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Malaria prophylaxis

Abel Kakuru, Paul Natureeba, Mary K Muhindo, Tamara D Clark, Diane V Havlir, Deborah Cohan, Grant Dorsey, Moses R Kamya, Theodore Ruel
BACKGROUND: HIV-exposed, uninfected (HEU) infants suffer high morbidity and mortality in the first year of life compared to HIV-unexposed, uninfected (HUU) infants, but accurate data on the contribution of malaria are limited. METHODS: The incidence of febrile illnesses and malaria were evaluated in a birth cohort of HEU infants. Infants were prescribed daily trimethoprim-sulfamethoxazole (TS) prophylaxis from 6 weeks of age until exclusion of HIV-infection after cessation of breastfeeding...
October 18, 2016: Malaria Journal
Jeffrey Livezey, Thomas Oliver, Louis Cantilena
A 32-year-old male developed neuropsychiatric symptoms 2 weeks after starting mefloquine 250 mg/week for malaria prophylaxis. He continued to take the medication for the next 4 months. Initial symptoms included vivid dreams and anxiety, as well as balance problems. These symptoms persisted and progressed over the next 4 years to include vertigo, emotional lability, and poor short-term memory, which have greatly affected his personal and professional life. An extensive evaluation revealed objective evidence supporting a central vestibulopathy...
December 2016: Drug Saf Case Rep
Engin Burak Selcuk, Uner Kayabas, Hulisi Binbasioglu, Baris Otlu, Yasar Bayindir, Bulent Bozdogan, Mehmet Karatas
BACKGROUND: The number of international travellers is increasing worldwide. Although health risks related to international travel are important and generally well-understood, the perception of these risks was unclear among Turkish travellers. We aimed to evaluate the attitudes and health risk awareness of Turkish travellers travelling to African countries. METHOD: A survey was performed of Turkish travellers bound for Africa from Istanbul International Ataturk Airport in July 2013...
September 20, 2016: Travel Medicine and Infectious Disease
Fredrick Kateera, Sam L Nsobya, Steven Tukwasibwe, Emmanuel Hakizimana, Leon Mutesa, Petra F Mens, Martin P Grobusch, Michèle van Vugt, Nirbhay Kumar
Faced with intense levels of chloroquine (CQ) resistance in Plasmodium falciparum malaria, Rwanda replaced CQ with amodiaquine (AQ)+sulfadoxine-pyrimethamine (SP) in 2001, and subsequently with artemether-lumefantrine (AL) in 2006, as first-line treatments for uncomplicated malaria. Following years of discontinuation of CQ use, re-emergence of CQ-susceptible parasites has been reported in countries including Malawi, Kenya and Tanzania. In contrast, high levels of SP resistant mutant parasites continue to be reported even in countries of presumed reduced SP drug selection pressure...
September 17, 2016: Acta Tropica
Josef Yayan, Kurt Rasche
Malaria is an acute, life-threatening infectious disease that spreads in tropical and subtropical regions. Malaria is mainly brought over to Germany by travelers, so the disease can be overlooked due to its nonspecific symptoms and a lack of experience of attending physicians. The aim of this study was to analyze, retrospectively, epidemiological and clinical data from patients examined for malaria. Patient data were collected from hospital charts at the Department of Internal Medicine, Saarland University Medical Center, Germany, for the period of 2004-2012...
September 20, 2016: Advances in Experimental Medicine and Biology
Tamar Lachish, Maskit Bar-Meir, Neta Eisenberg, Eli Schwartz
BACKGROUND: Current guidelines recommend daily dosing of atovaquone-proguanil (AP), beginning a day before travel to endemic areas and continuing for 7 days after departure. Adherence of long-term travellers to daily malaria chemoprophylaxis tends to be poor, even when residing in highly endemic malaria regions. Evidence from a volunteer challenging study suggests that non-daily, longer intervals dosing of AP provides effective protection against Plasmodium falciparum This study examines the effectiveness of twice weekly AP prophylaxis in long-term travellers to highly endemic P...
June 2016: Journal of Travel Medicine
Anna Longdoh Njunda, Charles Njumkeng, Shey Dickson Nsagha, Jules Clement Nguedia Assob, Tebit Emmanuel Kwenti
BACKGROUND: Coinfection with malaria and HIV is common in Sub-Saharan Africa. In the advent of a decline in the global incidence of malaria, it is important to generate updated data on the burden of malaria in people living with HIV (PLWHIV). This study was designed to determine the prevalence of malaria in PLWHIV in Yaounde, Cameroon, as well determine the association between CD4 (+) T cell count and malaria in the study population. METHODS: In a cross sectional study performed between April 2015 and June 2016, 355 PLWHIV were enrolled and blood samples were collected for analysis...
2016: BMC Public Health
Maryam Ghavami, Christie H Dapper, Seema Dalal, Kristina Holzschneider, Michael Klemba, Paul R Carlier
Despite the troubling psychiatric side-effects it causes in some patients, mefloquine (MQ) has been used for malaria prophylaxis and therapy, due to its activity against all Plasmodium species, its ease of dosing, and its relative safety in children and pregnant women. Yet at present there is no consensus on the mechanism of antimalarial action of MQ. Two leading hypotheses for the mechanism of MQ are inhibition of heme crystallization and inhibition of host cell hemoglobin endocytosis. In this report we show that MQ is a potent and rapid inhibitor of amino acid efflux from intact parasitized erythrocytes, which is a measure of the in vivo rate of host hemoglobin endocytosis and catabolism...
October 1, 2016: Bioorganic & Medicinal Chemistry Letters
N Jaén-Sánchez, L Suárez-Hormiga, C Carranza-Rodríguez, M Hernández-Cabrera, E Pisos-Álamo, L García-Reina, J L Pérez-Arellano
OBJECTIVE: The objective of this paper was to determine the demographic characteristics and the evolution of international travelers treated at the Unit of Infectious and Tropical Medicine in order to improve precautions prior to travel and, thus reduce the occurrence of these diseases. METHODS: A retrospective study of all international travelers served in UEIMT (Las Palmas de Gran Canaria) during the period 1998-2013 was performed. The following variables were collected using a standardized protocol were analyzed: age, gender, date of consultation, type of traveler, countries of destination and preventive measures undertaken (malaria chemoprophylaxis and vaccines)...
October 2016: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
Laurence Lagarce, Nicolas Lerolle, Pierre Asfar, Yohann Le Govic, Pascale Lainé-Cessac, Ludovic de Gentile
Non-pharmaceutical forms of Artemisia annua (a Chinese plant containing artemisinin) are used by some travellers who believe these products are safer than anti-malarial drugs. We report two cases of severe Plasmodium falciparum malaria requiring hospitalization in an Intensive Care Unit following prophylaxis with non-pharmaceutical A. annua in French travellers.
May 2016: Journal of Travel Medicine
Rukiyat Adeola Abdus-Salam, Folasade Adenike Bello, Fatai A Fehintola, Ayodele O Arowojolu
CONTEXT: The benefit of malaria prophylaxis in pregnancy is threatened by emergence of Plasmodium falciparum resistance to antimalarial agents for chemoprophylaxis and treatment. AIM: This study aimed to compare the effectiveness of azithromycin (AZ) with sulphadoxine-pyrimethamine (SP) for malaria prevention. SETTINGS AND DESIGN: A prospective comparative study of antenatal clinic attendees at the University College Hospital, Ibadan, Nigeria...
April 2016: Nigerian Postgraduate Medical Journal
Ronnie Kasirye, Heiner Grosskurth, Paula Munderi, Jonathan Levin, Zacchaeus Anywaine, Andrew Nunn, Anatoli Kamali, Kathy Baisley
BACKGROUND: The effect of CD4 count on malaria incidence in HIV infected adults on antiretroviral therapy (ART) was assessed in the context of a randomized controlled trial on the effect of stopping cotrimoxazole (CTX). METHODS: This study presents a sub-analysis of the COSTOP trial (ISRCTN44723643) which was carried out among HIV-infected Ugandan adults stable on ART with CD4 counts ≥250 cells/µl. Participants were randomized (1:1) to continue CTX or stop CTX and receive matching placebo, and were followed up for a minimum of 1 year (median 2...
2016: Malaria Journal
Katri Vilkman, Sari H Pakkanen, Tinja Lääveri, Heli Siikamäki, Anu Kantele
BACKGROUND: The annual number of international tourist arrivals has recently exceeded one billion, yet surprisingly few studies have characterized travelers' behavior, illness, and risk factors in a prospective setting. Particularly scarce are surveys of data spanning travel, return, and follow-up of the same cohort. This study examines behavior and illness among travelers while abroad, after return home, and at follow-up. Patterns of behavior connected to type of travel and illness are characterized so as to identify risk factors and provide background data for pre-travel advice...
2016: BMC Infectious Diseases
Josef Yayan, Kurt Rasche
Malaria is an acute, life-threatening infectious disease that spreads in tropical and subtropical regions. Malaria is mainly brought over to Germany by travelers, so the disease can be overlooked due to its nonspecific symptoms and a lack of experience of attending physicians. The aim of this study was to analyze, retrospectively, epidemiological and clinical data from patients examined for malaria. Patient data were collected from hospital charts at the Department of Internal Medicine, Saarland University Medical Center, Germany, for the period of 2004-2012...
July 13, 2016: Advances in Experimental Medicine and Biology
Benatus Sambili, Ronald Kimambo, Yun Peng, Elison Ishunga, Edna Matasha, Godfrey Matumu, Rita Noronha, David P Ngilangwa
Malaria and iron-deficient anemia during pregnancy pose considerable risks for the mother and newborn. Intermittent Preventive Treatment during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) and iron supplement to prevent anemia to all pregnant women receiving antenatal care (ANC) services is highly recommended. However, their compliance remains low. This study aimed at identifying factors influencing non-compliance of medications among pregnant women. A descriptive cross-sectional study was conducted in Simiyu region in northwest Tanzania using a structured questionnaire to collect data from 430 women who were pregnant or gave birth 12 months prior to data collection...
2016: International Journal of Environmental Research and Public Health
Michael R Hollingdale, Martha Sedegah
INTRODUCTION: Despite recent advances, malaria remains a major health threat both to populations in endemic areas as well travelers, including military personnel, to these areas. Subunit vaccines have not yet achieved sufficient efficacy needed for use in any of these at risk populations. AREAS COVERED: This review discusses the current status of various whole sporozoite vaccine approaches and is mainly focused on current clinical trials. Expert Commentary: Nearly 100% efficacy was achieved by administering multiple bites of radiation-attenuated sporozoite (RAS) Plasmodium falciparum-infected mosquitoes; this is impractical for widespread use...
June 21, 2016: Expert Review of Vaccines
Elina Hemminki, Bright I Nwaru, Graca Salomé, Saara Parkkali, Fatima Abacassamo, Orvalho Augusto, Julie Cliff, Elena Regushevskaya, Martinho Dgedge, Cesar Sousa, Baltazar Chilundo
OBJECTIVE: To compare routine versus selective (ie, screening and treatment for anaemia) prenatal iron prophylaxis in a malaria-endemic and HIV-prevalent setting, an extended analysis including previously missing data. DESIGN: A pragmatic randomised controlled clinical trial. SETTING: 2 health centres in Maputo, Mozambique. PARTICIPANTS: Pregnant women (≥18 years old; non-high-risk pregnancy) were randomly allocated to routine iron (n=2184) and selective iron (n=2142) groups...
2016: BMJ Open
Allison M Stickles, Martin J Smilkstein, Joanne M Morrisey, Yuexin Li, Isaac P Forquer, Jane X Kelly, Sovitj Pou, Rolf W Winter, Aaron Nilsen, Akhil B Vaidya, Michael K Riscoe
Antimalarial combination therapies play a crucial role in preventing the emergence of drug-resistant Plasmodium parasites. Although artemisinin-based combination therapies (ACTs) comprise the majority of these formulations, inhibitors of the mitochondrial cytochrome bc1 complex (cyt bc1) are among the few compounds that are effective for both acute antimalarial treatment and prophylaxis. There are two known sites for inhibition within cyt bc1: atovaquone (ATV) blocks the quinol oxidase (Qo) site of cyt bc1, while some members of the endochin-like quinolone (ELQ) family, including preclinical candidate ELQ-300, inhibit the quinone reductase (Qi) site and retain full potency against ATV-resistant Plasmodium falciparum strains with Qo site mutations...
August 2016: Antimicrobial Agents and Chemotherapy
G Dennis Shanks
Quinine, a bitter-tasting, short-acting alkaloid drug extracted from cinchona bark, was the first drug used widely for malaria chemoprophylaxis from the 19th century. Compliance was difficult to enforce even in organized groups such as the military, and its prophylaxis potential was often questioned. Severe adverse events such as blackwater fever occurred rarely, but its relationship to quinine remains uncertain. Quinine prophylaxis was often counterproductive from a public health viewpoint as it left large numbers of persons with suppressed infections producing gametocytes infective for mosquitoes...
August 3, 2016: American Journal of Tropical Medicine and Hygiene
Herbert Longwe, Kamija S Phiri, Nyanyiwe M Mbeye, Thandile Gondwe, Wilson L Mandala, Kondwani C Jambo
BACKGROUND: Cotrimoxazole (CTX) prophylaxis, recommended in HIV-exposed uninfected (HEU) children primarily against HIV-related opportunistic infections, has been shown to have some efficacy against Plasmodium falciparum malaria. The effects of CTX prophylaxis on the acquisition of P. falciparum antigen specific CD4(+) T cells-mediated immunity in HEU children is still not fully understood. METHODS: Peripheral blood was collected from HEU and HIV-unexposed uninfected (HUU) children at 6, 12 and 18 months of age...
2016: Malaria Journal
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