scholarly journals Novel pfdhps Haplotypes among Imported Cases of Plasmodium falciparum Malaria in the United Kingdom

2009 ◽  
Vol 53 (8) ◽  
pp. 3405-3410 ◽  
Author(s):  
Colin J. Sutherland ◽  
Helen Fifer ◽  
Richard J. Pearce ◽  
Faisal bin Reza ◽  
Meredydd Nicholas ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
United Kingdom ◽  
Plasmodium Falciparum Malaria ◽  
Index Patient ◽  
Malaria Episode ◽  
Reference Laboratory ◽  
African Origin ◽  
East African ◽  
Direct Dna Sequencing ◽  
The United Kingdom

ABSTRACT Treatment of acute malaria caused by Plasmodium falciparum may include long-half-life drugs, such as the antifolate combination sulfadoxine-pyrimethamine (SP), to provide posttreatment chemoprophylaxis against parasite recrudescence or delayed emergence from the liver. An unusual case of P. falciparum recrudescence in a returned British traveler who received such a regimen, as well as a series of 44 parasite isolates from the same hospital, was analyzed by PCR and direct DNA sequencing for the presence of markers of parasite resistance to chloroquine and antifolates. The index patient harbored a mixture of wild-type and resistant pfdhfr and pfdhps alleles upon initial presentation. During his second malaria episode, he harbored only resistant parasites, with the haplotypes IRNI (codons 51, 59, 108, and 164) and SGEAA (codons 436, 437, 540, 581, and 613) at these two loci, respectively. Analysis of isolates from 44 other patients showed that the pfdhfr haplotype IRNI was common (found in 81% of cases). The SGEAA haplotype of pfdhps was uncommon (found only in eight cases of East African origin [17%]). A previously undescribed mutation, I431V, was observed for seven cases of Nigerian origin, occurring as one of two haplotypes, VAGKGS or VAGKAA. The presence of this mutation was also confirmed in isolates of Nigerian origin from the United Kingdom Malaria Reference Laboratory. The presence of the pfdhps haplotype SGEAA in P. falciparum parasites of East African origin appears to compromise the efficacy of treatment regimens that include SP as a means to prevent recrudescence. Parasites with novel pfdhps haplotypes are circulating in West Africa. The response of these parasites to chemotherapy needs to be evaluated.

scholarly journals pfk13-Independent Treatment Failure in Four Imported Cases of Plasmodium falciparum Malaria Treated with Artemether-Lumefantrine in the United Kingdom

2017 ◽  
Vol 61 (3) ◽  
Author(s):  
Colin J. Sutherland ◽  
Paul Lansdell ◽  
Mandy Sanders ◽  
Julian Muwanguzi ◽  
Donelly A. van Schalkwyk ◽  
...  
Keyword(s):  
Plasmodium Falciparum ◽  
Treatment Failure ◽  
Falciparum Malaria ◽  
Artemisinin Resistance ◽  
Plasmodium Falciparum Malaria ◽  
African Origin ◽  
Case Histories ◽  
Content Type ◽  
The United Kingdom ◽  
Imported Cases

ABSTRACT We present case histories of four patients treated with artemether-lumefantrine for falciparum malaria in UK hospitals in 2015 to 2016. Each subsequently presented with recurrent symptoms and Plasmodium falciparum parasitemia within 6 weeks of treatment with no intervening travel to countries where malaria is endemic. Parasite isolates, all of African origin, harbored variants at some candidate resistance loci. No evidence of pfk13-mediated artemisinin resistance was found. Vigilance for signs of unsatisfactory antimalarial efficacy among imported cases of malaria is recommended.

scholarly journals A review of ethnicity, health and nutrition-related diseases in relation to migration in the United Kingdom

2001 ◽  
Vol 4 (2b) ◽  
pp. 647-657 ◽  
Author(s):  
J Landman ◽  
JK Cruickshank
Keyword(s):  
Physical Activity ◽  
United Kingdom ◽  
General Population ◽  
South Asian ◽  
Small Scale ◽  
East African ◽  
Dietary Practices ◽  
The United Kingdom ◽  
African Caribbean ◽  
And Migration

AbstractObjectives:To identify lessons from and gaps in research on diet-disease links among former migrants in the United Kingdom (UK).Results:Migrant status and self-identified ethnicity do not match so these terms mask differences in social, nutritional and health status within and between population groups. Some former migrants differ in causes of death from the general population, e.g.: fewer coronary heart disease deaths among Caribbean-born; fewer cancer deaths among Caribbean, South Asian- and East African-born adults. Irish- and Scottish-born have higher mortality from all causes. Experience of risk factors differ also, e.g.: higher prevalences of hypertension and diabetes in Caribbean- and South Asian-born adults than representative samples of the general population; obesity and raised waist-hip circumference ratios in South Asian, African-Caribbean and some Irish-born adults. Former migrants experience long-term disadvantage, associated with more self-defined illness and lower reported physical activity. Nutrient intake data from the few, recent, small-scale studies must be interpreted with caution due to methodological diversity. However, second generation offspring of former migrants appear to adopt British dietary patterns, increasing fat and reducing vegetable, fruit and pulse consumption compared with first generation migrants.Conclusions:There is insufficient evidence on why some former migrants but not others experience lower specific mortality than the general population. Dietary intake variations provide important clues particularly when examined by age and migration status. Majority ethnic and younger migrant groups could raise and sustain high fruit and vegetable intakes but lower proportions of fat, by adopting many dietary practices from older migrants. Objective measures of physical activity and longitudinal studies of diets among different ethnic groups are needed to explain diversity in health outcomes and provide for evidence-based action.

An Investigation, by Questionnaire, of Cases of Recalcitrant Vaginal Trichomoniasis Seen in Genitourinary Medicine Clinics in the United Kingdom

1992 ◽  
Vol 3 (1) ◽  
pp. 24-27 ◽  
Author(s):  
G R Kinghorn ◽  
Keyword(s):  
United Kingdom ◽  
Reference Laboratory ◽  
National Reference Laboratory ◽  
National Reference ◽  
The United Kingdom ◽  
Unsuccessful Treatment ◽  
Genitourinary Medicine ◽  
The Uk

A total of 24 cases of recalcitrant trichomoniasis were reported from 18 centres widely scattered throughout the UK. Most cases had received numerous courses of unsuccessful treatment. Nine (75%) of 12 tested isolates had a decreased susceptibility to metronidazole. Local laboratories were often unable to evaluate fully trichomonal isolates and it is recommended that consideration be given to the establishment of a national reference laboratory. Although there were no universal cures, successful alternatives to conventional treatments are detailed.

Malaria prophylaxis: an ever-changing problem

1982 ◽  
Vol 20 (26) ◽  
pp. 102-104
Keyword(s):  
Plasmodium Falciparum ◽  
United Kingdom ◽  
Far East ◽  
Antimalarial Drugs ◽  
Malaria Risk ◽  
Falciparum Infection ◽  
Malaria Prophylaxis ◽  
Plasmodium Falciparum Infection ◽  
The United Kingdom ◽  
Rapid Changes

The number of cases of malaria diagnosed in the United Kingdom continued to rise throughout the 1970s, reached an apparent plateau of about 2,000 cases a year in 1978 and 1979, and then declined slightly in 1980 and 1981, with 1576 cases in the latter year.1 The number of deaths due to Plasmodium falciparum infection has remained level at about six each year throughout the decade. Most of these infections and deaths could have been prevented by prophylaxis. Malaria risk is present in many parts of Africa, Central and Southern America, the Middle and Far East and Oceania; they are listed in a BMJ report.2 We have discussed this subject three times in recent years,3–5 but the rapid changes in susceptibility of plasmodia to antimalarial drugs require frequent revision of regimens for prophylaxis and treatment.

Marriage and Divorce Laws in East Africa

1959 ◽  
Vol 3 (2) ◽  
pp. 93-98 ◽  
Author(s):  
Arthur Phillips
Keyword(s):  
United Kingdom ◽  
East Africa ◽  
Customary Law ◽  
East African ◽  
Marriage And Divorce ◽  
The United Kingdom ◽  
Divorce Laws ◽  
Present Purpose

This paper is concerned mainly with the situation arising from the recognition of African customary law in the three largest of the East African territories administered under the authority of Her Majesty's Government in the United Kingdom—viz. Kenya, Uganda and Tanganyika. It will not be necessary, for the present purpose, to take any account of differences in constitutional status between the territories concerned.

Case 35

2020 ◽  
pp. 241-246
Author(s):  
Andrew Woodhouse
Keyword(s):  
Plasmodium Falciparum ◽  
Differential Diagnosis ◽  
United Kingdom ◽  
Correct Treatment ◽  
Imported Infection ◽  
The United Kingdom ◽  
Exposure History ◽  
Prompt Diagnosis

Malaria is among the most common imported infection brought into the United Kingdom . Recognition of malaria is crucial given the potential severe consequences including death, particularly from Plasmodium falciparum infection. Prompt diagnosis and correct treatment improves outcome and malaria must be considered in the differential diagnosis of fever in all travellers with an appropriate exposure history.

scholarly journals Distribution of Clostridium difficile PCR ribotype 027 in British hospitals

2007 ◽  
Vol 12 (17) ◽  
Author(s):  
J S Brazier ◽  
B Patel ◽  
A Pearson
Keyword(s):  
United Kingdom ◽  
Clostridium Difficile ◽  
Clostridium Difficile Infection ◽  
Virulent Strain ◽  
Reference Laboratory ◽  
Surveillance Programme ◽  
Ribotype 027 ◽  
The United Kingdom ◽  
South East England ◽  
Pcr Ribotype 027

An outbreak of Clostridium difficile infection in Stoke Mandeville hospital in south-east England [1] in 2004/2005 was primarily due to a new and possibly more virulent strain known in the United Kingdom (UK) as PCR ribotype 027. Coinciding with this outbreak, a surveillance programme of C. difficile isolates from symptomatic patients in England with additional results of outbreak investigation requests to the Anaerobe Reference Laboratory (ARL) in Cardiff has established the true extent of its spread throughout British hospitals.

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