Doses Of SP Research Articles

Socio-demographic and regional disparities in utilization of intermittent preventive treatment for malaria in pregnancy - Nigeria demographic health survey 2013.

Introductionmalaria in pregnancy can lead to medical emergencies. Utilization of intermittent preventive treatment for prevention of malaria in pregnancy with Sulphadoxine- Pyrimethamine (IPTp-SP) has remained low in developing countries in sub-Saharan Africa. This study aimed to identify the factors determining uptake of IPTp-SP in Nigeria using the 2013 Nigeria Demographic Health Survey.Methodswe conducted a secondary analysis of data extracted from the National Demographic Health Survey 2013 which used a three stage stratified sampling method to select respondents. Independent variables considered were age, marital status, the level of education of respondents and their spouses, region, location of residence, wealth-index and birth order. The dependent variable was the use of two or more doses of SP for IPTp in the two years before the survey. Descriptive statistics for socio-demographic and selected characteristics was done. Chi-square test was used to test associations between sociodemographic characteristics and IPTp-SP uptake. Multiple logistic regressions at 95% confidence interval were used to determine predictors of IPTp utilization using STATA version14 software.Resultsof the 38,948 women interviewed 12,473 (32%) had given birth two years preceding the survey and 15% used at least two doses of SP for IPTp. Women aged 30 years and above [aOR 1.4, C.I:1.1-1.7], in the middle class or higher wealth index [aOR 1.5, CI: 1.1-2.0], with two or more ANC visits [aOR 4.2, CI: 1.4 - 12.5], were more likely to use IPTp.Conclusionlate initiation of IPTp after the second trimester was a contributory factor for poor SP utilization. Interventions targeted at ensuring pregnant women attend ANC and use of IPTp-SP after quickening should be promoted.

Impact evaluation of malaria control interventions on morbidity and all-cause child mortality in Mali, 2000\u20132012

BackgroundMajor investments have been made since 2001, with intensification of malaria control interventions after 2006. Interventions included free distribution of insecticide-treated nets (ITN) to pregnant women and children under 5 years old, the introduction of artemisinin combination therapy (ACT) for malaria treatment, and indoor residual spraying of insecticides. Funders include the Government of Mali, the Global Fund to Fight AIDS, Tuberculosis and Malaria, and the US President’s Malaria Initiative.MethodsData from nationally representative household surveys conducted from 2000 to 2015 was used to performed the trend analysis for malaria intervention coverage, prevalence of morbidities among children under 5 years old [parasitemia and severe anaemia (< 8 g/dl)], and all-cause mortality of children under 5 (ACCM). Prevalence of contextual factors likely to contribute to ACCM were also assessed. The impact of these interventions was assessed on malaria morbidity and mortality using a plausibility argument. With the assumption that malaria contributes significantly to under-five mortality in settings with high malaria transmission, associations between malaria control interventions and all-cause under-five mortality (ACCM) were assessed taking into account other contextual factors related to child survival.ResultsIntervention coverage improved significantly from 2006 to 2012. Household ownership of ITN increased from 49% in 2006 to 84% in 2012. ITN use also increased over the same period, from 26% in 2006 to 69% in 2012 among children under 5 and from 28% in 2006 to 73% in 2012 among pregnant women. The coverage of intermittent preventive treatment in pregnancy (IPTp) using two or more doses of SP increased from 10% in 2006 to 29% in 2012. In 2010, 23% of febrile children under 5 received ACT, as opposed to 19% in 2012. The prevalence of Plasmodium falciparum infection increased from 2010 (38.6%) to 2012 (51.6%), followed by a decrease in 2015 (35.8%). The prevalence of severe anaemia decreased from 2010 (26.3%) to 2012 (20.6%) and continued to decline in 2015 (19.9%). An impressive decline in ACCM was observed, from 225 in 1997–2001 to 192 in 2002–2006 and 95 in 2008–2012. Changes in contextual factors such as climate, socio-economic, nutrition, and coverage of maternal and child health interventions over the evaluation period did not favour reductions in ACCM, and are therefore unlikely to explain the observed results.ConclusionsTaken as a whole, the evidence supports the conclusion that malaria control interventions substantially contributed to the observed decline in ACCM in Mali from 2000 to 2012, even in the context of continued high prevalence of parasitaemia explained by contextual factors such as climate change and political instability.

Uptake of intermittent preventive treatment for malaria during pregnancy with Sulphadoxine-Pyrimethamine (IPTp-SP) among postpartum women in Zomba District, Malawi: a cross-sectional study

BackgroundMalaria in pregnancy causes adverse birth outcomes. Intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine (IPTp-SP) is recommended as a chemoprevention therapy. Zomba district IPTp uptake falls far below the national average. The study was conducted to assess determinants of IPTp-SP uptake during pregnancy among postpartum women in Zomba district after adoption of new IPTp-SP policy in 2014.MethodsThis was a cross-sectional survey. Two public health facilities (HFs) were randomly selected from urban and rural areas in Zomba district. Study participants were postpartum women selected by using exit poll method from HFs. A total of 463 postpartum women were interviewed using structured questionnaire. Bivariate and multiple logistic regression was used in data analysis.ResultsOut of all the enrolled participants (n = 463), 92% women had complete information for analysis. Of these, (n = 426) women, 127 (29.8%, 95% CI: 25.6%–34.3%) received three or more doses of SP, 299 (70.2%, 95% CI: 65.7%–74.4%) received two or less doses. Women receiving SP from rural HF were less likely to get at least three doses of SP than urban women, (AOR = 0.31, 95% CI 0.13–0.70); Others less likely were those with three or few antenatal care (ANC) visits versus four or more visits (AOR = 0.29, 95% CI 0.18–0.48); not taking SP under direct observation therapy (DOT) (AOR = 0.18, 95% CI (0.05–0.63).ConclusionsThere is low utilisation of at least three doses of SP in this population and this seems to be associated with the number of ANC visits and use of DOTs. These determinants may therefore be important in shaping interventions aimed at increasing the uptake of IPTp in this district. In addition, the rural urban differential suggests the need for further research to understand the barriers and enablers of uptake in each context in order to improve the health of the community.

Adherence to Intermittent Preventive Treatment of Malaria in Pregnancy with Sulfadoxine–Pyrimethamine and Associated Factors: A Cross-Sectional Survey in Benin’s Public Hospitals.

Background: Gestational malaria is a public health problem, thus responsible for morbidity and mortality risk to both the foetus and the mother. The intermittent preventive treatment with sulfadoxine-pyrimethamine during pregnancy (IPTp-SP) is one of the strategies recommended by the WHO to prevent this pathology and its consequences during pregnancy. In Benin, the adherence rate remains below the programmatic targets. This study aimed to identify the factors associated to the adherence to at least two IPTp-SP doses for postpartum women of the University Hospital HKM of Cotonou (CNHU-HKM) and the University Hospital for Mother and Child (CHU-MEL) of Cotonou. Methods: A cross-sectional hospital-based study was conducted over a 3-month-period, from July to September 2015 in the field of gynaecology and obstetrics departments of the two hospitals. All the mothers who had delivered and were still hospitalized at the time of the study were enrolled. Results: During their last pregnancy, 63.11% of women had taken at least two doses of IPTp-SP. Four determinants of adherence to the two IPTp-SP doses were associated to the adherence to two doses of IPTp-SP: i) adequate knowledge of the number of doses of SP to be taken during the pregnancy (p-value&lt;0.0001), ii) participation in communication for social and behavioural change on IPTp-SP (p-value&lt;0.0001), iii) adequate knowledge of the number of tablets per dose of SP (p-value=0.0100), and iv) comprehensive knowledge of malaria prevention measures during pregnancy (p-value=0.0200). Conclusion: Raising and improving women's knowledge on malaria are necessary to achieve ITPp-SP adherence. Particular emphasis should therefore be placed on communication for social and behavioural change for pregnant women, family decision-makers, community leaders and healthcare workers.

Investigation of pregnancy-associated malaria by microscopy, rapid diagnostic test and PCR in Bandundu, the Democratic Republic of Congo.

The study was conducted to investigate malaria prevalence among a group of women in the Democratic Republic of Congo (DRC) who received intermittent preventive treatment in pregnancy with sulfadoxine-pyrimethamine (IPTp-SP). A total of 250 women from Bandundu city who received two doses of IPTp-SP were enrolled in the survey. Blood samples were collected at the time of delivery and malaria prevalence was determined using microscopy, rapid diagnostic test (RDT), and nested polymerase chain reaction (PCR). Malaria infection was detected in 81 (32.4%), 93 (37.2%), and 92 (36.8%) samples by microscopy, RDT, and PCR, respectively. Among 92 samples, P. falciparum mono-infection (n=87; 94.5%), P. falciparum+P. vivax (n=2; 2.2%) and P. falciparum+P. malariae (n=1; 1.1%) mixed infections, and P. vivax mono-infection (n=2; 2.2%) were detected. Prevalence of malaria was not affected by age and number of pregnancies (p>0.05). Microscopy and RDT, either alone (κ=0.29; p<0.001) or in combination (κ=0.33; p<0.001) showed a fair agreement with PCR. Our findings indicate that two doses of IPTp-SP did not protect the women against malaria in the DRC, and support the World Health Organization (WHO) guidelines that ensure a minimum of three doses of SP in pregnancy.

Evaluation of Malaria Screening during Pregnancy with Rapid Diagnostic Tests Performed by Community Health Workers in Burkina Faso

One of the current strategies to prevent malaria in pregnancy is intermittent preventive treatment with sulfadoxine-pyrimethamine (IPTp-SP). However, in order for pregnant women to receive an adequate number of SP doses, they should attend a health facility on a regular basis. In addition, SP resistance may decrease IPTp-SP efficacy. New or additional interventions for preventing malaria during pregnancy are therefore warranted. Because it is known that community health workers (CHWs) can diagnose and treat malaria in children, in this study screening and treatment of malaria in pregnancy by CHWs was evaluated as an addition to the regular IPTp-SP program. CHWs used rapid diagnostic tests (RDTs) for screening and artemether-lumefantrine was given in case of a positive RDT. Overall, CHWs were able to conduct RDTs with a sensitivity of 81.5% (95% confidence interval [CI] 67.9-90.2) and high specificity of 92.1% (95% CI 89.9-93.9) compared with microscopy. After a positive RDT, 79.1% of women received artemether-lumefantrine. When treatment was not given, this was largely due to the woman being already under treatment. Almost all treated women finished the full course of artemether-lumefantrine (96.4%). In conclusion, CHWs are capable of performing RDTs with high specificity and acceptable sensitivity, the latter being dependent on the limit of detection of RDTs. Furthermore, CHWs showed excellent adherence to test results and treatment guidelines, suggesting they can be deployed for screen and treat approaches of malaria in pregnancy.

Effects of different doses of silk peptide on energy metabolism during exercise in mice

[Purpose]This study was carried out to determine the optimal dose of silk peptide for enhancing fat metabolism during exercise. [Methods]Fifty male ICR mice were randomly divided into five groups: Sed, SP0, SP200, SP400, and SP800. All SP mice underwent training by running on a treadmill 5 times a week for 2 weeks (20 m/min, 8° slope, 50 min/day for the first week and 25 m/min, 8° slope, 50 min/day at about 70-75% of maximum oxygen uptake for the second week). [Results]After the 2 weeks, fat oxidation was measured during a 1-h exercise at the training conditions of the second week and was found to be 1.02 ± 0.15, 1.04 ± 0.17, 0.98 ± 0.10, 1.14 ± 0.19, and 1.15 ± 0.07 g/kg/h for Sed, SP0, SP200, SP400, and SP800 groups, respectively. The SP800 group had significantly higher fat oxidation levels than the SP0 group did at 36, 40, and 56 min and the Sed group did at 2, 4, 6, 8, 12, 14, 16, 20, 40, 46, 50, 52, 56, and 60 min. However, there was no significant difference among the groups in carbohydrate oxidation during the 1-h exercise. SP doses of 200 mg/kg and 400 mg/kg did not show any effect on fat and carbohydrate oxidation. [Conclusion]In conclusion, 800 mg/kg of silk peptide is the optimal dose for enhancing fat metabolism during exercise. In addition, silk peptide treatment could reduce body weight by enhancing fat metabolism.

Monitoring Compliance and Acceptability of Intermittent Preventive Treatment of Malaria Using Sulfadoxine Pyrimethamine after Ten Years of Implementation in Tanzania.

Intermittent preventive treatment using SP (IPTp-SP) is still a superior interventional approach to control malaria during pregnancy. However its rate of use has gone down tremendously in malaria endemic areas. This study forms part of a larger study aimed at monitoring the compliance of IPTp-SP policy in malaria endemic areas of Tanzania. Two cross-sectional studies were conducted in Dar es Salaam and Njombe Regions of Tanzania. Overall, 540 pregnant women and 21 healthcare workers were interviewed using structured questionnaires. This study revealed that 63% of women were not willing to take SP during pregnancy while 91% would only take it if they tested positive for malaria during antennal visits. 63% of the interviewed women did not know the recommended dose of SP required during pregnancy, despite the fact that 82% of the women were aware of the adverse effect of malaria during pregnancy. It was found out that 54% of pregnant women (30–40 weeks) took single dose, 34% took two doses, and 16% did not take SP at the time of interview. It was also found that SP was not administered under direct observed therapy in 86% of women. There was no significant relationship between number of doses received by pregnant women and antenatal clinic (ANC) start date (r2 = 0.0033, 95% CI (−0.016 to 0.034)). However positive correlation between drug uptake and drug availability was revealed (p = 0.0001). Knowledge on adverse effects of placental malaria among pregnant women was significantly associated with drug uptake (OR 11.81, 95% CI (5.755–24.23), p = 0.0001). We conclude that unavailability of drugs in ANC is the major reason hindering the implementation of IPTp-SP.

Metabolic fate of glucose in rats with traumatic brain injury and pyruvate or glucose treatments: A NMR spectroscopy study

Administration of sodium pyruvate (SP; 9.08 μmol/kg, i.p.), ethyl pyruvate (EP; 0.34 μmol/kg, i.p.) or glucose (GLC; 11.1 μmol/kg, i.p.) to rats after unilateral controlled cortical impact (CCI) injury has been reported to reduce neuronal loss and improve cerebral metabolism. In the present study these doses of each fuel or 8% saline (SAL; 5.47 nmoles/kg) were administered immediately and at 1, 3, 6 and 23 h post-CCI. At 24 h all CCI groups and non-treated Sham injury controls were infused with [1,2 13C] glucose for 68 min 13C nuclear magnetic resonance (NMR) spectra were obtained from cortex + hippocampus tissues from left (injured) and right (contralateral) hemispheres. All three fuels increased lactate labeling to a similar degree in the injured hemisphere. The amount of lactate labeled via the pentose phosphate and pyruvate recycling (PPP + PR) pathway increased in CCI-SAL and was not improved by SP, EP, and GLC treatments. Oxidative metabolism, as assessed by glutamate labeling, was reduced in CCI-SAL animals. The greatest improvement in oxidative metabolism was observed in animals treated with SP and fewer improvements after EP or GLC treatments. Compared to SAL, all three fuels restored glutamate and glutamine labeling via pyruvate carboxylase (PC), suggesting improved astrocyte metabolism following fuel treatment. Only SP treatments restored the amount of [4 13C] glutamate labeled by the PPP + PR pathway to sham levels. Milder injury effects in the contralateral hemisphere appear normalized by either SP or EP treatments, as increases in the total pool of 13C lactate and labeling of lactate in glycolysis, or decreases in the ratio of PC/PDH labeling of glutamine, were found only for CCI-SAL and CCI-GLC groups compared to Sham. The doses of SP, EP and GLC examined in this study all enhanced lactate labeling and restored astrocyte-specific PC activity but differentially affected neuronal metabolism after CCI injury. The restoration of astrocyte metabolism by all three fuel treatments may partially underlie their abilities to improve cerebral glucose utilization and to reduce neuronal loss following CCI injury.

Scaling-up the use of sulfadoxine-pyrimethamine for the preventive treatment of malaria in pregnancy: results and lessons on scalability, costs and programme impact from three local government areas in Sokoto State, Nigeria.

BackgroundIntermittent preventive treatment of malaria in pregnancy with 3+ doses of sulfadoxine-pyrimethamine (IPTp-SP) reduces maternal mortality and stillbirths in malaria endemic areas. Between December 2014 and December 2015, a project to scale up IPTp-SP to all pregnant women was implemented in three local government areas (LGA) of Sokoto State, Nigeria. The intervention included community education and mobilization, household distribution of SP, and community health information systems that reminded mothers of upcoming SP doses. Health facility IPTp-SP distribution continued in three intervention (population 661,606) and one counterfactual (population 167,971) LGAs. During the project lifespan, 31,493 pregnant women were eligible for at least one dose of IPTp-SP.MethodsCommunity and facility data on IPTp-SP distribution were collected in all four LGAs. Data from a subset of 9427 pregnant women, who were followed through 42 days postpartum, were analysed to assess associations between SP dosages and newborn status. Nominal cost and expense data in 2015 Nigerian Naira were obtained from expenditure records on the distribution of SP.ResultsEighty-two percent (n = 25,841) of eligible women received one or more doses of IPTp-SP. The SP1 coverage was 95% in the intervention LGAs; 26% in the counterfactual. Measurable SP3+ coverage was 45% in the intervention and 0% in the counterfactual LGAs. The mean number of SP doses in the intervention LGAs was 2.1; 0.4 in the counterfactual. Increased doses of IPTp-SP were associated with linear increases in newborn head circumference and lower odds of stillbirth. Any antenatal care utilization predicted larger newborn head circumference and lower odds of stillbirth. The cost of delivering three doses of SP, inclusive of the cost of medicines, was US$0.93–$1.20.ConclusionsIt is feasible, safe, and affordable to scale up the delivery of high impact IPTp-SP interventions in low resource malaria endemic settings, where few women access facility-based maternal health services. ClinicalTrials.gov Identifier NCT02758353. Registered 29 April 2016, retrospectively registeredElectronic supplementary materialThe online version of this article (doi:10.1186/s12936-016-1578-x) contains supplementary material, which is available to authorized users.

The toxicity of brown algae (sargassum sp) extract to mice (mus muscullus)

Indonesian is a country with very large and overflow marine biological resources. Utilization of seaweed has been developed and become a source of revenue for Indonesian who live in coastal areas with high potential for seaweed.The demand of seaweed in the world increases as increasing in the use of seaweed for various purposeamong others in the fields of industry, food, textile, paper, paints, cosmetics, medical and pharmaceutical field. Alginate is one of materials that commonly used in the field of dentistry as printed materials to create study models. Materials in the field of dentistry must be biocompatible to the oral cavity tissues. The materials should be stable, safe, comfortable, and certainly doesn’t have a toxicity character to the oral cavity tissues and other tissues in human body. The purpose of this study is to know the toxicity of extract brown algaeSargassum sp given orally to mice.The research perform experimental laboratory research type withexperimental post-tes-only control group design. The reseach samples applyfemales white mice (Mus muscullus). Research samples divided into 5 groups of 5 female mices for each treatment group. Treatment group 1 was given 500mg/kgBW doses of Sargassum sp, group 2 was given 1000mg/KgBW doses of Sargassum sp, group 3 was given 1500mg/KgBW doses of Sargassum sp, group 4 were 2000mg/KgBW doses of Sargassum sp, and a control group was given only dose of Na CMC. The result of this study isdose in humans are converted into 2000mg/KgBW in mice, is a doses that doesn’t cause the death of whole animals. Based of acute toxicity category, the extracts of Sargassum sp that obtained from Punaga Takalar Regency, South Sulawesi includes in the mild toxic.

Determinants of timely uptake of ITN and SP (IPT) and pregnancy time protected against malaria in Bukoba, Tanzania.

ObjectiveInsecticides treated nets (ITNs) and intermittent preventive therapy with two doses of sulfadoxine-pyrimethamine (SP IPTp) are the cornerstone for malaria control in pregnancy. Despite the coverage of these interventions being high, it is not known whether they confer optimal protection time against malaria in pregnancy. This study investigated the timing and determinants of timely uptake of SP(IPTp) and ITNs and the pregnancy time protected.MethodsA health facility based cross-sectional study was carried out in Bukoba urban district from 16th April to 29 May 2013. Involving pregnant women and post natal mothers attending Reproductive and Child Health (RCH) clinics. Data on their socio-economic background, pregnancy history and attendance to RCH, receipt of a voucher and acquisition of an ITN as well as SP for IPTp were collected. Their responses were validated from the records of antenatal cards. Data was analysed using SPSS computer program version 20.ResultsA total of 530 mothers were recruited. The overall uptake of SP IPTp was 96 % and the uptake of two SP (IPTp) doses was 86 %. Timely uptake of 1st dose was predicted by early antenatal booking, [AOR 2.59; 95 % CI 1.51–4.46; P = 0.001], and the availability of SP at the facility [AOR 4.63; 95 % CI 2.51–8.54; P < 0.0001]. Uptake of 2nd dose was independent of any predictor factors. A total of 486 (91.6 %) women received ITNs discount vouchers at different gestational age and of these, less than a quarter (21.4 %) received timely. Timely receipt of discount voucher was highly predicted by early antenatal booking [AOR 200; 95 % CI 80.38–498; P < 0.0001].ConclusionAlthough there is a high coverage of SP IPTp and discount vouchers for ITNs, timely uptake and therefore optimal protection time depended on early antenatal booking, the availability of (SP IPTp) and discount voucher at the health facility.

Usage patterns of paracetamol in France.

The aim of the present study was to describe the real-life usage patterns of paracetamol. The Echantillon Généraliste de Bénéficiaires (EGB) database, the permanent 1/97 representative sample from the French national healthcare insurance system, was searched in 2011 to identify usage patterns, concomitant chronic diseases and use of cardiovascular medication in users prescribed single-ingredient (SP) and combination (CP) paracetamol, representing 85% of all sales. Of 526 108 subjects aged ≥15years in the EGB, 268 725 (51%) had paracetamol dispensed on ≥1 occasion; of these, 207 707 (77%) were dispensed only SP and 61 018 (23%) received CP with or without SP. SP users were younger (48.3years vs. 50.5years), and 57% of SP users vs. 58% of CP users were female. Chronic comorbidities were more common in CP than SP users. SP users had, on average, 3.4 dispensings per year vs. 5.0 for CP users, for 36 defined daily doses (DDD, 3g) of SP vs. 53 DDD per year for CP; 49% SP users bought 14 DDD or fewer; 15% bought >60 DDD. Use of paracetamol increased with age from about 16 DDD per year in 15-30-year-olds to over 90 DDD per year in patients above the age of 75; 53% of patients ≤60years bought fewer than 14 DDD per year, whereas 55% of those >60 bought more than 30 DDD per year. More than half the dispensings exceeded the legal per-box limit of 8g. Over 50% of the French adult population were dispensed paracetamol at least once over the course of a year, generally for short-term use. Considering recent misgivings on the real efficacy and safety of paracetamol, such widespread use might have important public health consequences.

Combined application of chitinolytic bacterium Paenibacillus sp. D1 with low doses of chemical pesticides for better control of Helicoverpa armigera

ABSTRACTHelicoverpa armigera is a serious pest of Cajanus cajan in many parts of world. Rapid development of resistance against number of insecticides and cry toxin-based biocontrol agents has led to search for biocontrol agents with alternative mode of action. The ability of chitinolytic bacteria to degrade vital chitinous structure in insects suggests their potential in insect control. The present investigation was carried out to study insect control potential of a high chitinase producing bacterium, Paenibacillus sp. D1. Biocontrol studies with Helicoverpa larvae showed Paenibacillus sp. D1 and its chitinase to be potent antifeedant that reduced the feeding rate and body weight of the larvae. The decreased body weight was attributed to hydrolysis of the chitinous structures of the larvae. This was evident from decrease in the total chitin content and increased mortality of the larvae fed on the leaves treated with Paenibacillus sp. D1 and chitinase as compared to untreated controls. A combined dose of Paenibacillus sp. D1 or its chitinase with an organophosphate insecticide, acephate, was found to be more lethal than their individual treatments suggesting integrated insect control potential of the bacterium.

Assessment of the usage and effectiveness of intermittent preventive treatment and insecticide-treated nets on the indicators of malaria among pregnant women attending antenatal care in the Buea Health District, Cameroon.

BackgroundMalaria in pregnancy is an immense public health problem with at least 50 million pregnant women living in malaria endemic areas. To prevent malaria and its complications in pregnancy the World Health Organization recommends the use of intermittent preventive treatment sulfadoxine–pyrimethamine (IPTp-SP), the use of insecticide-treated nets (ITNs), and effective case management. In most malaria endemic countries in Africa, 40 % of pregnant women sleep under ITNs. In Cameroon, about 90 % of pregnant women receive the first dose of SP, while 64 % take the complete dose. Following the 2011 mass-campaign of free distribution of ITNs coupled with routine ANC distribution of ITN and adoption of IPTp in Cameroon, little has been done to assess the effectiveness of both interventions outside of Yaoundé, the capital city. This study sought to assess the usage and effectiveness of IPTp-SP and ITNs on malaria in pregnancy.MethodsThe research was a cross-sectional hospital-based study that included 410 pregnant women attending antenatal clinics in the Buea Health District. Capillary blood samples were collected to check malaria parasite by microscopy and haemoglobin levels by microhaematocrit technique.ResultsA prevalence of 13.4 and 41.7 % was detected for malaria and anaemia, respectively. The Overall coverage of ITN was 32.4 % while that of ITPp was 63.2 %. Malaria prevalence was least (7.2 %) amongst women using both IPTp-SP and ITN while those with no intervention had the highest malaria prevalence of 18.6 % (χ2 = 6.188; P = 0.103). Of the women with malaria, 12.73 % were using ITN and had taken at least one dose of SP, 38.18 % had taken at least one dose IPTp only, 10.91 % were using only ITN and 38.18 % were not using any preventive measure. There was a difference in anaemia status within the different intervention groups (χ2 = 8.673; P = 0.034). Pregnant women using both interventions were less associated to malaria (OR = 0.341, 95 % CI = 0.138–0.841) compared to those using only one control method.ConclusionRepeated doses of SP in combination with ITN use are effective in reducing malaria parasitaemia and improving haemoglobin level of pregnant women.

Bacteriological control by Raoultella sp. R11 on growth and toxins production of Microcystis aeruginosa

Microcystis aeruginosa is a cyanobacterium that can cause harmful algal blooms (HABs) in freshwater bodies. In this study, the bacterium Raoultella sp. R11 was evaluated for its ability to control the growth of M. aeruginosa. Algal growth, denitrification activity, and toxin production were measured in the presence of various concentrations of Raoultella sp. R11. The algicidal effects of Raoultella sp. R11 were studied by measuring the zeta potential (surface charge), the activity of superoxide dismutase (SOD), and the concentrations of chlorophyll-a, dissolved organic matter, and microcystin-LR in algal cultures. The results suggested that chlorophyll-a removal, which indicates algal death, was correlated with the dose of Raoultella sp. R11. The zeta potential and denitrification activity decreased in the presence of bacteria in a dose-dependent manner. SOD activity was correlated with the inoculation dosage of Raoultella sp. R11. Using a 30% (v/v) dose of bacterial culture, the removal efficiency of chlorophyll-a was as high as 94.28% after 6days. In addition, dissolved microbial metabolites and humic acid were detected in high quantities whereas low quantities of protein-like substances and fulvic acid were found. Furthermore, toxic microcystin-LR produced by the algae was eliminated at up to 92.21% efficiency. A high denitrification rate (1.57mg NO3--NL−1h−1) and chlorophyll-a removal efficiency (73.12%) were observed within 6days at an inoculation dosage of 20% (v/v) of bacterial culture. Our findings indicated that Raoultella sp. R11 has a high potential for applications in simultaneously controlling M. aeruginosa and facilitating denitrification in freshwater bodies.

Factors influencing utilization of intermittent preventive treatment for pregnancy in the Gushegu district, Ghana, 2013.

IntroductionThe coverage of adequate (≥2 doses) IPTp-SP in Ghana is below the national target of 80% and that is a threat to reducing the incidence of malaria in pregnancy. The primary objective of the study was to determine the client and facility related factors associated with adequate uptake of IPTp-SP and suggest approaches for increased uptake.MethodsA cross sectional study was conducted among ANC clients and staff in Gushegu, questionnaires was administered to 330 conveniently sampled nursing mothers and all ANC staff present. A checklist and observation were used to collect health facility data. Data was analyzed descriptively and associations between the related factors and adequate uptake of IPTp-SP were determined.ResultsA total of 91.5% and 8.5% of respondents took adequate (≥2doses) and inadequate (≤1dose) IPTp-SP respectively. 85.4% respondents were early first ANC attendance and 80% were multiple gravidae. Mean ANC visits was 5.0 (standard deviation = 2.2). The key determinants for inadequate uptake of IPTp were Unemployment [OR= 4.9 95% CI (1.9-13.1], single gravidae [OR= 3.4 95% CI (1.5-7.6)] and late first ANC visit [OR= 6.8 95% CI (3.0-15.4)]. DOT practice, good staff attitude and health talk at the facility were observed and confirmed by ANC clients as satisfactory. adequate uptake of SP among respondents was high. Majorities were unemployed, have had multiple pregnancies and made early first ANC visits. Unemployment and late first ANC visits are significantly associated with taking inadequate SP dose.ConclusionAdequate uptake of SP among respondents was high. Majorities were unemployed, have had multiple pregnancies and made early first ANC visits. Unemployment and late first ANC visits are significantly associated with taking inadequate SP dose.

Evaluation of substance-P toxicity with single dose and repeated dose in rats

Toxicity study evaluating the effects of intravenous injection of SP with single- and repeated-dose in rats was performed. Single 100, 50, and 10 mg/kg doses of SP were administered and animals were monitored for 14 days. Although 10 mg/kg dose did not affect behavior and survival, 100 and 50 mg/kg doses elicited mortality, suggesting the minimum lethal dose (MLD) of SP to be between 10 and 50 mg/kg. To evaluate the toxicity of repeated dosing, rats were injected twice first two days per week with 30, 10, and 3 mg/kg of SP over 2 weeks and evaluated for survival, behavior, hematological factors, and organ weight. All rats administered with 10 and 3 mg/kg SP survived with minor changes in behavior and hematological indices. Thus, certain poison dose was estimated to be approximately 3 mg/kg, indicating that application of SP below 3mg/kg may not be associated with toxicity.

High prevalence of dhfr and dhps molecular markers in Plasmodium falciparum in pregnant women of Nchelenge district, Northern Zambia.

BackgroundSulphadoxine-pyrimethamine (SP) is the recommended drug for intermittent preventive treatment in pregnancy (IPTp) in most African countries, including Zambia. However, malaria is still one of the leading causes of morbidity and mortality in pregnant women despite reports of greater than 50% of women taking at least two doses of SP in IPTp. Studies have shown that resistance to SP is associated with mutations in the dhfr and dhps gene of Plasmodium falciparum. This study examined the prevalence of dhfr and dhps polymorphisms in P. falciparum found in pregnant women of Nchelenge district.MethodThis cross-sectional study was conducted in 2013 in Nchelenge, a holoendemic area with malaria prevalence estimated at 50% throughout the year. Three rural health centres were randomly selected and a census survey carried out at each health centre. A questionnaire was administered and malaria testing done using RDT and microscopy, with collection of a dried blood spot. A chelex extraction was done to extract parasite DNA from dried blood spots followed by nested PCR and enzyme restriction digestion.ResultsOf the enrolled participants (n = 375), the median age of the women was 23. The prevalence of malaria by PCR was 22%. The PCR positive samples examined (n = 72) showed a high prevalence of dhfr triple (Asn-108 + Arg-59 + Ile-59) mutant (68%) and dhps double (Gly -437 + Glu-540) mutant (21%). The quintuple haplotype was found in 17% with 2 samples with an additional Gly-581mutation. In addition 6% mutations at Val-16 were found and none found at Thr-108 respectively, these both confer resistance to cycloguanil. Multivariate analysis showed that there was an association between malaria and women aged 30-34 years old p < 0.05(AOR: 0.36) at 95% CI.ConclusionThis study showed a high number of mutations in the dhfr and dhps genes. The high malaria endemicity in the general population of this area may have contributed to the high prevalence of resistant parasites in pregnant women, suggesting a need to examine the efficacy of SP given that it is the only approved drug for IPTp in Zambia.

Antenatal care visit attendance, intermittent preventive treatment during pregnancy (IPTp) and malaria parasitaemia at delivery.

BackgroundThe determinants and barriers for delivery and uptake of IPTp vary with different regions in sub-Saharan Africa. This study evaluated the determinants of ANC clinic attendance and IPTp-SP uptake among parturient women from Mount Cameroon Area and hypothesized that time of first ANC clinic attendance could influence uptake of IPTp-SP/dosage and consequently malaria parasite infection status at delivery.MethodsTwo cross sectional surveys were carried out at the Government Medical Centre in the Mutengene Health Area, Mt Cameroon Area from March to October 2007 and June 2008 to April 2009. Consented parturient women were consecutively enrolled in both surveys. In 2007, socio-demographic data, ANC clinic attendance, gestational age, fever history and reported use/dosage of IPTp-SP were documented using a structured questionnaire. In the second survey only IPT-SP usage/dosage was recorded. Malaria parasitaemia at delivery was determined by blood smear microscopy and placental histology.Results and discussionIn 2007, among the 287 women interviewed, 2.2%, 59.7%, and 38.1% enrolled in the first, second and third trimester respectively. About 90% of women received at least one dose SP but only 53% received the two doses in 2007 and by 2009 IPTp-two doses coverage increased to 64%. Early clinic attendance was associated (P = 0.016) with fever history while being unmarried (OR = 2.2; 95% CI: 1.3-3.8) was significantly associated with fewer clinic visits (<4visits). Women who received one SP dose (OR = 3.7; 95% CI: 2.0-6.8) were more likely not to have attended ≥ 4visits. A higher proportion (P < 0.001) of women with first visit during the third trimester received only one dose, meanwhile, those who had an early first ANC attendance were more likely (OR = 0.4; 95% CI = 0.2 - 0.7) to receive two or more doses. Microscopic parasitaemia at delivery was frequent (P = 0.007) among women who enrolled in the third trimester and had received only one SP dose than in those with two doses.ConclusionIn the study area, late first ANC clinic enrolment and fewer clinic visits may prevent the uptake of two SP doses and education on early and regular ANC clinic visits can increase IPTp coverage.