Malaria Medicines Research Articles

Awareness, knowledge, attitude, and practice of adverse drug reaction reporting among health workers in primary health centres participating in seasonal malaria chemoprevention campaign in Nigeria in 2022: a cross-sectional survey

BackgroundEvaluating health workers’ knowledge and practice of adverse drug reaction (ADR) reporting is an important step in identifying gaps in quality ADR reporting during public health interventions like the seasonal malaria chemoprevention (SMC) campaign. Pharmacovigilance (PV) monitoring is vital in SMC due to the number of children exposed to malaria medicines for a period of 4 or 5 months during the campaign. In Nigeria more than 10 million children are exposed to SMC medicines every year. The scale of this intervention emphasised the need for efficient and effective safety monitoring during the campaign. Thus, the objective of this study was to evaluate healthcare workers’ (HCW) awareness, knowledge, attitude and practice (KAP) of ADR reporting in health facilities participating in SMC campaign to identify pharmacovigilance gaps which may suggest possible ways to ensure safety during the campaign.MethodsWorld Health Organization’s service availability and readiness assessment (SARA) recommendations were used to sample 2,598 out of 5,195 used as supervising health facilities (HFs) during the 2022 SMC campaign across nine states of the country. Out of the sampled HFs, 2,144 eligible and consented health facility workers (HFWs) were assessed for awareness, and KAP of ADR using the validated 45-item self-administered questionnaire. The data was analysed using descriptive statistics and correlation analysis at p < 0.05.ResultsThe majority of the respondents are males (n = 1,333, 62.2%). The HFWs showed good awareness (n = 2,037, 95.0%) of pharmacovigilance (PV). However, only 809 (37.7%) of them had good knowledge scores. The mean ADR reporting attitude score (85.0 ± 15.3%) was good with many of the respondents (n = 1,548, 72.2%) having a good score. However, the respondents’ ADR practice was suboptimal, only 1,356 (63.2%) of them had encounters with ADR, and a lot of negative perceived barriers to ADR reporting were identified in the study. For example, 493 (23%) believed that ADRs were not reported because they were not serious and life-threatening while 248 (11.6%) reported a fear of liability. Correlation analysis revealed female gender (r = 0.163, p < 0.001), older age (r = 0.207, p < 0.001) and years of practice (r = 0.050, p = 0.021) as factors significantly associated with ADR knowledge and attitude scores.ConclusionThe study indicated that HCWs across health facilities participating in SMC campaigns have ADR reporting knowledge and practice gaps. The study suggest training alone may not be effective in addressing gaps in ADR reporting. In addition to PV training, implementers can include continuous mentoring of health care workers or other similar interventions as part of strategy to improve ADR reporting. Also, context specific strategies to improve ADR reporting among health care worker needs to be implemented to address under-reporting of ADRs during SMC campaigns and other malaria public health interventions.

Machine Learning Predicts 1-[(4-Fluorophenyl) Methyl] Indole-2,3- Dione as Drug Lead for Peptide Deformylase in Plasmodium falciparum

Malaria continues to be a serious illness for world health. Deadly parasites that cause malaria infect female Anopheles mosquitoes and bite humans are the disease's vector. Since Plasmodium falciparum is the deadliest of the five Plasmodium species and research indicates that medicines for malaria are increasingly revealing drug-resistance mechanisms, it is imperative that new and effective medications be developed. This project aims to identify and produce a novel therapeutic lead against a P. falciparum target that has been validated. Target2Scan, a programmed tool, was employed in this investigation to find potential therapeutic targets for P. falciparum peptide deformylase. After the tool received the target signature, it ran a BLAST methodology to find targets that resembled peptide deformylase. To ascertain the binding affinities of protein-ligand complexes, molecular docking was performed using PyRx and CBDock. Of the 12,561 compounds produced, 11,304 were used as the training set and 1,256 as the test set. Six ligands were produced by machine learning as potential therapeutic leads, and using molecular docking, 1-[(4-fluorophenyl) methyl] indole-2,3-dione showed the greatest biding effect on peptide deformylase when compared to 5-chloro-1-(2-phenylethyl) indole-2,3-dione. The higher binding affinity of 1-[(4-fluorophenyl) methyl] indole-2,3-dione over 5-chloro-1-(2-phenylethyl) indole-2,3-dione and other ligands on peptide deformylase suggests that it has the ability to suppress P. falciparum pepide deformylase activity.

Cytotoxicity Test of Ethyl Acetate Fraction and Ethanol Fraction of Papaya Leaf Extract (Carica Papaya. L) Against Hep-2 Laryngeal Cancer Cells

Papaya leaves are used as medicine for fever, malaria, increased appetite, constipation, and anti-cancer. In the previous study using the Brine Shrimp Lethality Test (BSLT), an ethanol extract of papaya leaf had an LC50 value of 23.73 mg/mL. This suggests that papaya leaves are a compound, that uses a 70% ethanol extract of papaya leaves and has cytotoxic potential. Research objectives: This research aimed to determine the cytotoxic effect of the ethanol and ethyl acetate fractions of a 70 % ethanol extract of papaya leaf against Hep-2 cells. Performed in vitro by the direct calculation method (viable cell count), so its LC50 is known. The ethanol and ethyl acetate fraction of papaya leaf extract as a test solution was made in 5 concentrations, with concentrations of 20.93; 16.26; 12.64; 9.82, and 7.63 µg/ml. Result: The results obtained the LC50 ethanol fraction of 11.2616 μg/ml and the ethyl acetate fraction of LC50 12.4 of 882 μg/ml. Conclusion: Based on this, it can be concluded that the fraction of ethanol and ethyl acetate extracts of papaya (Carica papaya L.) have cytotoxic properties against Hep-2 cells in a range that goes very, very toxic, i.e., 5–50 µg/ml, and have the potential to be developed as an anticancer drug.

Cytotoxic Potential of Compounds Isolated from Non-Polar Fractions of Sungkai Plant Leaves (Peronema canescens Jack) Against Artemia salina Leach Larvae

The sungkai plant (Peronema canescens Jack), belonging to the Lamiaceae family, is a plant that is traditionally used as medicine, including toothache, malaria, and fever medicine. In this research, isolation was carried out with vacuum liquid chromatography (VLC), solid and liquid fractions were obtained. The solid fraction was further separated using column chromatography to obtain the isolated compound as a white solid (amorphous) weighing 10 mg (melting point 140˚C-142˚C). The results of the UV spectrum data show that there are no conjugated double bonds. The results of the IR spectrum show the presence of C-H groups at wave numbers 2921,49 cm-1 and 2856,94 cm-1, C=O groups at wave numbers, C=C groups at wave numbers 1641,51 cm-1, and dimethyl germinal which is characteristic of triterpenoid compounds at wave numbers 1456.68 cm-1 and 1372.41 cm-1. Meanwhile, the isolated oil was analyzed for chemical components using GC-MS. It was discovered that there were 83 chemical compound components contained therein with 4 main compound components, namely pentadecanoic acid (16.65%), 9,12-octadecanoic acid (16.12%), propyl palmitate (7.89%), and hexadecenoic acid, methyl ester (5.59%). A cytotoxic test was carried out on both fractions using the Brine Shrimp Lethality Test (BSLT) method. The results showed that the isolated compound was non-toxic with an LC50 value of 190214.2807 mg/L and the isolated oil was very toxic with an LC50 value of 34.2452 mg/L.

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COVER PHOTOS: Top: Sam Agbor Enow (left) supervises the preparation of malaria medicine injectable artesunate by Nurse Haoua Abba at Bogo District Hospital, Far North Region, Cameroon, September 23, 2021. Sam has been trained to provide Outreach Training Supportive Supervision Plus (OTSS+) to ensure that healthcare providers know, and can follow, national guidelines for correctly diagnosing and treating malaria. Photo Credit: Mwangi Kirubi, PMI Impact Malaria. Bottom left: Nurse Gertrude Doku teaches her team how to conduct a malaria rapid–diagnostic test (mRDT) at the Tinkong Community–Based Health Planning and Services (CHPS) Compound in Ghana. Photo Credit: Emmanuel Attramah, PMI Impact Malaria. Bottom right: A health provider in Zambia provides care to a child with malaria while an Outreach, Training, and Supportive Supervision (OTSS) visit takes place. OTSS is a quality assurance approach at the health–facility level, that uses standard automated checklists centered on continuous improvement of the competencies of health providers in malaria diagnosis and treatment. Photo Credit: PMI Impact Malaria

Treatment-seeking behavior for malaria among communities in Indonesia: A systematic review.

Indonesia stands as one of the nine malaria-endemic countries in Southeast Asia with a total of 443,530 cases in 2022. Eastern Indonesia is listed as an area with high malaria endemicity and the Indonesian government has set a target of eliminating malaria by 2030. From 2010 to 2014, the number of malaria cases decreased but stagnated until 2020 and have continued to increase. Stagnation may occur as a result of many non-medical treatment-seeking behaviors. The aim of this systematic review was to provide a summary and overview of malaria treatment-seeking behavior among communities in several regions in Indonesia. The searches were conducted through four databases (Cochrane, PubMed, Google Scholar, and ScienceDirect) using medical subject headings (MeSH) "treatment-seeking behavior" OR "health-seeking behavior" AND "malaria" AND "Indonesia". This systematic review was limited to studies conducted in Indonesia that were published between 2013 and 2023 using either a quantitative or qualitative approach. Out of 2831 studies, a total of thirteen studies were included. The pattern of seeking malaria treatment varied between doing nothing or no action, self-treatment (purchasing drugs at pharmacies and consuming leftover medicines), traditional medicine, and medical treatment (public health facilities or malaria control clinics). Those behaviors are attributed to education level, socioeconomic level, occupation, distance from home to health facilities, geographical conditions, and people's perceptions of malaria and antimalarial medicines. There is still a range of malaria treatment-seeking behavior outside of recommended medical treatment in communities in several regions in Indonesia. The phenomenon of medical pluralism and syncretism requires approaches from various sectors in order to achieve a malaria-free Indonesia by 2030.

Profiles of global mutations in the human intercellular adhesion molecule-1 (ICAM-1) shed light on population-specific malaria susceptibility

Plasmodium falciparum is responsible for malaria-related morbidity and mortality. PfEMP1 (P. falciparum erythrocyte membrane protein 1) mediates infected erythrocytes adhesion to various surface vascular receptors, including intercellular adhesion molecule-1 (ICAM-1), associating this interaction with severe malaria in several studies. Genetic variation in host ICAM-1 plays a significant role in determining susceptibility to malaria infection via clinical phenotypes such as the ICAM-1Kilifi variant which has been reported to be associated with susceptibility in populations. Our genomic and structural analysis of single nucleotide polymorphisms (SNPs) in ICAM-1 revealed 9 unique mutations each in its distinct A-type and BC-type PfEMP1 DBLβ-interacting regions. These mutations are noted in only a few field isolates and mainly in the African/African American population. The ICAM-1Kilifi variant lies in a flexible loop proximal to the DBLβ-interacting region. This analysis will assist in establishing functional correlations of reported global mutations via experimental and clinical studies and in the tailored design of population-specific genetic surveillance studies. Understanding host polymorphism as an evolutionary force in diverse populations can help to predict predisposition to disease severity and will contribute towards laying the framework for designing population-specific personalized medicines for severe malaria.

Assessment of the Global Fund-supported procurement and supply chain reforms at the Ethiopian Pharmaceuticals Supply Agency: a mixed-methods study

ObjectiveThe Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) partnered with the Ethiopian Pharmaceutical Supply Agency (EPSA) in 2018–2019 to reform procurement and supply chain management (PSCM) procedures...

Cluster-based lateral transshipments for the Zambian health supply chain

Many low- and middle-income countries, including Zambia, suffer from unreliable distribution of health commodities leading to high variation in service levels across health facilities. Our work investigates how transshipment can improve system-wide service levels, equity across facilities, and average inventory levels. We focus on the distribution of malaria medicines in Zambia’s public pharmaceutical supply chain, which is heavily impacted by the rainy season leading to seasonality and uncertainty in demand and lead times. We use the more advanced deep reinforcement learning method Proximal Policy Optimization to develop transshipment policies and compare their performance with currently available, easy-to-use heuristics. To ensure that the model applies to settings of a realistic scale, we adopt a policy architecture that effectively decouples the policy’s complexity from the problem dimensions. We find that deep reinforcement learning is mainly useful in resource-constrained environments where system-wide inventory is scarce. When sufficient inventory is available, transshipment heuristics are more appealing from an overall cost-effectiveness perspective. Based on our numerical experiments, we formulate policy insights that can support policymakers in a humanitarian health context.

Assessing the acceptability and feasibility of reactive drug administration for malaria elimination in a Plasmodium vivax predominant setting: a qualitative study in two provinces in Thailand

BackgroundReactive case detection (RACD) or testing and treatment of close contacts of recent malaria cases, is commonly practiced in settings approaching malaria elimination, but standard diagnostics have limited sensitivity to detect low level infections. Reactive drug administration (RDA), or presumptive treatment without testing, is an alternative approach, but better understanding regarding community acceptability and operational feasibility are needed.MethodsA qualitative study was conducted as part of a two-arm cluster randomized-controlled trial evaluating the effectiveness of RDA targeting high-risk villages and forest workers for reducing Plasmodium vivax and P. falciparum malaria in Thailand. Key informant interviews (KIIs) and focus group discussions (FGDs) were conducted virtually among key public health staff, village health volunteers (VHVs), and household members that implemented or received RDA activities. Transcriptions were reviewed, coded, and managed manually using Dedoose qualitative data analysis software, then underwent qualitative content analysis to identify key themes.ResultsRDA was well accepted by household members and public health staff that implemented it. RDA participation was driven by fear of contracting malaria, eagerness to receive protection provided by malaria medicines, and the increased access to health care. Concerns were raised about the safety of taking malaria medicines without having an illness, particularly if underlying health conditions existed. Health promotion hospital (HPH) staff implementing RDA noted its operational feasibility, but highlighted difficulty in traveling to remote areas, and requested additional travel resources and hiring more VHVs. Other challenges were highlighted including the need for additional training for VHVs on malaria activities and the inability of HPH staff to conduct RDA due to other health priorities (e.g., Covid-19). More training and practice for VHVs were noted as ways to improve implementation of RDA.ConclusionsTo maximize uptake of RDA, regular education and sensitization campaigns in collaboration with village leaders on the purpose and rationale of RDA will be critical. To alleviate safety concerns and increase participant safety, a rigorous pharmacovigilance program will be important. To accelerate uptake of RDA, trust between HPH staff and VHVs and the communities they serve must continue to be strengthened to ensure acceptance of the intervention.Trial registrationThis study was approved by the Committee on Human Research at the University of California San Francisco (19–28,060) and the local Ethics Committee for Research in Human Subjects at Tak Provincial Health office (009/63) and Kanchanaburi Provincial health office (Kor Chor 0032.002/2185). Local authorities and health officers in the provinces, districts, and villages agreed upon and coordinated the implementation of the study. All methods in this study were carried out in accordance with relevant guidelines and regulations.

Identification and analysis of aromatic components in Piper sarmentosum Roxb. from Meru Betiri National Park

Piper sarmentosum Roxb or known as mana Karuk is an aromatic plant that has extraordinary potential, namely as a mucus expectorant, its roots are efficacious as a ureter and overcome gallstones. This plant is also used as an asthma drug, a cure for skin diseases such as tinea versicolor, stomach pain, malaria medicine, relieve bone pain and dental pain. The components of aromatic chemical compounds in the leaves and fruits from Meru Betiri National Park (MBNP) have not been identified. This study aimed to identify and analyze the aromatic components of P. sarmentosum leaves and fruits from MBNP using SPME-GCMS. The research method is laboratory research. The research samples and research materials were the leaves and fruit of the P. sarmentosum plant taken in MBNP. The SPME-GCMS tool is used in research to identify and analyze aromatic compounds. The research instrument used was an identification and analysis sheet of aromatic compounds from the P. sarmentosum plant. The data analysis technique uses the SPME-GCMS test. The results of the study showed that there were 46 volatile compounds found in the leaves, while in the fruit there were 29 volatile compounds. The main aromatic compound groups in the leaves and fruits of P. sarmentosum are terpenes, namely monoterpene. The other components consist of organic benzene compounds. P. sarmentosum Roxb. has 46 aromatic compounds in the leaves and 29 other aromatic compounds found in the fruit. Furthermore, research results must be tested in more depth regarding biological activity and mechanism of action through the best methods so that they can be recommended as new drug innovations in society.

Cytoplasmic isoleucyl tRNA synthetase as an attractive multistage antimalarial drug target.

Development of antimalarial compounds into clinical candidates remains costly and arduous without detailed knowledge of the target. As resistance increases and treatment options at various stages of disease are limited, it is critical to identify multistage drug targets that are readily interrogated in biochemical assays. Whole-genome sequencing of 18 parasite clones evolved using thienopyrimidine compounds with submicromolar, rapid-killing, pan-life cycle antiparasitic activity showed that all had acquired mutations in the P. falciparum cytoplasmic isoleucyl tRNA synthetase (cIRS). Engineering two of the mutations into drug-naïve parasites recapitulated the resistance phenotype, and parasites with conditional knockdowns of cIRS became hypersensitive to two thienopyrimidines. Purified recombinant P. vivax cIRS inhibition, cross-resistance, and biochemical assays indicated a noncompetitive, allosteric binding site that is distinct from that of known cIRS inhibitors mupirocin and reveromycin A.Our data show that Plasmodium cIRS is an important chemically and genetically validated target for next-generation medicines for malaria.

Malaria Illness and Accessing Healthcare in an African Indigenous Population: A Qualitative Study of the Lived Experiences of Uganda’s Batwa in Kanungu District

Purpose: Malaria continues to be a public health threat, especially in sub-Saharan Africa, including Uganda. While Batwa Indigenous People (IPs) face a higher burden of malaria, there is limited understanding of their malaria-lived experiences. We assessed and characterized malaria illness and accessing healthcare lived experiences of the Batwa in Kanungu district to inform contextually and culturally appropriate public health interventions. Methods: An exploratory qualitative study was conducted in 5 Batwa settlements where 5 Focus Group Discussions (n = 36) and 13 Key Informant Interviews (n = 13) were held. Data were collected using printed guides and voice recorders in April 2018. Transcripts from the data that captured the lived experiences of the symptoms, prevention, treatment and barriers to accessing formal healthcare services were applied to Atlas.ti a qualitative data analysis software and condensed into codes, categories, and themes. Results: Many Batwa have experienced malaria in their households, and they know its causes and risk factors, like not sleeping under insecticide-treated mosquito nets (ITNs), living near water bodies, prevention measures like the use of ITNs, and vector management. The lived experiences demonstrate malaria management by an Indigenous population in a rural setting and comprised detecting malaria symptoms, use of herbs as first line of treatment, buying medicines from drug shops, and village health teams (VHTs) treatment. For many Batwa accessing formal healthcare is normally a second option. Barriers for malaria treatment included: long distances to health facilities, geographically difficult terrain, economic constraints, irregular health outreaches, and stockouts of malaria medicines at health facilities. Conclusion: This study characterized Batwa’s malaria illness lived experiences and access to healthcare in rural remote settings. These experiences are essential in appreciating the ways in which Indigenous populations understand and manage common illnesses and how appropriate policies and interventions can be developed.

A Synthesis and Review of Ethnomedicinal Uses, Phytochemistry and Biological Activities of Paropsia brazzeana Baill. (Passifloraceae)

Paropsia brazzeana is a shrub used traditionally to treat various human diseases and ailments. Paropsia brazzeana naturally occurs from Cameroon and the Central African Republic south to Angola, the Caprivi strip of Namibia, Botswana and Zimbabwe. The aim of this review was to provide an overview and critically analyze the ethnomedical uses, phytochemistry and biological activities of P. brazzeana. The results of the current study are based on literature survey conducted using various search engines such as Elsevier, Pubmed, Google scholar, Springer, Science Direct, Taylor and Francis, and pre-electronic sources such as books, book chapters, scientific journals and other grey literature. The fruit, leaf, leaf sap, root, root bark and stem bark decoction or infusion of P. brazzeana are mainly used as charm and rituals, and traditional medicine for gastro-intestinal infections, gonorrhoea, malaria and toothache. Chemical constituents identified from P. brazzeana include alkaloids, hydrocyanic acid, polyphenol, proanthocyanidins, reducing sugars, saponins, steroids, tannins and terpenes. The species possesses biological activities such as antiamoebic, antibacterial and antispasmodic activities. Paropsia brazzeana is a valuable medicinal plant species and future research should focus on animal experiments aimed at assessing toxicity and clinical efficacy of species extracts.

Botanical Description, Traditional Uses, Phytochemistry, and Pharmacology of the Genus Artabotrys: A Review.

Artabotrys is a genus of small trees in the family Annonaceae. This genus contained over 100 perennial medicinal plants available in the old world tropics. Artabotrys plants have a lengthy history of use in medicine for malaria, diarrhea, backache, and scrofula treatments, as well as some of which were used as tea-like beverages. About 90 reports were reviewed from inception to now, in which the decoctions of about 9 species were used in traditional folk medicines. With 234 isolated compounds, Artabotrys metabolites can be classified as alkaloids, terpenoids, sterols, flavonoids, polyoxygenated cyclohexenes, fatty acids, acetogenins, etc. Significantly, alkaloidal aporphines were separated and identified as the main isolates. Artabotrys plants are also rich in the essential oils. Especially, A. hexapetalus exerted a great role in perfumery industry. Artabotrys constituents possessed various pharmacological values, such as antioxidative, antidiabetic, hepatoprotective, and mosquito repellency, but cytotoxic and antimicrobial activities are the most striking features. In conclusion, Artabotrys plant extracts and their metabolites are of great socio-economic importance, thereby more and more phytochemical and pharmacological investigations are expected.

Access and Adequate Utilization of Malaria Control Interventions among Women of Childbearing Age from 15 to 49 years in Badbaado IDPs Settlements, Mogadishu, Somalia

Background: Although there is limited national data and statistics on the burden of malaria in Somalia, it is considered a&amp;nbsp;major public health problem&amp;nbsp;in the country. children below 5 years, pregnant, lactating women and non-immune migrants carry most of the disease burden. the world malaria report 2020 estimated that there were around 759,000 cases and 1,942 deaths in Somalia in 2019.&#x0D; &#x0D; Aim of the study: The purpose of this study is to explore the results of a rapid assessment of the extent of current access and adequate utilization of malaria control interventions among women of childbearing age from 15 to 49 years in Badbaado IDPs Settlements, Dharkenley District, Mogadishu, Somalia. &#x0D; &#x0D; Method: This study applied a non-probability purposive sampling strategy for recruiting study participants. A total of 150 women aged 15 to 49 years old were selected, and semi-structured questionnaires were the main data collection methods. The data was analyzed using SPSS version 23 and used a P-value of 95% to assess associations between variables with &amp;le;0.05 regarded as a statistically significant.&#x0D; &#x0D; Results: The incidence of malaria among respondents was 59 cases (39.3%), of which 39 (66.1%) were mothers followed by 17 cases (28.8%) of children under the age of five years. The vast majority of 51 (63.0%) of the respondents who seek treatment confirmed that the distance from the health facility to their residence is about three kilometers or further. The majority of 39 (66.1%) of the respondents who were infected with malaria did not take the malaria medicine, while non-availability and/or non-affordability of the prescribed medicines in the clinics was the reason for not taking the medicine. Most of the respondents, 140 out of 150 of the study participants (93.3%), confirmed that they did not get any malarial services in their internally displaced persons IDPs settlements. Almost all of the respondents&amp;rsquo; household members 147 (98%) did not own insecticide-treated bed nets (ITNs), reasoning that due to the lack of distribution of ITNs and the unaffordability of their costs. &#x0D; &#x0D; Conclusion and Recommendation: The study revealed a high incidence of malaria cases. However, this study recommends the government and other stakeholders should provide funding to establish IDPs settlements clinics and increase mobile teams to provide adequate and accessible public health services to combat malaria in these vulnerable populations.

Aktivitas Antibakteri Ekstrak Kulit Batang Tumbuhan Johar (Senna siamea Lam) pada Berbagai Polaritas Pelarut

Johar plant is a type of plant from the Fabaceae family which is widely used in traditional medicine such as malaria, itching and diabetes medicine. This study aims to determine the antibacterial activity of Johar stem bark extract with different levels of solvent polarity on the growth of Staphylococcus aureus and Escherichia coli bacteria and to determine the active compound class by TLC-Bioautography. The extraction of active compounds used a multilevel maceration method starting with n-hexane (non polar), followed by ethyl acetate (semi-polar) and ethanol (polar) solvents. Antibacterial activity testing was carried out by diffusion well method with a concentration variant of 25% and 50%. The results showed that n-hexane, ethyl acetate, and ethanol extract had antibacterial activity against the two test bacteria. Ethyl acetate and ethanol extract from Johar stem bark at a concentration of 50% were classified as very strong antibacterials with inhibition zone diameters against S. aureus, which were 22.02±0.84 mm and 20.16±0.23 mm, respectively. The results of the TLC-Bioautography test showed that the three test extracts had strong antibacterial activity against S. aureus and E. coli. In the n-hexane extract with n-hexane: ethyl acetate (9:1) eluent using Lieberman-Burchard spray reagent, it was suspected that triterpenoid compounds were present. In ethyl acetate extract with n-hexane: ethyl acetate (6:4) eluent and ethanol extract with chloroform: methanol (8:2) eluent using FeCl3 1% spray reagent, it was suspected that the tannin compound was present in both extracts.

Mitigating health policy fragmentation through interlocks. The networks between American and Swiss public-private partnerships

The boards of health partnerships such as the Roll Back Malaria Partnership (RBM) and Medicines for Malaria Venture (MMV) create networks through cross-board membership (interlocks). While these networks bear the risk of cooptation and collusion in corporate governance, in public-private partnerships they may facilitate cooperation and responsiveness to health policy. This is feasible only through networks with specific characteristics discussed in this article. The analysis shows one whole network connecting 10 health partnerships established in Canada, Switzerland and United Sates, and belonging to two different subsectors (Product Development and Coordination and Financing). However, confluence on a few central interlocks makes the behavior of interlock individuals and organizations crucial for the effectiveness of the network, rendering good governance practices all the more important. At the same time, network clustering opens the possibility of tackling interdependencies at sub-level where expertise can be critically brought to bear. The article shows that, whether considered as a vector of collusion or as a bridge for coordination, the practice of overlooking partnership interlocks hinders both health policy oversight and strategic operation.

THE EFFECT OF CONCENTRATION AND FREQUENCY OF GIBERELLINS ON THE GROWTH OF ARTEMISIA ANNUA Linn

Artemisia is one of the plants that can be used as an alternative medicine for malaria. The Artemisia plant contains secondary metabolites in the form of artemisinin compounds that function as antimalarials. One of the efforts that can be done to increase the growth of Artemisia annua. plants is by using a growth regulator of gibberellins (GA3). Using a Randomized Block Factorial Designs (RBFD) with the first factor being the concentration of 50 mg.L-1 (K1), mg.L-1(K2), 150 mg.L-1 (K3), 200 mg.L-1 (K4). The second factor has 3 frequencies, 1 time giving 7HSPT (F1), 2 times giving 7HSPT and 14HSPT (F2), and 3 times giving 7HSPT, 14HSPT and 30HSPT (F3). In addition, there were plants that were not given GA3 control (without treatment). Parameters observed were plant height, leaf area, glandular trichome density, and plant dry weight. The results showed that the administration of gibberellins (GA3) with different concentrations and frequencies on plant height, leaf area, glandular trichome density, and dry weight of A. annua plants had no significant effect. Plants have not been able to grow properly because the provision of gibberellins that have not been active stimulates all plant tissues and directly seeps through the roots, stems and leaves.

KADAR TOTAL FLAVONOID DAN AKTIVITAS ANTIOKSIDAN FRAKSI n-HEKSANA DAUN GAHARU (Gyrinops versteegii)

The use of herbal medicines as antioxidants has increased recently. One of them is gaharu leaf (Gyrinops versteegii). Gaharu plants have been widely used by people to treat various types of diseases. Papuan people have used the roots, bark and leaves of gaharu as malaria medicine and skin treatment. This research intended to ascertain the total content of flavonoids and antioxidant capacity of the n-hexane fraction in gaharu leaves’ extract. A total amount of 100 g dry powders of gaharu leaves, with water content of 8.59%, macerated with 96% ethanol, resulted in 10 g of concentrated extract obtained by evaporation using vacuum rotary evaporator. This extract then proceeded to the fractionation stage using solvents such as n-hexane, chloroform and ethyl acetate. The results obtained were 5.66 g of n-hexane, 2.23 g of chloroform, 0.85 g of ethyl acetate and 1.14 g of the remaining water extract. Phytochemical screening showed that the n-hexane extract positively contained flavonoids with the highest total flavonoid contents of 1557.66 mg QE/100 g. In-vitro test for the antioxidant activity of the n-hexane fraction utilizing the procedure of DPPH (1,1-diphenyl-2-picrylhydrazyl) showed the IC50 value of 126.76 ppm. These results indicate that the n-Hexane fraction of gaharu leaves’ extract has a high total flavonoid contents and consists of active antioxidant compounds with medium capacity.&#x0D; Keywords: oxidative stress, flavonoids, fraction n-Hexane, DPPH and antioxidant&#x0D;