Malaria Related Deaths among Children with Manifestations of Fever Symptoms on Admission in a Secondary Health Care Institution in Western Region of Ghana – A Retrospective Study | Chapter 3 | Current Trends in Disease and Health Vol. 3

Background: Malaria is a major contributor to deaths in children especially in sub-Saharan Africa. Children less than five years of age are susceptible to malaria infection in endemic regions leading to serious complications. Malaria causes death in children either directly through Cerebral Malaria (CM) and Severe Malaria Anaemia (SMA) or indirectly through co-morbidity with pneumonia or a sequela like hypoglycaemia.

Methods: This retrospective study examined malaria-related deaths among children at Effia-Nkwanta hospital within a study period of 3 years.

Results: A total of 1,416 medical records were reviewed, out of which 223 were medical records of children with fatal outcomes. Deaths over the study period due to all causes were 15.7% (223/1416) and confirmed malaria was 13.7% (40/292). Deaths due to all causes and confirmed malaria decreased from 21.6% and 24.3% in 2010 to 11.1% and 4.4% in 2012, respectively. Anti-malarial testing was done for 152 of the children with 40 positive and 112 negative results. Seventy-one children had no malaria testing done on them, with 23.4% in 2010 40.3% in 2011 and 35.5% in 2012. Anti-malarial treatment was administered to 83% of children who tested negative and 80% of children without anti-malarial testing.

Conclusion: Deaths in the children declined from 2010 to 2012 in this study. Despite this improvement, there was poor anti-malarial testing and improper use of anti-malarial treatment. National malaria programs should ensure improvement in anti-malarial testing and strict adherence to the anti-malarial treatment protocol.

Author(s) Details

Verner N. Orish

Department of Microbiology and Immunology, School of Medicine, University of Health and Allied Sciences, Ho, Volta Region, Ghana.

Adekunle O. Sanyaolu,  

AMOOF Healthcare Consulting, Canada.

Mahama Francois,

Ho Polytechnic, Ho, Volta Region, Ghana.

Bruku K. Silverius,

Takoradi Polytechnic, Sekondi-Takoradi, Sekondi, Western Region, Ghana.

Onyekachi S. Onyeabor,

Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, USA.

Chuku Okorie,

Essex County College, Newark, New Jersey, USA.

Nnaemeka C. Iriemenam,

Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Idi-Araba, Lagos, Nigeria. View Book – http://bp.bookpi.org/index.php/bpi/catalog/book/148

Sickle Cell Disease and Severity of Malaria | Chapter 08 | Current Trends in Disease and Health Vol. 2

Background: The relationship between sickle cell disease and malaria remains controversial and the hypothesis that sickle cell disease protects against malaria is widespread.

Methodology: A descriptive and retrospective study over a two-year period (2014-2016) was conducted in pediatric departments A and B of the National Hospital of Niamey (HNN). The objective is to assess the relative risk between sickle cell disease and the severity of malaria.

Results: Nine hundred and seventy four (974) patients infected with Plasmodium falciparum were included in this study. Thirteen point twenty four percent (129/974) of patients had sickle cell disease, of which 93.8% (121/129) had SS form and 6.2% (8/129) SC form. Seventy-nine point eight percent (103/129) of sickle cell patients had severe malaria (RR = 0.9, p = 0.17). Ninety six point one percent (99/103) of patients with severe malaria have SS hemoglobin versus 3.8% (4/103) who have SC hemoglobin  (RR = 0.6, p = 0.05). Eleven point forty three percent (4/35) of sickle cell patients died of malaria (RR = 0.1, p = 0.4). Seventy-five percent (3/4) of the deceased sickle cell have SS hemoglobin versus 25% (1/4) who have SC hemoglobin (RR = 5, p = 0.2).

Conclusion: Heterozygous sickle cell patients have less severe malaria than homozygotes. Malaria is more severe and more lethal in homozygous sickle cell patients. A strategy for the prevention of sickle cell malaria should be developed during periods of high transmission.

Author(s) Details

Maman Daou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.
Hôpital National de Niamey, Niger.

Ibrahim Alkasoume
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.

Mahamadou Doutchi
Faculté de Médecine de l’université de Zinder, Niger.

Samaila Boubacar
Hôpital National de Niamey, Niger.

Mansour Maman Anou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.

Mahamane Moustapha lamine
Centre de Recherche Médicale et Sanitaire de Niamey, Niger.
Université Cheikh Anta Diop de Dakar, Sénégal.

Ramatoulaye Hamidou Lazoumar
Centre de Recherche Médicale et Sanitaire de Niamey, Niger.

Kamayé Moumouni
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.
Hôpital National de Niamey, Niger.

Djibo Yacouba Hamadou
Faculté des Sciences de la Santé, l’Université Abdou Moumouni de Niamey, Niger.

Ibrahim Maman Laminou
Centre de Recherche Médicale et Sanitaire de Niamey, Niger.

View Books: http://bp.bookpi.org/index.php/bpi/catalog/book/91

Perceptions of the Traditional Medical Practitioners of North-Western Nigeria on Malaria Treatment and the Potential Antiplasmodial Properties of Plumeria rubra Stem-Bark | Chapter 02 | Modern Advances in Pharmaceutical Research Vol. 2

Aims: The apparent lack of scientific proof of efficacies claimed by the traditional medical practitioners (TMPs) (locally known as Magori/’Yan-ganye, in Hausa language) of North-Western Nigeria with respect to malaria and the many drawbacks of the current antimalarial drugs stimulated this study. The study was carried out to evaluate the perception of the TMPs on the causes, diagnosis and treatment of malaria and evaluate the potential antiplasmodial properties (in-vivo in Albino mice) of Plumeria rubra Linn. (Apocynaceae) commonly used in traditional treatment of malaria in North-Western Nigeria. The study was aimed at providing scientific basis for use of traditional health knowledge and use of medicinal plant resources in the treatment of malaria.

Study Design: Using an ethno-medical survey, information was obtained from the TMPs relating to identification of plants, their medicinal uses and the mode of preparations of remedies on traditional treatment of malaria.

Place and Duration of Study: The ethno-medicinal survey was carried out at the premises of TMPs from December, 2005 to May, 2008. The laboratory work was carried out at the Department of Pharmacognosy and Drug Development, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria from July, 2008 to February, 2010.

Methodology: An ethno-medical survey was conducted in twenty Local Government Areas across four States (Kaduna, Kano, Katsina and Jigawa) in North-Western Nigeria. The communities covered in the survey were selected on the basis of their reputation for being homes to a number of TMPs. The plant used was selected on the basis of ethno-medical information obtained from the TMPs using an exclusion criterion based on claim for activity score. The preferable solvent used by the local people was found to be mostly water and/or alcohol, the plant material was therefore extracted by maceration technique using 70% v/v aqueous-ethanol. The metabolites profiles of the extracts were determined using thin layer chromatographic (TLC) technique on commercially prepared silica gel pre-coated flexible plates.

Results: The TMPs were able to define, diagnose and presumably treat malaria using the indigenous medicines. Median lethal dose (LD50) was established to be greater than 5 gkg-1 for the aqueous extract and 3.8 gkg-1 for the chloroform extract orally in mice respectively. Antiplasmodial evaluation of the two extracts revealed that the two extracts exhibited dose-dependent in-vivo suppressive, curative and prophylactive properties on the development of parasitaemia in Albino mice using a chloroquine sensitive strain of Plasmodium berghei (NK-65). TLC profile fingerprints of the aqueous extract revealed three distinct spots with Rf values of 0.23, 0.39 and 0.75 whereas that the chloroform extract revealed three distinct spots with Rf values of 0.33, 0.42 and 0.55 when it was developed in ethyl acetate: ethanol: water: ammonia (65:25:9:1).

Conclusion: These results represented the first conducted evaluation of the perception of TMPs of North-Western Nigeria on the causes, diagnosis and treatment of malaria, antiplasmodial and thin layer chromatographic profile fingerprinting studies on Plumeria rubra bark found in North-Western Nigeria. The findings are therefore expected to provide the necessary scientific basis for rational use of traditional health knowledge and use of medicinal plant resources of North-Western Nigeria in the treatment of malaria.

Author(s) Details

Umar Adam Katsayal
Department of Pharmacognosy and Drug Development, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria.

Mujitaba Suleiman Abubakar
Department of Pharmacognosy and Drug Development, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria.

Abubakar Ahmed
Department of Pharmacognosy and Drug Development, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria.

Ezzeddeen Mukhtar Abdurahman
Department of Pharmacognosy and Drug Development, Faculty of Pharmaceutical Sciences, Ahmadu Bello University, Zaria, Nigeria.

Read full article: http://bp.bookpi.org/index.php/bpi/catalog/view/85/1195/838-1
View Volume: https://doi.org/10.9734/bpi/mapr/v2

Detection of Plasmodium falciparum K13 Propeller A569G Mutation after Artesunate-amodiaquine Treatment Failure in Niger | Chapter 04 | Advances and Trends in Biotechnology and Genetics Vol. 2

Background: Artemisinin (ART) resistance is a problem that may compromise the elimination of malaria. It is associated with point mutations in the kelch gene PF3D7_1343700 or K13 propeller (pfk13). A recent worldwide map of pfk13 polymorphisms revealed more than 100 non-synonymous (NS) mutations. However, it remains unclear whether these mutations are the result of drug pressure or the expression of a natural polymorphism, because of the scarcity of in-vivo selection of pfK13 mutations data in Africa.

Methodology: This survey evaluates the association between mutations in PfK13 and the response to treatment with artemether-lumefantrine (AL) and artesunate-amodiaquine (ASAQ) at Gaya, Niger. Mutations in PfK13 before and after treatment were analyzed and used as evidence for the selection of drug resistance following drug pressure.

Results: A total of 161 DNA from patients included in a therapeutic efficacy survey comparing AL vs ASAQ at Gaya sentinel site in 2011 were amplified and sequenced. Five SNPs were identified including 3 non-synonymous (NS) mutations (R528K, A569G and V637I) and 2 synonymous (SY) mutations (C469C and Q613Q). Four SNPs were observed prior to artemisinin-based Combination Therapy (ACT) including 2 NS (R528K and V637I) and 2 SY (C469C and Q613Q) mutations. One NS mutation was selected by ASAQ (PfK13A569G) whereas AL treatment did not select any mutation.

Conclusion: This study suggests that the mutation pfk13A569G is selected by ASAQ. Further mutagenesis studies (CRISPR/Cas9 or Z-Finger Nuclease) will be needed to confirm if pfk13A569G confers resistance to artemisinin.

Author(s) Details

Ibrahim Maman Laminou
Centre de Recherche Médicale et Sanitaire-Niamey, Niger.

Moustapha Mahamane Lamine
Université Cheick Anta Diop de Dakar, Sénégal.

Ibrahim Arzika
Centre de Recherche Médicale et Sanitaire-Niamey, Niger.

Boubacar Mahamadou
Centre de Recherche Médicale et Sanitaire-Niamey, Niger.

D. Gora
Université Cheick Anta Diop de Dakar, Sénégal.

A. Dieye
Université Cheick Anta Diop de Dakar, Sénégal.

Read full article: http://bp.bookpi.org/index.php/bpi/catalog/view/82/1165/808-1
View Volume: https://doi.org/10.9734/bpi/atbg/v2

Association between Immunoglobulin G Subtypes Immune responses to Plasmodium falciparum Merozoite Surface Protein 1-19 and Malaria | Chapter 10 | Current Trends in Disease and Health Vol. 1

Aims: To determine Immunoglobulin G (IgG) subtypes (IgG1, IgG2, IgG3 and IgG4) responses to PfMSP1-19 antigens and their associations with malaria across different age groups.

Study Design: A community based cross sectional study.

Place and Duration of Study: Bondo Ward, in Handeni district of Tanga Region between January and May 2016. 

Methodology: We included 331 participants; 216 females, 115 males aged between 1 and 82 years, with a median age of 10 years and an inter-quartile range 5 -30 years. Two milliliters of blood was collected from each participant in EDTA coated tubes for detection of malaria and serology. Anti-MSP1-19 IgG subtypes were measured by indirect ELISA based on a protocol developed by Afro Immuno-Assay Consortium. Demographic data were collected using designed record form.

Results: Out of 331 participants, 68 (20.5%) were malaria positive. We report malaria prevalence to be highest in the age category of between 6 and 15 years, compared to individuals above 15 years (OR= 4.5; 95% CI = 2.2–8.9). Most participants were seropositive for total IgG (87.0%), IgG1 (78.5%) and IgG3 (52.9%). Concentration (optical densities) of total IgG, IgG1 and IgG3 was generally lower in the 1-5 year age category. There was no clear pattern for IgG 2 and IgG4 seropositivity across age categories. After adjusting for age, only IgG1 seropositivity was significantly associated with lower malaria prevalence in all age categories (OR=0.4; 95% CI = 0.2 – 0.8).

Conclusion: IgG1subtype to MSP1-19 is associated with lower malaria prevalence which may imply its possible suitability a target of a prospective malaria vaccine.  We report a high prevalence of malaria in the study area, with highest malaria prevalence recorded in older children of 6-15 years of age. Our findings show that only IgG1 antibody to MSP1-19 is associated with low malaria prevalence, suggesting a possible protective role of the subtype against malaria. We report very low responses and seropositivity of IgG2 and IgG4 subtypes. Based on our present findings, IgG1 to MSP1-19 could be an important target of a prospective malaria vaccine.

Author(s) Details

Emmanuel Athanase
Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania.

Arnold Ndaro
Kilimanjaro Clinical Research Institute, P.O.Box 2236, Moshi, Tanzania.
Kilimanjaro Christian Medical Centre, P.O.Box 3010, Moshi, Tanzania.

Linda Minja
Kilimanjaro Clinical Research Institute, P.O.Box 2236, Moshi, Tanzania.

Jaffu Chilongola
Kilimanjaro Christian Medical University College, P.O.Box 2240, Moshi, Tanzania.

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Assessment of Antimalarial Drug Use among the Patients in a Tertiary Hospital in Northern Part of Nigeria | Chapter 05 | Current Trends in Disease and Health Vol. 1

Aims: To assess the pattern of antimalarial drug use among the patients attending the teaching hospital in Jos North local Government of Nigeria.

Study Design: Cross-sectional study.

Place and Duration of Study: Tertiary hospital in Jos North Local Government of Plateau state of Nigeria, between July and September, 2012.

Methodology: A sample size of 441 male and female patients was selected into this study using a universal sampling. Information on the knowledge, attitudes and practices with respect to antimalarial drug use were obtained with the aid of a pre-tested interviewer-administered questionnaire. Data was analyzed using the SPSS software.

Results: Four hundred and forty one (441) patients completed the questionnaire. Respondent knowledge of malaria with respect to description of malaria decreased (42.7% to 0.2%). Almost all the patients were able to describe the causes and symptoms of malaria. One hundred and sixty nine (38.3%) frequently treated their malaria with Sulphadoxine-Pyrimethamine (SP) combination, Three hundred and eighty two (86.6%) reported to have used oral preparation, almost half of the respondents (47.6%) obtained these medications from many sources apart from hospitals, only two hundred and forty eight reported to comply to treatment. Majority of the participants always used some methods for the prevention of malaria.

Conclusion: Concerted effort should be made to educate the population on malaria as well as the importance of drug adherence. Provision of ACTs at subsidized costs will go a long way in improving malaria treatment services in Nigeria, indigenous plantations for cultivating active ingredients and local manufacturing of ACTs is further expected to lower the costs of the drugs and increase its utilization and lower the incidence and impact of malaria. It will be important for interventions to be directed at educating the consumers on malaria pathogenesis, diagnosis, therapy and prevention and importance of drug adherence in order to improve the quality, efficacy of treatments and to reduce local morbidity and mortality in the future.

Author(s) Details

Modupe I. Builders
Department of Pharmacology, Faculty of Pharmacy, Bingham University, Karu, Nasarawa State, Nigeria.

Dr. Jonah Y. Peter
Department of Medical Microbiology and Parasitology, College of Health Sciences, University of Abuja, Abuja, Nigeria.

Read full article: http://bp.bookpi.org/index.php/bpi/catalog/view/59/644/524-1

View Volume: https://doi.org/10.9734/bpi/ctdah/v1