Artenimol–piperaquine in children with uncomplicated imported falciparum malaria: experience from a prospective cohort

Abstract Background Although malaria remains one of the major public health threats in inter-tropical areas, there is limited understanding of imported malaria in children by paediatricians and emergency practitioners in non-endemic countries, often resulting in misdiagnosis and inadequate treatment. Moreover, classical treatments (atovaquone-proguanil, quinine, mefloquine) are limited either by lengthy treatment courses or by side effects. Since 2010, the World Health Organization (WHO) has recommended the use of oral artemisinin-based combination therapy for the treatment of uncomplicated Plasmodium falciparum malaria worldwide. The benefits of artenimol–piperaquine in children have been validated in endemic countries but experience remains limited in cases of imported malaria. Methods This prospective observational study in routine paediatric care took place at the Emergency Department, Robert-Debré Hospital (Paris, France) from September 2012 to December 2014. Tolerance and efficacy of artenimol–piperaquine in children presenting with the following inclusion criteria were assessed: P. falciparum positive on thin or thick blood smear; and the absence of WHO-defined features of severity. Results Among 83 children included in this study, treatment with artenimol–piperaquine was successful in 82 children (98.8%). None of the adverse events were severe and all were considered mild with no significant clinical impact. This also applied to cardiological adverse events despite a significant increase of the mean post-treatment QTc interval. Conclusion Artenimol–piperaquine displays a satisfying efficacy and tolerance profile as a first-line treatment for children with imported uncomplicated falciparum malaria and only necessitates three once-daily oral intakes of the medication. Comparative studies versus artemether-lumefantrine or atovaquone-proguanil would be useful to confirm the results of this study.

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Clinical Features and Mortality Associated with Severe Malaria in Adults in Southern Mauritania

Tropical Medicine and Infectious Disease ◽

10.3390/tropicalmed6010001 ◽

2020 ◽

Vol 6 (1) ◽

pp. 1

Author(s):

Boushab Mohamed Boushab ◽

Mohamed Salem Ould Ahmedou Salem ◽

Ali Ould Mohamed Salem Boukhary ◽

Philippe Parola ◽

Leonardo Basco

Keyword(s):

Renal Failure ◽

Respiratory Distress ◽

Severe Malaria ◽

Falciparum Malaria ◽

Clinical Features ◽

Signs And Symptoms ◽

Plasmodium Falciparum Malaria ◽

Severe Anaemia ◽

World Health ◽

Health Organization

Severe malaria in adults is not well-studied in Sahelian Africa. Clinical features and mortality associated with severe Plasmodium falciparum malaria in adult patients hospitalized in Kiffa, southern Mauritania, were analysed. Patients over 15 years old admitted for severe malaria between August 2016 and December 2019 were included in the present retrospective study. The World Health Organization (WHO) criteria were used to define severe malaria. The presenting clinical characteristics and outcome were compared. Of 4266 patients hospitalized during the study period, 573 (13.4%) had a positive rapid diagnostic test for malaria, and 99 (17.3%; mean age, 37.5 years; range 15–79 years; sex-ratio M/F, 2.1) satisfied the criteria for severe malaria. On admission, the following signs and symptoms were observed in more than one-fourth of the patients: fever (98%), impairment of consciousness (81.8%), multiple convulsions (70.7%), cardiovascular collapse (61.6%), respiratory distress (43.4%), severe anaemia ≤ 80 g/L (36.4%), haemoglobinuria (27.3%), and renal failure (25.3%). Patients were treated with parenteral quinine or artemether. Fourteen (14.1%) patients died. Multiple convulsions, respiratory distress, severe anaemia, haemoglobinuria, acute renal failure, jaundice, and abnormal bleeding occurred more frequently (p < 0.05) in deceased patients. Mortality due to severe falciparum malaria is high among adults in southern Mauritania. An adoption of the WHO-recommended first-line treatment for severe malaria, such as parenteral artesunate, is required to lower the mortality rate associated with severe malaria.

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Vaccination Coverage for Routine Vaccines and Herd Immunity Levels against Measles and Pertussis in the World in 2019

Vaccines ◽

10.3390/vaccines9030256 ◽

2021 ◽

Vol 9 (3) ◽

pp. 256

Author(s):

Pedro Plans-Rubió

Keyword(s):

Vaccination Coverage ◽

Action Plan ◽

Herd Immunity ◽

World Health ◽

Immunization Programs ◽

National Immunization ◽

The World ◽

Measles Vaccination ◽

The Mean ◽

Health Organization

In 2012, the World Health Organization (WHO) established the Global Vaccine Action Plan with the objective to promote essential vaccinations in all countries and achieve at least 90% vaccination coverage for all routine vaccines by 2020. The study assessed the mean percentages of vaccination coverage in 2019 for 13 routine vaccines, vaccination coverage variation from 2015 to 2019, and herd immunity levels against measles and pertussis in 2019 in countries and regions of WHO. In 2019, the mean percentages of vaccination coverage were lower than 90% for 10 (78.9%) routine vaccines. The mean percentages of vaccination coverage also decreased from 2015 to 2019 for six (46.2%) routine vaccines. The prevalence of individuals with vaccine-induced measles immunity in the target measles vaccination population was 88.1%, and the prevalence of individuals with vaccine-induced pertussis immunity in the target pertussis vaccination population was 81.1%. Herd immunity against measles viruses with Ro = 18 was established in 63 (32.5%) countries but not established in any region. Herd immunity against pertussis agents was not established in any country and in any region of WHO. National immunization programs must be improved to achieve ≥90% vaccination coverage in all countries and regions. Likewise, it is necessary to achieve ≥95% vaccination coverage with two doses of measles vaccines and three doses of pertussis vaccines in all countries and regions.

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The use of vitreous renal chemistries in the discrimination of postmortem fresh water drowning

Toxicology Research and Application ◽

10.1177/2397847321997523 ◽

2021 ◽

Vol 5 ◽

pp. 239784732199752

Author(s):

Eni-yimini Solomon Agoro ◽

Charles German Ikimi ◽

Tommy Edidiong

Keyword(s):

Fresh Water ◽

Biochemical Parameters ◽

World Health ◽

The World ◽

Diacetyl Monoxime ◽

Water Pond ◽

The Mean ◽

Health Organization ◽

Post Hoc ◽

Cover Up

Background: The World Health Organization (WHO) has estimated drowning as the leading cause of unintentional death in the world, with 372,000 deaths reported annually. Not all drowning are unintentional; some could be disguised to cover up an act of heinous criminality. This study was aimed at using some vitreous renal function biochemical parameters as a discriminant of postmortem fresh water drowning. Twelve albino rabbits constituted the sample size as validated by Mead’s formula. The study was divided into three groups; the control, postmortem-drowned and truly drowned as mimicked using an artificial fresh water pond. Vitreous humours were extracted using Coe method. The vitreous renal chemistries were analysed using diacetyl monoxime, Jaffe’s test, uricase and ion-selective electrode (ISE) methods respectively. Result: The mean of vitreous creatinine, urea, uric acid, Na+, K+, Cl−, Ca2+, glucose and CO2 of the control, postmortem-drowned and truly drowned groups were compared using One-way Anova (post-hoc-LSD) with the aid of SPSS Inc., Chicago, IL, USA; Version 18–21 package. The findings revealed a significant increase in concentrations of vitreous creatinine, glucose, Ca2+ and K+ of the drowned death group, whereas vitreous concentrations of CO2 and urea significantly decreased when compared to the controls and/or postmortem-drowned death. Conclusion: The study has shown that some of the studied vitreous biochemical parameters could be used as an ancillary tool in discriminating death due to fresh water drowning from that of disguised or postmortem-drowned death.

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Low-dose amikacin in the treatment of Multidrug-resistant Tuberculosis (MDR-TB)

BMC Infectious Diseases ◽

10.1186/s12879-021-05947-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Natasha F. Sabur ◽

Mantaj S. Brar ◽

Lisa Wu ◽

Sarah K. Brode

Keyword(s):

Hearing Loss ◽

Adverse Events ◽

Low Dose ◽

Multidrug Resistant ◽

Significant Rise ◽

World Health ◽

Therapeutic Drug ◽

Successful Treatment Outcome ◽

Mdr Tb ◽

Health Organization

Abstract Background The World Health Organization recommends intravenous amikacin for the treatment of MDR-TB at a dose of 15 mg/kg. However, higher doses are associated with significant toxicity. Methods Patients with MDR-TB treated at our institution receive amikacin at 8–10 mg/kg, with dose adjustment based on therapeutic drug monitoring. We conducted a retrospective cohort study of patients with MDR-TB who received amikacin between 2010 and 2016. Results Forty-nine patients were included in the study. The median starting dose of amikacin was 8.9 mg/kg (IQR 8, 10), and target therapeutic drug levels were achieved at a median of 12 days (IQR 5, 26). The median duration of amikacin treatment was 7.2 months (IQR 5.7, 8), and median time to sputum culture conversion was 1 month (IQR 1,2). Six patients (12.2%) experienced hearing loss based on formal audiometry testing (95% CI 4.6–24.8%); 22.2% had subjective hearing loss (95% CI 11.2–37.1%) and 31.9% subjective tinnitus (95% CI 19.1–47.1%). Ten patients (23%) had a significant rise in serum creatinine (95% CI 11.8–38.6%), but only 5 patients had a GFR < 60 at treatment completion. 84% of patients had a successful treatment outcome (95% CI 84–99%). Conclusions Low dose amikacin is associated with relatively low rates of aminoglycoside-related adverse events. We hypothesize that low-dose amikacin can be used as a safe and effective treatment for MDR-TB in situations where an adequate regimen cannot be constructed with Group A and B drugs, and where careful monitoring for adverse events is feasible.

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Dental caries in 6-12-year-old indigenous and non-indigenous schoolchildren in the Amazon basin of Ecuador

Brazilian Dental Journal ◽

10.1590/s0103-64402008000100015 ◽

2008 ◽

Vol 19 (1) ◽

pp. 83-86 ◽

Cited By ~ 14

Author(s):

Widman Medina ◽

Anna-Karin Hurtig ◽

Miguel San Sebastián ◽

Edy Quizhpe ◽

Cristian Romero

Keyword(s):

Amazon Basin ◽

Ethnic Origin ◽

World Health ◽

Caries Experience ◽

Cross Sectional ◽

Health Response ◽

Indigenous Children ◽

Prevention And Health Promotion ◽

The Mean ◽

Health Organization

The purpose of this study was to evaluate the caries experience among 6-12-year-old indigenous (Naporunas) and non-indigenous (recent settlers of mixed ethnic origin) schoolchildren, living in the Amazon basin of Ecuador. Cross-sectional data were obtained from 1,449 clinical exams according to the World Health Organization criteria. Nine (7.6%) indigenous and 3 (4.5%) non-indigenous children had no caries experience in their primary dentition at the age of 6. The mean dmft value (SD) among indigenous and non-indigenous children aged 6 was 6.40 (3.36) and 8.36 (3.93), respectively. Sixty-four (54.2%) indigenous and 29 (43.3%) non-indigenous children had no caries experience in their permanent first molars at the age of 6. Only 7 (6.26%) indigenous and 2 (2.60%) non-indigenous children were caries-free at the age of 12. The mean DMFT values (SD) for 12-year-olds were 4.47 (2.85) among indigenous and 5.25 (2.89) among non-indigenous children. Fillings were almost non existent. Caries rates were high among both groups, with untreated carious lesions predominating in all ages. The data of indigenous children suggest adoption of a non-traditional diet. An appropriate oral health response based primarily on prevention and health promotion is needed.

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PRESENCE AND LEVELS OF CONCENTRATION OF POLYCYCLIC AROMATIC HYDROCARBONS (PAHS) IN SMOKED FISH, HIDES AND SKIN OF SLAUGHTER CATTLE AND GOATS IN AWKA URBAN, NIGERIA

International Journal of Current Pharmaceutical Research ◽

10.22159/ijpps.2019v11i2.33014 ◽

2019 ◽

pp. 14-17

Author(s):

IKECHUKWU OFOMATA ◽

LYNDA ONYINYE OBODOECHI ◽

REGINALD IKECHUKWU OBIDIKE ◽

JOHN ANAELOM NWANTA

Keyword(s):

World Health ◽

Fish Tissues ◽

Anambra State ◽

Smoked Fish ◽

Permissible Level ◽

Flame Ionization ◽

Slaughter Cattle ◽

Polycyclic Aromatic ◽

The Mean ◽

Health Organization

Objective: This study evaluated the presence and concentration of PAHs in singed and unsinged hides and skin of slaughter cattle and goats and smoked and non-smoked fish in Awka urban area of Anambra State, Nigeria. Methods: Sixty samples of singed and unsinged hides and skin for were collected from Kwata slaughterhouse in Awka town where fish tissues were also collected from fish smoking spots in Awka urban. The samples were examined for the presence PAHs such as: benzo[a]pyrene; benzo[a]anthracene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene using gas chromatography equipped with flame ionization detector. Results: The result showed that the mean concentrations (µg/kg) of benzo[a]pyrene and indeno [1-2-3cd]pyrene in unsinged cattle hides were 7.89±7.77 and 2.25±0.97 respectively. The mean concentrations upon singeing were of 15.81±14.93 and 3.55±2.89. The mean concentrations (µg/kg) of benzo[a]pyrene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene in unsigned goat skins were 6.52±10.77; 6.58±5.93 and 3.48±0.00 respectively. When the goatskin was singed, the mean concentrations were 17.50±26.03; 10.84±11.19 and 8.79±11.77. The mean concentrations (µg/kg) of benzo[a]pyrene; benzo[k]flouranthene and indeno[1-2-3cd]pyrene in non-smoked fish were 8.65±9.67; 2.11±2.10 and 54.76±60.35 respectively. When the fish were smoked, the mean concentrations of 26.42±40.21; 6.64±11.11 and 599.36±1395.61 were recorded respectively. In all species of animals sampled, no trace of benzo[a]anthracene was detected. Conclusion: The mean concentrations of all carcinogenic PAHs detected in this work were below the maximum permissible level set by World Health Organization (WHO) and European Commission (30µg/kg) with the exception of indeno[1-2-3cd]pyrene in smoked and non-smoked fish, which was far above the permissible level.

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Assessment of quality of life in type 2 diabetes mellitus patients using World Health Organization quality of life-BREF questionnaire and appraisal of diabetes scale - a cross-sectional study

Italian Journal of Medicine ◽

10.4081/itjm.2021.1444 ◽

2021 ◽

Vol 15 (3) ◽

Author(s):

Supriya Patil ◽

Yamini Patil ◽

Sanjay Kumar Patil

Keyword(s):

Quality Of Life ◽

Cross Sectional Study ◽

World Health ◽

Diabetic Patients ◽

Sectional Study ◽

Cross Sectional ◽

The Mean ◽

Health Organization

Diabetes is a chronic metabolic disorder that disturbs the quality of life (QOL) of patients. Therefore, evaluation of diabetes- related QOL could be a key outcome measure for its management. This study assessed the QOL in type 2 diabetes mellitus (T2DM) patients using the World Health Organization (WHO) quality of life (QOL)˗BREF questionnaire and disease-specific appraisal of diabetes scale (ADS). In this cross-sectional study, 520 T2DM patients were included. Patients’ demographic data, clinical information was collected through interviews, and the WHOQOL-BREF instrument and ADS were used for the QOL of patients. Statistical analysis was performed by using R software (Version 3.6.0). The mean ADS scores were lower in controlled diabetic subjects (18.50±3.08) and higher in uncontrolled diabetic subjects (19.29±2.73) (P<0.05). For WHOQOL-BREF, the mean scores for all the domains (overall general health, physical, psychological, social, and environmental) were significantly higher in controlled diabetic subjects (P<0.001). In addition, the age, duration of diabetes, associated comorbidities, treatment, and HbA1c level of patients showed a highly significant correlation with WHOQOL-BREF (P<0.001). Diabetic patients had poor-to-average QOL. Therefore, public health measures and education of diabetic patients are essential to create more awareness for improving the QOL of T2DM.

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Spinal surgery complications: an unsolved problem—Is the World Health Organization Safety Surgical Checklist an useful tool to reduce them?

European Spine Journal ◽

10.1007/s00586-019-06203-x ◽

2019 ◽

Vol 29 (5) ◽

pp. 927-936

Author(s):

Giovanni Barbanti-Brodano ◽

Cristiana Griffoni ◽

Jarkko Halme ◽

Giuseppe Tedesco ◽

Silvia Terzi ◽

...

Keyword(s):

World Health Organization ◽

Spinal Surgery ◽

World Health ◽

The World ◽

Oncological Diseases ◽

Supplementary Material ◽

The Mean ◽

Health Organization ◽

Surgical Checklist

Abstract Purpose To investigate whether the World Health Organization Safety Surgical Checklist (SSC) is an effective tool to reduce complications in spinal surgery. Methods We retrospectively evaluated the clinical and radiological charts prospectively collected from patients who underwent a spinal surgery procedure from January 2010 to December 2012. The aim of this study was to compare the incidence of complications between two periods, from January to December 2010 (without checklist) and from January 2011 and December 2012 (with checklist), in order to assess the checklist’s effectiveness. Results The sample size was 917 patients with an average of 30-month follow-up. The mean age was 52.88 years. The majority of procedures were performed for oncological diseases (54.4%) and degenerative diseases (39.8%). In total, 159 complications were detected (17.3%). The overall incidence of complications for trauma, infectious pathology, oncology, and degenerative disease was 22.2%, 19.2%, 18.4%, and 15.3%, respectively. No correlation was observed between the type of pathology and the complication incidence. We observed a reduction in the overall incidence of complications following the introduction of the SSC: In 2010 without checklist, the incidence of complications was 24.2%, while in 2011 and 2012, following the checklist introduction, the incidence of complications was 16.7% and 11.7%, respectively (mean 14.2%). Conclusions The SSC seems to be an effective tool to reduce complications in spinal surgery. We propose to extend the use of checklist system also to the preoperative and postoperative phases in order to further reduce the incidence of complications. Graphic abstract These slides can be retrieved under Electronic Supplementary Material.

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Preventing the re-establishment of malaria in Sri Lanka amidst the COVID-19 pandemic

Malaria Journal ◽

10.1186/s12936-020-03465-5 ◽

2020 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Prasad Ranaweera ◽

Rajitha Wickremasinghe ◽

Kamini Mendis

Keyword(s):

Sri Lanka ◽

Task Force ◽

Health Sector ◽

Police Department ◽

Control Programme ◽

Imported Malaria ◽

World Health ◽

Cumulative Number ◽

Health Organization ◽

Health Programmes

Abstract The COVID-19 pandemic has had a considerable impact on other health programmes in countries, including on malaria, and is currently under much discussion. As many countries are accelerating efforts to eliminate malaria or to prevent the re-establishment of malaria from recently eliminated countries, the COVID-19 pandemic has the potential to cause major interruptions to ongoing anti-malaria operations and risk jeopardizing the gains that have been made so far. Sri Lanka, having eliminated malaria in 2012, was certified by the World Health Organization as a malaria-free country in 2016 and now implements a rigorous programme to prevent its re-establishment owing to the high receptivity and vulnerability of the country to malaria. Sri Lanka has also dealt with the COVID-19 epidemic quite successfully limiting the cumulative number of infections and deaths through co-ordinated efforts between the health sector and other relevant sectors, namely the military, the Police Department, Departments of Airport and Aviation and Foreign Affairs, all of which have been deployed for the COVID-19 epidemic under the umbrella of a Presidential Task Force. The relevance of imported infections and the need for a multi-sectoral response are features common to both the control of the COVID-19 epidemic and the Prevention of Re-establishment (POR) programme for malaria. Sri Lanka’s malaria POR programme has, therefore, creatively integrated its activities with those of the COVID-19 control programme. Through highly coordinated operations the return to the country of Sri Lankan nationals stranded overseas by the COVID-19 pandemic, many from malaria endemic countries, are being monitored for malaria as well as COVID-19 in an integrated case surveillance system under quarantine conditions, to the success of both programmes. Twenty-three imported malaria cases were detected from February to October through 2773 microscopic blood examinations performed for malaria in quarantine centres, this number being not much different to the incidence of imported malaria during the same period last year. This experience highlights the importance of integrated case surveillance and the need for a highly coordinated multi-sectoral approach in dealing with emerging new infections. It also suggests that synergies between the COVID-19 epidemic control programme and other health programmes may be found and developed to the advantage of both.

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