Akintunde Sowunmi

..Artemisinin-based combination treatments (ACTs) are the recommended first-line antimalarials globally, but their influence on the risk factors associated with gametocyte carriage has had little evaluation in endemic areas...

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..Efforts in this study were thus devoted to development and evaluation of a simple, cost-effective and sensitive method for quantification of sulphadoxine in small capillary samples of whole blood dried on filter paper...

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..Drug resistance in Plasmodium falciparum is common in many endemic and other settings but there is no clear recommendation on when to change therapy when there is delay in parasite clearance after initiation of therapy in African children...

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..AMQ clears parasitemia and reduces gametocyte carriage more rapidly and causes lesser fall in hematocrit than MQ, but both regimens are effective treatment of uncomplicated P. falciparum malaria in Nigerian children...

..Half of the children with recrudescence were still anaemic at 4 weeks. These findings have implications for the control of the burden of malarial anaemia in children in sub-Saharan African countries...

..However, gametocyte males persisted after this period in children with AQ-R infections. AQ-recrudescent infections are relatively low (25 of 612.4%) in children from this endemic area...

..The results are discussed in the light of management of uncomplicated hyperparasitaemia in children in endemic settings...

..falciparum malaria by exerting greater effects on post-treatment gametocyte density and gametocyte sex ratio...

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..PYG may be used as an indicator of response to CQCP but not PS or PS-based combination drugs...

..Hyperparasitaemia is a feature of childhood severe malaria but there is little information on the risk factors for hyperparasitaemia in malarious children..

..76, df = 1, P = 0.009). These results indicate that acute malaria contribute to sub-optimal growth in young children and may have implications for malaria control efforts in sub-Saharan Africa...

..These results suggest that artesunate and artesunate-amodiaquine reduce gametocyte carriage and may reduce transmissibility in P. falciparum malaria by accelerating asexual clearance and influencing gametocyte sex ratio...

..17 and 0.65, respectively). Artemisinin drugs may reduce the extent and rate of fall in PfMAA during treatment and may attenuate malaria-associated anaemia in children...

..This suggests a potential clinical application of the reversal phenomenon...

..Both regimens were well tolerated. Artemether-lumefantrine clears parasitemia more rapidly than ASP but both combinations are effective in treatment of uncomplicated P. falciparum malaria in Nigerian children...

..5, may have implications for malaria control efforts in endemic settings...

..The study protocol was designed to evaluate more closely the early effects and the standard measures of efficacies of these two regimens...

..All regimens were well tolerated. AL, AAcf and AAcp cleared fever and parasitemia rapidly and had similar rates of resolution of MAA after treatment in malarious Nigerian children...

..Continuous monitoring of pfcrt SVMNT haplotype is required in endemic areas of Africa, where artesunate-amodiaquine combination is used for treatment of acute uncomplicated malaria...

..Reduction of gametocyte carriage by these two treatment regimens may reduce transmissibility in P. falciparum malaria, and this reduction is presumed to be related to the accelerated clearance of the asexual forms of the parasite...

..The detection of PIG 72 h after the commencement of CQ treatment may be used as a microscopical indicator of a poor response to CQ in children from this endemic area...

..Both treatments were well tolerated but adverse drug reactions were commoner in the children given PS. CQ/CP is effective in PS treatment failure in Nigerian children and may be useful for this condition in African children in general...

..We assessed the safety, treatment efficacy and effects on gametocyte carriage of the combination of artesunate plus amodiaquine and chloroquine plus pyrimethamine-sulfadoxine in children...

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..falciparum population in Ibadan, Nigeria. The study has also shown the dynamics of P. falciparum infections in this population before and after chloroquine treatment in an area of high malaria transmission...

..These findings may have implications for malaria control efforts in sub-Saharan Africa where control of the disease depends almost entirely on chemotherapy...

..Artesunate-amodiaquine and artemether-lumefantrine remain efficacious treatments of uncomplicated falciparum malaria in Nigerian children 5 years after adoption...

..falciparum malaria from Ibadan - the addition of ketotifen to CQ produced little or no significant enhancement of the antimalarial effect of CQ...

..However, little is known about the prevalence of codon-268 mutations in natural populations of P. falciparum without previous exposure to the drug in Africa...

..Detailed toxicological studies are required to understand the full clinical implications of CP's elevation of erythrocytic CQ concentrations...

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..falciparum malaria. It may therefore be useful as an alternative to CQ in areas of CQ resistance...

..It therefore appears that continuing the use of CQ in areas where some parasites are resistant to the drug may confer survival and propagation advantages on the resistant parasites...

..Further studies are needed before the strength of the association between the point mutations identified as markers of drug resistance and clinical outcome can be accurately evaluated, in this and other regions of intense transmission...

..Pfmdr1 polymorphisms may result in reduction in the therapeutic efficacy of this newly adopted combination treatment for uncomplicated falciparum malaria in Saharan countries of Africa...

..The CQPS and AQPS combinations appear to be well tolerated and may be useful as alternatives to monotherapy with CQ or AQ as resistance to the single drugs develops...

..In resource-poor communities using chloroquine plus chlorpheniramine, the easily identifiable predictors of treatment failure might be used to identify children requiring alternative antimalarial drugs...

..0 days respectively. The study shows that, in Nigeria, CQ is now less effective than AM, S-P, QN and M in acute falciparum malaria in the group most vulnerable to the infection (the under-five-year-olds).(ABSTRACT TRUNCATED AT 250 WORDS)..

..Further development of the procedure will enhance its valuable application in clinical management of drug-resistant malaria in the endemic areas...

..Although the clinical characteristics and responses to oral therapy of children with and without HP are therefore very similar, young children with HP appear to have an increased risk of developing other features of severe malaria...

..Treatment with a CQ-CP combination (CQ and CP for 3 days and then CP alone for another 4 days) is also effective but requires continuing administration after the signs and symptoms of acute malaria have disappeared...

..0005). Mutant T76 allele was detectable in 60% and 57% of blood and saliva samples, respectively. This finding shows rapid detection of pLDH in patient saliva...

..These findings may have implications for malaria management efforts in sub-Saharan Africa...

..falciparum malaria...

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..falciparum to pyrimethamine and sulphadoxine in vitro, but the clinical significance is unclear. We assessed the safety, treatment efficacy, and effects on gametocyte carriage of adding probenecid to pyrimethamine-sulphadoxine...

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..Together, these findings may have implications for malaria-control efforts in all areas of sub-Saharan Africa where treatment of malaria depends almost entirely on antimalarial monotherapy...

..If MBSR is more infective to mosquitoes at low gametocytaemia, then these findings may have significant implications for malaria control efforts in endemic settings where malaria-associated anaemia is common...

..falciparum asexual forms. Estimation of parasite viability indices ex vivo permits comparison of the relative speed of antimalarial drug action...

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..Macrogometocytes are cleared from the circulation faster than microgametocytes but chloroquine treatment of chloroquine-sensitive infections has little or no significant effect on gametocyte sex ratios in this group of children...

..Fixed dose ACT with shorter courses and fewer tablets may be key determinants to ease of administration and compliance...

..The binding kinetics between CQ, resistance-reversing agents, AGP and other plasma proteins will clearly need to elucidated if clinically effective resistance-reversing agents are to be selected in vitro...

..There was no apparent relationship between the indices of parasite- or hepatomegaly-disposition kinetics and the duration of pruritus...

..These results suggest that both drugs are effective in uncomplicated Plasmodium falciparum hyperparasitaemia in children from an endemic area of south-west Nigeria...

..The addition of CP to CQ does not significantly amplify the cardiac effects of CQ in children with acute uncomplicated falciparum malaria...

..8)% (range 75-100). The cure rate on day 14 was 100%. The drug was well tolerated. These results suggest that artemether is rapidly effective in acute recrudescent Plasmodium falciparum malaria and is without deleterious side effects...

..Although sex ratios in Plasmodium may naturally become more male-biased as the infection progresses, it is possible that PS treatment may have contributed to the male-biased sex ratios observed post-treatment...

..Safety of Fansimef for 24 weeks in endemic areas was comparable for standard antimalarials in this trial and provides support for the use of this drug for the treatment of resistant malaria in indigenous African populations...

..These results show that artemether is a potentially useful drug for moderate and severe malaria and its place in the chemotherapy of malaria deserves further study...

..These findings may be important in our understanding of P. falciparum transmission sustenance, response to chloroquine therapy and contribution of chloroquine to gametocyte carriage as seasonal changes occur...

..We therefore suggest that artemether is a good alternative to the currently used drugs in the parenteral treatment of severe but uncomplicated malaria and may be useful in preventing the possible development of cerebral malaria...

..To evaluate the efficacy of two dosing regimens of cotrimoxazole in the treatment of falciparum malaria and compare the efficacy with that of chloroquine, the first-line antimalaria drug in the area of study...

..28). Considering the high level of CQ resistance and drug use in the study area, the observed linkage disequilibrium between the mutant pfcrtT76 and pfmdr1Y86 alleles is maintained epistatically through directional CQ selective pressure...

..The dhfr and dhps quintuple mutant (dhfr triple mutant+dhps double mutant) was the genotype most strongly associated with SP treatment failure (OR=24.72, 95%CI=8.24-74.15) in both younger and older children...

..falciparum. The combination of mutant pfcrtT76 and pfmdr1Y86 alleles may be useful markers for monitoring the development and spread of AQ resistance, when combining this drug with other antimalarials for treatment of malaria in Africa...

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..However, there are no studies on the influence of these diseases on the absorption and pharmacokinetics of caffeine in Africans...

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..33 +/- 0.13) (P=0.00004, 0.0014 respectively). No gross malformations were observed in pups delivered by infected or non-infected animals treated with the combinations of chloroquine and Promethazine...

..falciparum infections on the basis of HRPII based dipstick results alone. Microscopy or PCR diagnosis where possible, should be carried out in order to confirm negative P. falciparum HRPII-based dipstick tests...

..The long transit time of absorbed cyanide in the plasma suggests that frequent intake of gari could cause cyanide to accumulate in the plasma...

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..Falls in haematocrit in the first 3 days after treatment began were similar and <5%. Declines in parasitaemias were monoexponential with both treatments with an estimated half-life of 1?h...

..However, parasite population sex ratios, inbreeding rates and overall parasite rate were unaffected...

..falciparum malaria, and supports the use of the liver 'rate' as a malariometric index for assessing the intensity of transmission in endemic areas...

..Chloroquine/chloropheniramine produces a higher cure rate than chloroquine alone and reverses chloroquine insensitivity in Plasmodium falciparum in vivo. It may be a useful way of optimising the antimalarial effect of chloroquine...

..9; 95% confidence interval=1.2-21.3; P=0.03). These findings may have implications for control efforts in some sub-Saharan African countries, where TS is recommended for the management of malaria in children, with or without pneumonia...

..Ethnomedicine has been shown to be a potential source of antimalarial compounds or source of template for the synthesis of novel antimalarial molecules...

..Despite the ECG abnormalities, there was no clinical symptom. These findings indicate that, in children, the currently recommended dose of halofantrine for the treatment of falciparum malaria may produce serious cardiac side effects...

..Similarly, addition of 1.0 x 10(-6)M verapamil did not affect the activity of mefloquine against the sensitive or resistant parasites...

..The results confirm the efficacy of two of the eight herbal remedies, thereby validating the role of ethnomedicine as a possible source for the discovery of new chemotherapeutic agents in the treatment of P. falciparum malaria...

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