The Effects of Rumah Panggung Environment, Social Culture, and Behavior on Malaria Incidence in Kori Village, Indonesia

Malaria is an infectious disease that still cannot be solved in Kori village, West Nusa Tenggara, Indonesia, where the most of people live in rumah panggung (Stilts House). The purpose of this study was to know whether there were the effects of rumah panggung environment, social culture, and behavior on malaria incidence in the Kori village. A cross-sectional study was performed to explore the effects of rumah panggung environment, social culture and behavior on malaria incidence. This study recruited 280 respondents, who live in the rumah panggung, permanent residents in Kori village, were age above 17 years old, and suffered from malaria in the past year. The collected data were analyzed with path analysis. The results of this study showed that the environment of rumah panggung and behavior have a direct effect on the incidence of malaria (p < 0.05). It could be concluded that improvement of environmental conditions of rumah panggung, sociocultural, and behavioral changes to maintain a healthy environment are needed to reduce the malaria incidence.

Effect of the Ethanolic Leaf Extract of Ficus exasperata on Biochemical Indices of Albino Mice Experimentally Infected with Plasmodium berghei (NK 65)

Ficus exasperata is a plant used in the traditional management of malaria in south-south Nigeria. An investigation into the effects of the ethanolic extract of the leaf of the plant on some biochemical indices in albino mice infected with Plasmodium berghei (NK 65) was conducted. 48 mice with weight range of 13-23 g were grouped into six (A, B, C, D, E, and F). Each group contained 8 mice. Groups A, B, C, D and E were infected with blood containing the parasite. Group F was not infected and served as the normal control. On the 6th day after infection, 4 mice from each group were sacrificed and blood samples are collected for investigation. The remaining mice in each group were treated. Mice in Groups A, B and C were administered orally with 200, 300 and 500 mg/kg body weight of Ficus exasperata respectively for six days. Group D was not treated while Group F was given distilled water. Group E was treated with 5 mg/kg body weight of chloroquine. On the 6th day post treatment, these mice were sacrificed and blood samples were collected for biochemical analysis. The results indicated that on the 6th day post inoculation, the levels of aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) in all the mice infected with the parasite were significantly (p < 0.05) elevated. However, on the 6th day post administration of extract, the increased levels of AST, ALP and ALT were significantly (p < 0.05) reduced in groups administered with 300 and 500 mg/kg body weight of the extract compared with groups D and F. The reduction in the levels of these enzymes is an indication that F. exasperata have no hepatotoxic effect on the mice at the dose levels administered.

Stability Analysis of a Human-Mosquito Model of Malaria with Infective Immigrants

In this paper, we analyse the stability of the SEIR model of malaria with infective immigrants which was recently formulated by the authors. The model consists of an SEIR model for the human population and SI Model for the mosquitoes. Susceptible humans become infected after they are bitten by infectious mosquitoes and move on to the Exposed, Infected and Recovered classes respectively. The susceptible mosquito becomes infected after biting an infected person and remains infected till death. We calculate the reproduction number R0 using the next generation method and then discuss about the stability of the equilibrium points. We use the Lyapunov function to show the global stability of the equilibrium points.

Adverse Drug Reactions Monitoring in the Northern Region of Zambia

The Copperbelt University Health Services (CBUHS) was designated by the Zambia Medicines Regulatory Authority (ZAMRA), formally the Pharmaceutical Regulatory Authority (PRA) as a regional pharmacovigilance centre to carryout activities of drug safety monitoring in four provinces in Zambia. CBUHS’s mandate included stimulating the reporting of adverse drug reactions (ADRs), as well as collecting and collating ADR reports from health institutions in the four provinces. This report covers the researchers’ experiences from May 2008 to September, 2016. The main objectives are 1) to monitor ADRs in the Zambian population, 2) to disseminate information to all health professionals in the region advising that the CBU health was a centre for reporting ADRs in the region, 3) to monitor polypharmacy as well as the benefit-risk profile of medicines, 4) to generate independent, evidence based recommendations on the safety of medicines, 5) to support ZAMRA in formulating safety related regulatory decisions for medicines, and 6) to communicate findings with all key stakeholders. The methodology involved monthly visits, beginning in early May 2008 to September, 2016, by the CBUHS to health institutions in the programme areas. Activities included holding discussions with health workers, distribution of ADR forms and collection of ADRs reports. These reports, once collected, were documented and assessed at the CBUHS. A report was then prepared for ZAMRA on quarterly basis. At ZAMRA, serious ADRs were noted and recommendations made to the Ministry of Health of the Republic of Zambia. The results show that 2,600 ADRs reports were received at the pharmacovigilance regional centre. Most of the ADRs reports that received were due to antiretroviral drugs, as well as a few from anti-malarial drugs like Artemether/Lumefantrine – Coartem®. Three hundred and twelve ADRs were entered in the Uppsala Monitoring Centre WHO Vigiflow for further analysis. It was concluded that in general, 2008-16 were exciting years for the pharmacovigilance group at CBUHS. From a very tentative beginning, a lot of strides were made and contacts established with healthcare facilities in the region. The researchers were encouraged by the support received from the Copperbelt University management, the motivation provided by ZAMRA and most importantly the enthusiasm of health workers in all the health care facilities visited. As a centre for drug safety in Zambia, the results show it achieves its objectives for monitoring ADRs, Pharmacovigilance (drug safety monitoring), and activities of monitoring ADRs as well as preventing them. However, the centre faces critical challenges caused by erratic funding that prevents the smooth running of the programme.

Quantitative Assessment of Different Formulations of Antimalarials in Sentinel Sites of India

Substandard and counterfeit antimalarials is a major problem in malaria endemic areas. The availability of counterfeit/ substandard medicines is not only decreasing the efficacy in patients, but it is also one of the contributing factors for developing antimalarial drug resistance. Owing to this, a pilot study was conducted to survey quality of drugs collected from different malaria endemic areas of India. Artesunate+Sulphadoxine-Pyrimethamine (AS+SP), Artemether-Lumefantrine (AL), Chloroquine (CQ) tablets were randomly picked from public health facilities in selected states of India. The quality of antimalarial drugs from these areas was assessed by using Global Pharma Health Fund Minilab test kit. This includes physical/visual inspection and disintegration test. Thin-layer chromatography (TLC) was carried out for semi-quantitative assessment of active pharmaceutical ingredients. A total of 45 brands, out of which 21 were for CQ, 14 for AL and 10 for AS+SP were tested from Uttar Pradesh (U.P.), Mizoram, Meghalaya and Gujrat states. One out of 45 samples showed variable disintegration and retension factor. The variable disintegration and retention factor which would have been due to substandard quality or other factors including storage. However, HPLC analysis confirms standard active pharmaceutical ingredient, but may be due to humid temperature and moisture in storage may account for the observed result.

A Framework for Early Differential Diagnosis of Tropical Confusable Diseases Using the Fuzzy Cognitive Map Engine

The overarching aim of this study is to develop a soft-computing system for the differential diagnosis of tropical diseases. These conditions are of concern to health bodies, physicians, and the community at large because of their mortality rates, and difficulties in early diagnosis due to the fact that they present with symptoms that overlap, and thus become ‘confusable’. We report on the first phase of our study, which focuses on the development of a fuzzy cognitive map model for early differential diagnosis of tropical diseases. We used malaria as a case disease to show the effectiveness of the FCM technology as an aid to the medical practitioner in the diagnosis of tropical diseases. Our model takes cognizance of manifested symptoms and other non-clinical factors that could contribute to symptoms manifestations. Our model showed 85% accuracy in diagnosis, as against the physicians’ initial hypothesis, which stood at 55% accuracy. It is expected that the next stage of our study will provide a multi-disease, multi-symptom model that also improves efficiency by utilizing a decision support filter that works on an algorithm, which mimics the physician’s diagnosis process.

In silico Studies on Selected Drug Targets for Combating Drug Resistance in Plasmodium falcifarum

With drug resistance becoming widespread in Plasmodium falciparum infections, the development of the alternative drugs is the desired strategy for prevention and cure of malaria. Three drug targets were selected to screen promising drug molecules from the GSK library of 13469 molecules. Using an in silico structure-based drug designing approach, the differences in binding energies of the substrate and inhibitor were exploited between target sites of parasite and human to design a drug molecule against Plasmodium. The docking studies have shown several promising molecules from GSK library with more effective binding as compared to the already known inhibitors for the drug targets. Though stronger interaction has been shown by several molecules as compared to the reference, few molecules have shown the potential as drug candidates though in vitro studies are required to validate the results. In case of thymidylate synthase-dihydrofolatereductase (TS-DHFR), three compounds have shown promise for future studies as potential drugs.

Inhibitory Effects of Extracts and Isolates from Kigelia africana Fruits against Pathogenic Bacteria and Yeasts

Kigelia africana (Lam.) Benth. (Bignoniaceae) is a reputed traditional remedy for various human ailments such as skin diseases, microbial infections, melanoma, stomach troubles, metabolic disorders, malaria and general pains. In spite of the fruit being widely used for purposes related to its antibacterial and antifungal properties, the chemical constituents associated with the activity have not been fully identified. To elucidate the active principles, we evaluated the antimicrobial activity of fruit extracts and purified fractions against Staphylococcus aureus, Enterococcus faecalis, Moraxella catarrhalis, Escherichia coli, Candida albicans and Candida tropicalis. Shade-dried fruits were powdered and extracted with hydroalcoholic (1:1) mixture by soaking at room temperature for 72 h. The crude extract was further fractionated by column chromatography, with successive elution using hexane, dichloromethane, ethyl acetate, acetone and methanol. The dichloromethane and ethyl acetate fractions were combined and subjected to column chromatography to furnish a wax and oil from the eluates of 20% and 40% ethyl acetate in hexane, respectively. The GC-MS and GC×GC-MS results revealed that linoleic acid, linolenic acid, palmitic acid, arachidic acid and stearic acid were the major constituents in both oil and wax. The crude hydroalcoholic extract exhibited the strongest activity with MICs of 0.125-0.5 mg/mL, followed by the ethyl acetate (MICs = 0.125-1.0 mg/mL), dichloromethane (MICs = 0.250-2.0 mg/mL), hexane (MICs = 0.25- 2.0 mg/mL), acetone (MICs = 0.5-2.0 mg/mL) and methanol (MICs = 1.0-2.0 mg/mL), whereas the wax (MICs = 2.0-4.0 mg/mL) and oil (MICs = 4.0-8.0 mg/mL) showed poor activity. The study concludes that synergistic interactions of chemical constituents could be responsible for the antimicrobial activity of K. africana fruits, which needs a more holistic approach to understand the mechanism of its antimicrobial activity.

Spatio-Temporal Analysis and Mapping of Malaria in Thailand

This paper proposes a GLMM with spatial and temporal effects for malaria data in Thailand. A Bayesian method is used for parameter estimation via Gibbs sampling MCMC. A conditional autoregressive (CAR) model is assumed to present the spatial effects. The temporal correlation is presented through the covariance matrix of the random effects. The malaria quarterly data have been extracted from the Bureau of Epidemiology, Ministry of Public Health of Thailand. The factors considered are rainfall and temperature. The result shows that rainfall and temperature are positively related to the malaria morbidity rate. The posterior means of the estimated morbidity rates are used to construct the malaria maps. The top 5 highest morbidity rates (per 100,000 population) are in Trat (Q3, 111.70), Chiang Mai (Q3, 104.70), Narathiwat (Q4, 97.69), Chiang Mai (Q2, 88.51), and Chanthaburi (Q3, 86.82). According to the DIC criterion, the proposed model has a better performance than the GLMM with spatial effects but without temporal terms.

The Efficacy of Andrographis paniculata and Chromolaena odorata Plant Extract against Malaria Parasite

Malaria constitutes one of the major health problems in Nigeria. One of the reasons attributed for the upsurge was the development of resistance of Plasmodium falciparum and the emergence of multi-resistant strains of the parasite to anti-malaria drugs. A continued search for other effective, safe and cheap plantbased anti-malaria agents thus becomes imperative in the face of these difficulties. The objective of this study is therefore to evaluate the in vivo anti-malarial efficacy of ethanolic extracts of Chromolaena odorata and Androgaphis paniculata leaves. The two plants were evaluated for their anti-malaria efficacy in vivo in a 4-day curative test assay against Plasmodium berghei strain in mice. The group treated with 500mg/ml dose of ethanolic extract of A. paniculata plant showed parasite suppression with increase in Packed Cell Volume (PCV) value except day 3 which showed a slight decrease in PCV value. During the 4-day curative test, an increase in the PCV values, weight measurement and zero count of Plasmodium berghei parasite values was recorded after day 3 of drug administration. These results obtained in group treated with A. paniculata extract showed anti-malarial efficacy with higher mortality rate in parasitaemia count when compared with Chromolaena odorata group. These results justify the use of ethanolic extracts of A. paniculata plant as medicinal herb used in folklore medicine in the treatment of malaria.

Forecasting Malaria Cases in Bujumbura

The focus in this work is to assess which method allows a better forecasting of malaria cases in Bujumbura ( Burundi) when taking into account association between climatic factors and the disease. For the period 1996-2007, real monthly data on both malaria epidemiology and climate in Bujumbura are described and analyzed. We propose a hierarchical approach to achieve our objective. We first fit a Generalized Additive Model to malaria cases to obtain an accurate predictor, which is then used to predict future observations. Various well-known forecasting methods are compared leading to different results. Based on in-sample mean average percentage error (MAPE), the multiplicative exponential smoothing state space model with multiplicative error and seasonality performed better.

Biotransformation of Artemisinin by using a Novel Soil Isolated Microorganism

Artemisinin is a potential antimalarial drug effective against the multidrug resistant forms of Malarial Parasites. The current production of artemisinin is insufficient to meet the global demand. In the present study microbial biotransformation of arteannuin B, a biogenetic precursor of artemisinin to the later has been investigated. Screening studies carried out on several soil borne microorganisms have yielded one novel species with the bioconversion ability. Crude cell free extract of 72h old culture of the isolate had shown the bioconversion activity. On incubation with the substrate arteannuin B, crude cell free extract of the isolate had shown a bioconversion of 18.54% to artemisinin on molar basis with a specific activity of 0.18 units/mg.

Plasmodium Vivax Malaria Transmission in a Network of Villages

Malaria is a serious, acute and chronic relapsing infection to humans. It is characterized by periodic attacks of chills, fever, nausea, vomiting, back pain, increased sweating anemia, splenomegaly (enlargement of the spleen) and often-fatal complications.The malaria disease is caused by the multiplication of protozoa parasite of the genus Plasmodium. Malaria in humans is due to 4 types of malaria parasites such that Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale. P.vivax malaria differs from P. falciparum malaria in that a person suffering from P. vivax malaria can experience relapses of the disease. Between the relapses, the malaria parasite will remain dormant in the liver of the patient, leading to the patient being classified as being in the dormant class. A mathematical model for the transmission of P. vivax is developed in which the human population is divided into four classes, the susceptible, the infected, the dormant and the recovered. In this paper, we formulate the dynamical model of P. vivax malaria to see the distribution of this disease at the district level.

Mutational Effect to Particular Interaction Energy of Cycloguanil Drug to Plasmodium Plasmodium Falciparum Dihydrofolate Reductase Enzymes

In order to find the particular interaction energy between cylcloguanil and the amino acids surrounding the pocket of wild type and quadruple mutant type PfDHFR enzymes, the MP2 method with basis set 6-31G(d,p) level of calculations was performed. The obtained interaction energies found that Asp54 has the strongest interaction energy to both wild type and mutant type of - 12.439 and -11.250 kcal/mol, respectively and three amino acids; Asp54, Ile164 and Ile14 formed the H-bonding with cycloguanil drug. Importantly, the mutation at Ser108Asn was the key important of cycloguanil resistant with showing repulsive interaction energy.

Mathematical Model for the Transmission of Two Plasmodium Malaria

Malaria is transmitted to the human by biting of infected Anopheles mosquitoes. This disease is a serious, acute and chronic relapsing infection to humans. Fever, nausea, vomiting, back pain, increased sweating anemia and splenomegaly (enlargement of the spleen) are the symptoms of the patients who infected with this disease. It is caused by the multiplication of protozoa parasite of the genus Plasmodium. Plasmodium falciparum, Plasmodium vivax, Plasmodium malariae and Plasmodium ovale are the four types of Plasmodium malaria. A mathematical model for the transmission of Plasmodium Malaria is developed in which the human and vector population are divided into two classes, the susceptible and the infectious classes. In this paper, we formulate the dynamical model of Plasmodium falciparum and Plasmodium vivax malaria. The standard dynamical analysis is used for analyzing the behavior for the transmission of this disease. The Threshold condition is found and numerical results are shown to confirm the analytical results.

The Integrated Management of Health Care Strategies and Differential Diagnosis by Expert System Technology: A Single-Dimensional Approach

The Integrated Management of Child illnesses (IMCI) and the surveillance Health Information Systems (HIS) are related strategies that are designed to manage child illnesses and community practices of diseases. However, both strategies do not function well together because of classification incompatibilities and, as such, are difficult to use by health care personnel in rural areas where a majority of people lack the basic knowledge of interpreting disease classification from these methods. This paper discusses a single approach on how a stand-alone expert system can be used as a prompt diagnostic tool for all cases of illnesses presented. The system combines the action-oriented IMCI and the disease-oriented HIS approaches to diagnose malaria and typhoid fever in the rural areas of the Niger-delta region.

Evaluation and Preparation of Crystal Modifications of Artesunate: In vivo Studies

Five crystal modifications of water insoluble artesunate were generated by recrystallizing it from various solvents with improved physicochemical properties. These generated crystal forms were characterized to select the most potent and soluble form. SEM of all the forms showed changes in external shape leading them to be different morphologically. DSC thermograms of Form III and Form V showed broad endotherm peaks at 83.04oC and 76.96oC prior to melting fusion of drug respectively. Calculated weight loss in TGA revealed that Form III and Form V are methanol and acetone solvates respectively. However, few additional peaks were appeared in XRPD pattern in these two solvate forms. All forms exhibit exothermic behavior in buffer and two solvates display maximum ease of molecular release from the lattice. Methanol and acetone solvates were found to be most soluble forms and exhibited higher antimalarial efficacy showing higher survival rate (83.3%) after 30 days.

Modelling the Role of Prophylaxis in Malaria Prevention

Malaria is by far the world-s most persistent tropical parasitic disease and is endemic to tropical areas where the climatic and weather conditions allow continuous breeding of the mosquitoes that spread malaria. A mathematical model for the transmission of malaria with prophylaxis prevention is analyzed. The stability analysis of the equilibria is presented with the aim of finding threshold conditions under which malaria clears or persists in the human population. Our results suggest that eradication of mosquitoes and prophylaxis prevention can significantly reduce the malaria burden on the human population.

Climate Change and the Problem of Malaria in Armenia

The data presented in this work show that in Armenia a rise of air temperature is expected in the season, and annual terms. As a result of the noted increase in temperature, a significant growth of vulnerability of the territory of Armenia in relation to malaria is expected. Zoning by the risk of renewed malaria transmission has been performed.

Analysing Environmental Risks and Perceptions of Risks to Assess Health and Well-being in Poor Areas of Abidjan

This study analyzed environmental health risks and people-s perceptions of risks related to waste management in poor settlements of Abidjan, to develop integrated solutions for health and well-being improvement. The trans-disciplinary approach used relied on remote sensing, a geographic information system (GIS), qualitative and quantitative methods such as interviews and a household survey (n=1800). Mitigating strategies were then developed using an integrated participatory stakeholder workshop. Waste management deficiencies resulting in lack of drainage and uncontrolled solid and liquid waste disposal in the poor settlements lead to severe environmental health risks. Health problems were caused by direct handling of waste, as well as through broader exposure of the population. People in poor settlements had little awareness of health risks related to waste management in their community and a general lack of knowledge pertaining to sanitation systems. This unfortunate combination was the key determinant affecting the health and vulnerability. For example, an increased prevalence of malaria (47.1%) and diarrhoea (19.2%) was observed in the rainy season when compared to the dry season (32.3% and 14.3%). Concerted and adapted solutions that suited all the stakeholders concerned were developed in a participatory workshop to allow for improvement of health and well-being.