condition and availability of adequate equipment to enable the provision of needed care. The findings suggest that patient self-efficacy and support, physician-related factors, policy factors, and economic factors are important aspects that must be addressed to achieve optimal hypertension management. Given the work demands identified by physicians, future research should investigate cost-effective strategies of shifting physician responsibilities to well-trained no-physician clinicians in order to improve hypertension management.

scholarly journals Getting closer to a vaccine against malaria

2011 ◽  
Vol 32 (3) ◽  
pp. 127
Author(s):  
Robin F Anders
Keyword(s):  
Malaria Vaccine ◽  
Protective Efficacy ◽  
Sub Saharan Africa ◽  
Bed Nets ◽  
Effective Vaccine ◽  
Early Case ◽  
Sub Saharan ◽  
Global Eradication ◽  
Effective Use ◽  
Early Case Detection

Despite recent progress in the control of malaria in several countries, this disease still kills nearly one million young children in sub-Saharan Africa each year and it contributes significantly to poverty in many of the poorest countries in the world. The effective use of existing control tools (insecticide-impregnated bed nets, residual insecticide spraying and early case detection with effective treatment) should eliminate malaria from additional regions but global eradication of malaria is not feasible without the development of a highly effective vaccine. The most advanced malaria vaccine, known as RTS,S, is likely to be licensed for use in the next few years. The protective efficacy of RTS,S is unlikely to exceed 50% but numerous other approaches to vaccinating against malaria are showing some promise and, consequently, there are good prospects that a second-generation malaria vaccine will be much more effective.

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