Management Of Malaria Research Articles

Antimalarial activity of borrelidin and fumagilin in Plasmodium berghei-infected mice.

Malaria remains a significant global health burden, with drug resistance posing a major challenge to its control. The emergence of resistance to antimalarial drugs represents a critical issue in malaria management, as it heightens the likelihood of morbidity and mortality associated with the disease. There is an urgent requirement for a novel candidate drug with a distinct mechanism of action. In light of the ongoing challenges in malaria management, particularly the emergence of drug resistance, this study aimed to investigate the efficacy of a novel combination therapy of borrelidin and fumagilin against Plasmodium berghei infection on Swiss Webster mice. The findings of this study could contribute to developing new and effective antimalarial treatments. This study employed a unique approach, using Swiss Webster mice aged 6-8 weeks and dividing them into five groups, each with five mice. The therapeutic efficacy of the combination treatment was evaluated through a comprehensive assessment of parasitemia levels, survival rates, and histological changes in the liver and spleen. This rigorous methodology ensures the reliability and validity of our findings. The combination of borrelidin and fumagilin led to the lowest parasitemia at 5%, contrasting with the control group reaching 15%. Moreover, the combination group exhibited the highest inhibition rate of 69.6% on day nine post-infection. Histopathological alterations were limited to sinusoid dilation, hepatocyte ballooning, and the presence of hemozoin. These findings suggest that the combination of borrelidin and fumagilin holds promise as a potential antimalarial therapy.

Assessing the Malaria Burden and Community Response to the Malaria Control and Management Programs in Omoro District, Northern Uganda.

Background: Malaria remains the leading cause of hospitalization and death in the healthcare system. This study explored the malaria burden and community response to government malaria control programs in Omoro district. Method: This retrospective study involved 576 patient results from purposely selected health facilities data from health center III (HCIII) of Odek, Bobi, and Lapainat and health center IV (HCIV) of Lalogi. And prospective random section study involved 288 participants from Lutori and Lagude cells and Atyang A and Lagwaya villages who consented to answer the pretested questionnaire. Results: The prevalence of malaria in Omoro district in 2018 and 2019 was 81.6% and 97.2% for hospital record positivity and community surveys, respectively. The participants had 100% knowledge of malaria signs, symptoms, and cause. The average number of malaria attacks an individual received in the district from the health facility and community data was three. Nonadherence to government control programs was associated with an increased incidence of malaria infections. From questionnaire, the proportion of people that used local herbal remedies for treatment and prevention of malaria were 21.2% of the sampled 288 participants. Conclusion: The high rate of malaria attacks indicates that the area has a high prevalence of malaria-carrying mosquitoes. The increase in the proportion of malaria attacks in 2019 suggests that the burden of malaria increased compared with that in the previous year, with approximately 21% of local herbal remedies for malaria treatment and management. The findings of this study suggest that malaria attacks are associated with household size, age, sex, occupation, and the household head. Participants who did not respond positively to government programs experienced more malaria attacks. These findings can be used to develop interventions to reduce the incidence of malaria in this population.

Plant-based nanoparticles targeting malaria management.

Malaria is one of the most devastating diseases across the globe, particularly in low-income countries in Sub-Saharan Africa. The increasing incidence of malaria morbidity is mainly due to the shortcomings of preventative measures such as the lack of vaccines and inappropriate control over the parasite vector. Additionally, high mortality rates arise from therapeutic failures due to poor patient adherence and drug resistance development. Although the causative pathogen (Plasmodium spp.) is an intracellular parasite, the recommended antimalarial drugs show large volumes of distribution and low-to no-specificity towards the host cell. This leads to severe side effects that hamper patient compliance and promote the emergence of drug-resistant strains. Recent research efforts are promising to enable the discovery of new antimalarial agents; however, the lack of efficient means to achieve targeted delivery remains a concern, given the risk of further resistance development. New strategies based on green nanotechnologies are a promising avenue for malaria management due to their potential to eliminate malaria vectors (Anopheles sp.) and to encapsulate existing and emerging antimalarial agents and deliver them to different target sites. In this review we summarized studies on the use of plant-derived nanoparticles as cost-effective preventative measures against malaria parasites, starting from the vector stage. We also reviewed plant-based nanoengineering strategies to target malaria parasites, and further discussed the site-specific delivery of natural products using ligand-decorated nanoparticles that act through receptors on the host cells or malaria parasites. The exploration of traditionally established plant medicines, surface-engineered nanoparticles and the molecular targets of parasite/host cells may provide valuable insights for future discovery of antimalarial drugs and open new avenues for advancing science toward the goal of malaria eradication.

In silico studies of benzothiazole derivatives as potential inhibitors of Anopheles funestus and Anopheles gambiae trehalase.

In malaria management, insecticides play a crucial role in targeting disease vectors. Benzothiazole derivatives have also been reported to possess insecticidal properties, among several other properties they exhibit. The female Anopheles mosquito is responsible for transmitting the malaria parasite when infected. Anopheles gambiae (Ag) and Anopheles funestus (Af) are two of the most notable Anopheles species known to spread malaria in Nigeria. Trehalase is an enzyme that breaks down trehalose. Recent research has proposed it as a viable target for inhibition since it aids in flight and stress adaptation. This study aimed to investigate benzothiazole derivatives as potential inhibitors of trehalase of Anopheles funestus (AfTre) and Anopheles gambiae (AgTre) using toxicity profiling, molecular docking, and dynamic simulation for future insecticidal intervention. A total of 4,214 benzothiazole-based compounds were obtained from the PubChem database and subjected to screening against the 3D modelled structure of AfTre and AgTre. Compounds with some toxicity levels were optimised, and the obtained lead compounds were further investigated through molecular docking studies. Furthermore, the best hit was subjected to parameters such as RMSD, RMSF, SASA, Rg, and hydrogen bond to confirm its stability when in a complex with AfTre, and these parameters were compared to that of validamycin A (control ligand). The post-screening analysis showed binding affinities of -8.7 and -8.2kcal/mol (compound 1), -8.2 and -7.4kcal/mol (compound 2), compared to -6.3 and -5.1kcal/mol (Validamycin A, a known inhibitor) against AfTre and AgTre, respectively. The molecular dynamics simulation showed that compound 1 (the best hit) had good stability when in complex with AfTre. These findings suggest that these best hits can serve as potential inhibitors for the development of novel insecticides in the control of malaria vectors.

Funding and compliance to Test-before-Treat recommendation in management of uncomplicated malaria among primary health care workers in Anambra State, Nigeria - a cross-sectional comparative study

Funding and compliance to Test-before-Treat recommendation in management of uncomplicated malaria among primary health care workers in Anambra State, Nigeria - a cross-sectional comparative study

Exploring the hidden mental health consequences of malaria beyond the fever.

Malaria morbidity has various presentations and the focus now shifts to uncommon signs and symptoms of malaria infection such as cognitive impairment to address the morbidity when the mortality declines. About 50% of children admitted to hospitals due to malaria experience neurological complications due to factors like low blood sugar, inflammation, elevated pressure, decreased oxygen levels, and excitotoxicity. Malaria during pregnancy negatively also impacts children's cognitive, behavioral, and executive function leading to neurodevelopmental delay due to increased susceptibility which can significantly affect maternal and child health, leading to higher rates of underestimated factors like anxiety, depression, and PTSD. Despite having the world's second-largest tribal population, India's indigenous and tribal communities and their mental health are less explored and less understood. Western psychological tools and neurocognitive assessment tools are not universally applicable, thus necessitating the development of tailored tools to investigate psychological or neurocognitive impairment. This paper has illuminated the hidden mental health consequences of malaria infection, emphasizing the prevalence, nature, and implications of psychological distress among affected individuals. The findings underscore the importance of recognizing and addressing these psychological consequences in the holistic management and prevention of malaria and its mental health consequences.

Clinico-epidemiological profiles & outcome of severe malaria in children under-five in the tribal area of Kalahandi, Odisha.

Severe malaria is a cause of excess mortality and morbidity in children in malaria-endemic areas where indigenous people live. Currently, available reports are all from secondary or tertiary care hospitals across India and some African countries. The objective of this study was to assess the clinical and epidemiological profiles of children under five years in two primary care health centres located in tribal-dominant Thuamul Rampur Block of Kalahandi district, Odisha. The outcome of management of severe malaria in these children was also assessed. A retrospective review of case records of children under five years of age diagnosed and admitted with severe malaria in two non-governmental primary care facilities between 2017 and 2022, was undertaken. There was a declining trend in malaria cases documented in primary care health facilities between January 2017 and June 2022. Of the 4858 cases recorded, 242 (4.9%) had severe malaria, of whom 70.7 per cent (n=171) were children under 5 yr. The median age of the study children was 24 months (16-36). Children aged 1-2 yr had a significantly higher risk of malaria. The majority were tribals (87%), more than half the children presented with neurological manifestations (64.4%), and 49.6 per cent had respiratory manifestations, while 20.5 per cent had severe anaemia (Hb <5 g/dl). Most, 167 (97.7%) severe malaria was due to Plasmodium falciparum. Thirty-two percent of children were severely wasted (WHZ < -3 SD) and 28 per cent were moderately wasted (WHZ <-2 SD). There was no fatality among the 171 children who were managed for severe malaria in the two primary care facilities. In high endemic areas severe malaria is predominantly a disease of under-five children and is caused by P. falciparum. Clinical manifestations of severe malaria in children can be varied and life-threatening. Primary health facilities can manage severe malaria successfully, thereby reducing child mortality. Effective collaboration between malaria control and nutrition intervention programmes is essential for appropriate case management.

Assessment of the performance of five malaria rapid diagnostic tests in health facilities in Abidjan (Côte d'Ivoire).

Regular monitoring of malaria rapid diagnostic tests (RDTs) for the management of uncomplicated malaria in healthcare facilities is a key factor in improving diagnostic quality and ensuring better case management. This study aimed to assess the performance of five RDTs (Standard Q Malaria P.f Ag and Standard Q Malaria P.f/Pan (SD Biosensor, Korea), One Step Malaria HRP2/pLDH (P.f/Pan) (Guangzhou Wondfo Biotech Co., Ltd., China), Malaria Pf/Pan (B&O Pharm, France), and Malaria test P.f/pan (Das Labor, Germany)) in two healthcare facilities in Abidjan. This cross-sectional study was conducted between September and October 2022. Overall, 250 patients suffering from uncomplicated malaria were included with a predominance of female patients (56.6%). The mean age was 22.3 years (SD = 20.6; range, 0.17-73). Of the patients tested, forty-six (46) tested positive for thick smears, reflecting a prevalence of 18.5%. Plasmodium falciparum was the most commonly detected species (93.5%). The geometric mean parasitemia was 6,111.80 parasites/μl (SD = 80,026.93) (range: 116-412461). The sensitivity ranged from 95.24% to 95.65%, whereas the specificity ranged from 93.07 to 94.09% for all five tests evaluated. The false positive rate of the tests was less than 10%. No invalid test results were reported. Two-thirds of P. malariae cases detected by microscopy showed also positive results with all the RDTs. All five RDTs showed 100% sensitivity at low parasitemia levels (< 1,000 parasites/μl blood) including three cases of parasites < 200 parasites/μl blood. This study demonstrated the importance of monitoring the performance of RDTs in clinical samples.

Factors influencing health workers' adherence to malaria treatment guidelines in under-five children in Nigeria: A scoping review.

Malaria is a leading cause of mortality in children aged 5 years and below in Nigeria. Treatment guidelines stipulate among other recommendations, testing by microscopy or a rapid diagnostic test (RDT) before treatment. Non-adherence to these guidelines portends a challenge, especially among vulnerable under-five children. This study explored the factors influencing Nigerian public health workers' (HWs) adherence to these guidelines in under-five children. A review of literature published between 2011- 2023 was conducted on Web of Science, Ovid Embase, Medline, Global Health, CAB Abstracts, Scopus, and Global Index Medicus. Data was extracted and analyzed under 4 themes: diagnosis, compliance with test results, use of recommended treatment, post-treatment counselling and severe malaria management. Nineteen (19) studies were included for review. Training and supervision, RDT and antimalarial availability, good knowledge of, and positive perception of RDTs promoted adherence to mRDT use. A lack of confidence in RDTs and age (≥ 40 years) fuelled presumptive treatment, especially among clinicians. mRDT and artemisinin-based combination therapy (ACT) stockouts dissuaded HWs from adhering to case management guidelines. Caregiver pressure for treatment was identified as a barrier to compliance with test results. It is important to design context-specific strategies to improve adherence to guidelines for malaria case management, especially in under-five children. Training on the guidelines should be tailored, needs-based, and continuous, and HWs should be supportively supervised in implementing case management. Maintaining an adequate supply of quality-assured mRDTs and antimalarials can facilitate adherence to the guidelines.

Intensive Care Management of Severe Malaria in Low Income Country

Objectives: The aim of this study was to evaluate the management of severe malaria at the Niamey National Hospital (NNH). Patients and Methods: Prospective study was conducted in intensive care unit (ICU) of the Niamey National Hospital, from September, 2020 to October, 2021. Data collected included: age, sex, medical history, temperature (°C), oxygen saturation (%), neurological, respiratory and circulatory distress, biological exams, treatment, prognostic and the mortality. The data was processed and analyzed by Word 2019 and Epi infos 7.2. Results: The sample included thirty-six patients admitted in intensive care unit (ICU) for severe malaria. Hospital prevalence was 9.54%. The mean age of patients was 20.69 years with extremes of 3 years and 47 years; sex ratio was 1.25 (M/F). In this study 78% of our patients had no médical history. Patients had fever in 25% of cases. Neurological signs were dominated by convulsions with 52.77%. Clinically patients had respiratory distress 25% and circulatory distress represent 42% of cases. Hepatomegaly was present in 22% of cases and icterus for 10.1%. The average parasite density was 320 elements/μL with extremes ranging from 120 to 14800 parasites/μL. Severe anemia was encountered in 47% of cases and 89 % of patients have ionic disorders. Hyperparasitemia was found for 19% of cases and acute renal failure in 11%. Neurological form dominated with 64% of cases. All of our patients had received intravenous artesunate. Evolution was favorable in 89% of cases and the mortality rate was 8%. The average length of hospital stay in intensive care was 6.69 days. Conclusion: Severe malaria is frequent in intensive care, nevertheless it’s clinical and paraclinical manifestations are serious, constituting life-threatening distress. The trend was favourable in the majority of cases.

Effects of formal education on malaria knowledge among people attending Federal Medical Centre, Owerri, Imo State, Nigeria

Globally, malaria continues to be a life-threatening infectious disease in more than 100 countries. It is endemic in Africa, especially Nigeria where it is a major cause of morbidity and mortality. It affects all age brackets but more severe among children under the age of 5 and pregnant women. This study was undertaken to evaluate the knowledge of people attending health care at Federal Medical Centre (FMC), Owerri in Imo State, Nigeria on malaria with emphasis on causes, signs and symptoms, preventions, and management of the disease. The study was conducted in Federal Medical Centre, Owerri Imo state, Southeast Nigeria. This cross-sectional hospital based study was conducted on 250 participants. A well-structured questionnaire was administered to elicit information on socio-demographic characteristics and respondents’ knowledge on cause, signs and symptoms, prevention and management of malaria. The socio-demographic variables for the respondents showed that 26.0% had no formal education, whereas 74.0% had formal education. On the knowledge of causes of malaria, 67.4% of the educated study populace had sound knowledge against their counterpart that had 31.9%. Regarding knowledge of malaria signs and symptoms, the respondent without and with formal education had 40.34% and 79.7% respectively. The respondents without formal education had 38.0% against their counterpart that had 61.3% knowledge on malaria prevention. With respect to knowledge on management of malaria, those that had formal education reported 88.9% knowledge, while the participants without formal education recorded 38.8%. Generally, respondents with formal education had significantly better knowledge than those without formal education.

Comparative study of malaria course

Globally in 2022, there were an estimated 249 million malaria cases and 608 000 malaria deaths in 85 countries. Malaria is a major cause of death in tropical and sub-tropical countries, killing each year over 1 million people globally. Although effective ways to manage malaria now exist, the number of malaria cases is still increasing, due to several factors. In this emergency situation, prompt and effective diagnostic methods are essential for the management and control of malaria. The most common early symptoms of malaria are fever, headache and chills. Symptoms usually start within 10– 15 days of getting bitten by an infected mosquito. Symptoms may be mild for some people, especially for those who have had a malaria infection before. Because some malaria symptoms are not specific, getting tested early is important. For primary malaria vivax the symptoms such as non-typical fever, nausea, vomiting, myalgia, absence of tachycardia, severe anemia, normocytosis in blood are characteristic for a significant part of cases, while the neurological disturbance is observed during the severe course. At the same time, heart, liver, and kidney complications are observed during the mild course that is necessary to consider during the diagnosis and disease treatment. Keywords: Malaria vivax, prodromal period, fever, alanine aminotransferase, aspartate aminotransferase

Access to healthcare services and confidence in healthcare professionals’ management of malaria: the views of Francophone sub-Saharan African Immigrants living in western Canada

BackgroundThere is a paucity of knowledge about the healthcare attitudes and practices of French-speaking immigrants originating from Sub-Saharan Africa (FISSA) living in minority settings. The purpose of this study was to characterize FISSA healthcare experiences and confidence in the malaria-related knowledge of health professionals in Edmonton.MethodsA structured survey was used to examine a cohort of 382 FISSA (48% female; 52% male) living in Edmonton. FISSA general healthcare attitudes, experiences and satisfaction with the Canadian healthcare system were studied. Healthcare Competency Perception (HCP) was characterized by using an index score. Statistical analyses were performed to evaluate the impact of healthcare experiences and other outcomes.ResultsIntriguingly, while only 42% of FISSA had a French-speaking family physician, 83% (197/238) of those who had received health care services in Alberta found that access to medical treatment was easy, and 77% (188/243) were satisfied with received care. Although 70% (171/243) of FISSA did not receive services in French, 82% (199/243) surprisingly reported having good levels of comprehension during their visits. Satisfaction with care was associated with having a family physician (p = 0.018) and having health insurance (p = 0.041). Nevertheless, confidence in the healthcare system’s ability to treat malaria effectively was significantly lower, with only 39% (148/382) receiving a positive score on the HCP index.ConclusionThis study provides an important insight into FISSA experience with and perception of the Alberta’s healthcare system.

Antiplasmodial Profiling of Mangifera indica's Herbal Formulation and Its Ability to Ameliorate Hematological Derangements in Plasmodium berghei-Infected Mice

Background Malaria caused by Plasmodium falciparum with an average prevalence of 75% in Nigeria, can be treated. Chemical-based medications, one of the methods used to treat it, frequently causes hematological abnormalities in the blood tissues. However, the ethnobotanical and scientific usage of Mangifera indica for the management of malaria in Nigeria necessitated this study on the antiplasmodial evaluation, the hematological profiling of Plasmodium berghei-infected mice treated with Mangifera indica's herbal formulation as well as the isolation and characterization of bioactive compounds from the plants. Method The plant's coarse leaves (3 kg) and stem bark (3.2 g) were weighed, divided into groups of leaves (250.71 g), stem bark (509.34 g), leaves/stem bark (1:1) (101.24/101.24 g), leaves/stem bark (1:2) (164.39/328.78 g), and leaves/stem bark (2:1) (218.50/109.25 g), macerated in 3 L of ethanol for 72 h, filtered, and concentrated. For each extract, the following weights and yields were recorded: 31.3 g leaves (15.2%), 43.8 g stem bark (8.7%), 34.8 g leaves/stem bark (1:1) (17.2%), 29.2 g leaves/stem bark (1:2) (5.92%), and 26.1 g leaves/stem bark (2:1) (7.96%). According to established methods, the herbal formulation was employed for hematological testing, GC-MS analysis, and in vivo antiplasmodial evaluation based on standard protocols. Results The leaves: Stem bark (1:2) extract (the best therapeutic response) of 98.92% was better than ACT (98.63%). GCMS analysis revealed predominantly mangiferin and esters of linoleic acids that could have enhanced erythropoiesis, mitigated infections, as well as boosted platelet aggregation in P berghei-infected mice as observed from the hematological assay. Conclusion Therefore, the extract of leaves: stem bark (1:2) had the best antiplasmodial therapeutic response and hematoprotective activity in P berghei-infected mice.

Liver injury in malaria infected patients in Douala-Cameroon and its association with poor medical practice

BackgroundMalaria is an endemic mosquito-borne disease in sub-Saharan regions, including Cameroon. Due to the obligatory hepatic stage of its pathogenic agents, malaria can induce liver damage if not properly treated. Hence, we assessed the impact of malaria infection on liver transaminases among febrile patients consulting at the Deido District Hospital, Douala-Cameroon, in regard to their attitude towards the practice of preventive measures, treatment, and management of malaria.MethodsOver 10 weeks, 150 febrile patients and 28 healthy individuals serving as the control group were enrolled and their blood samples screened for Plasmodium species by Giemsa Staining and liver injury evaluated by measuring the serum level of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) activities. The socio-demographic characteristics of participants and their attitude towards the practice of preventive measures, treatment, and management of malaria were collected using a structured- questionnaire.ResultsAmong tested febrile patients, 113 (75%) were malaria-positive. Females were more affected (65.5%) than males; the most affected age group were adults between 30-60 years (55.8%). A significant association (p˂0.05; relative risk [RR] = 1.424 or p˂0.05; RR = 1.947) was found between malaria infection and non-use of mosquito nets or insecticides, respectively. The serum level of ALT and AST activities in malaria-positive were significantly (p<0.05) increased, compared to healthy or malaria-negative individuals. Furthermore, transaminase activity was significantly (p<0.05) elevated in non-practitioners of preventive measures; and in patients who engaged in auto-medication or traditional medication, compared to those who sought treatment from health centers.ConclusionOur findings demonstrated that non-practice of preventive measures, improper treatment and management of malaria infection can lead to an abnormal increase in serum level of transaminases which may reflect liver injury.

The Role of Faith-based Organisations in Childhood Malaria Management among Mothers of Under-five Children in Osogbo, Nigeria

Malaria remains a major health challenge in Nigeria despite efforts at reducing its prevalence. Previous studies on malaria focused mainly on the biomedical aspects. However, little is known about the role of faith-based organisations in malaria management. Health Belief Model (HBM) provided the framework explaining mothers understanding of malaria illness, while exploratory and descriptive designs were utilized. The study was conducted among selected mothers of under-five children in Osogbo using the qualitative method comprising twelve focus group discussions (FGDs); six among mothers 15-35years (three each among literates and non-literates); six among mothers 35years and above (three each among literates and non-literates mothers). Qualitative data were content analysed. Malaria treatment behaviour of the mothers was a complex process, assisted by faith-based organisations through the provision of insecticides treated net (ITNs), awareness campaigns, routine immunization of pregnant mothers, and more. However, hording militated against the effective use of ITNs by mothers in malaria management. This finding corroborates common understanding that faith-based organisations play important role in malaria management by actually providing biomedically accepted resources which led to the reduction of mosquito spread, hence increases the chances of the survival of both children and mothers. Therefore, increased collaboration between government and faith-based organisations is needed to improve malaria management facilities and avail mothers with appropriate education on malaria management strategies to reduce complications from malaria.

Plasmodium vivax merozoite-specific thrombospondin-related anonymous protein (PvMTRAP) interacts with human CD36, suggesting a novel ligand–receptor interaction for reticulocyte invasion

BackgroundThe Plasmodium vivax merozoite restrictively invades immature erythrocytes, suggesting that its ligand(s) might interact with corresponding receptor(s) that are selectively abundant on reticulocytes to complete the invasion. Finding the ligand‒receptor interaction involved in P. vivax invasion is critical to vivax malaria management; nevertheless, it remains to be unraveled.MethodsA library of reticulocyte receptors and P. vivax ligands were expressed by a HEK293E mammalian cell expression system and were then used to screen the interaction using enzyme-linked immunosorbent assay (ELISA). A flow cytometry-based erythrocyte binding assay and bio-layer interferometry experiment were further utilized to cellularly and quantitatively identify the ligand‒receptor interaction, respectively.ResultsPlasmodium vivax merozoite-specific thrombospondin-related anonymous protein (PvMTRAP) was found to interact with human CD36 using systematic screening. This interaction was specific at a molecular level from in vitro analysis and comparable to that of P. vivax Duffy binding protein (PvDBP) and Duffy antigen receptor for chemokines (DARC) (KD: 37.0 ± 1.4 nM and 7.7 ± 0.5 nM, respectively). Flow cytometry indicated that PvMTRAP preferentially binds to reticulocytes, on which CD36 is selectively present.ConclusionsHuman CD36 is selectively abundant on reticulocytes and is able to interact specifically with PvMTRAP, suggesting that it may function as a ligand and receptor during the invasion of reticulocytes by P. vivax.Graphical

Antimalarial Effects of Ethanolic Leaf Extracts of Azadirachta indica and Ocimum gratissimum, and Their Histologic Effects on Some Organs (Liver, Kidney and Heart) of Plasmodium berghei Infected Albino Mice

Azadirachta indica (Neem) and Ociumum gratissimum (clove Basil) have long been employed locally for the management of malaria. The present study compared antimalaria activities of the ethanolic leaf extracts of the individual plants, and assessed their combined effects on some organs of malaria-infected mice, at the Parasitology and Histopathology units, Federal Medical Centre (FMC), Owerri, from January to March, 2021. The leaves of the different plants were extracted with absolute ethanol (BDL 95%) for the test. Clean albino mice were experimentally infected intraperitoneally with chloroquine-sensitive Plasmodium berghei NK65 strain. Parasitaemia level was determined before parasite inoculation and at 24 hours post treatment period. Histopathological study on the liver, kidney, and heart was carried out using the Paraffin Setions method. Extracts of the leaves were administered orally, while chloroquine administration was intramuscular. The efficacy of the leaf extracts was tested on the P. berghei infected albino mice using the 4-day curative test. The lethal median dose (LD50) recorded for neem and clove basil leaf extracts were 31.62 and 1246.9 mg/kg body weight, respectively. Significant activity against the parasite was produced by infected mice treated with extracts of A. indica and O. gratissimum, and their combinations throughout the treatment period (P&lt;.05). Highest reduction of parasitaemia was observed on day 4. Maximum parasitaemia reduction (78.65%) was attained with 30mg/kg of the combined extracts on the 7th day. Mild pathological lesions were observed in mice treated with A. indica leaf extract. These observations indicate better anti-malaria activity of the combination therapy as compared with the individual extracts of A. indica and O. grassimum, and indicate good antimalarial and protective roles of the plant extracts on the parasitized mice at large, as it slows down development of resistance.

Prophylaxis Failure and Successful Management of Delayed-Onset Malaria with Renal Complications: A Case Report with Oral Artemether-Lumefantrine Treatment

This case report presents a critical clinical scenario involving a 55-year-old patient who developed severe Plasmodium falciparum malaria with renal complications despite receiving doxycycline prophylaxis while traveling in a malaria-endemic region. The case emphasizes the potential failure of doxycycline prophylaxis and highlights the importance of considering malaria in patients with a history of travel to endemic areas, even if they have adhered to prophylactic treatment. The patient’s clinical presentation included fever, extreme fatigue, and loss of consciousness, leading to hospitalization. Laboratory findings revealed severe anemia, elevated liver enzymes, and impaired renal function, consistent with the criteria for severe malaria. The diagnosis was confirmed by the presence of Plasmodium falciparum parasites on thin blood smears. Due to limited access to parenteral antimalarial medications in Kosovo, the patient received oral artemether-lumefantrine, resulting in clinical improvement. Supportive care and dialysis played a vital role in the patient’s recovery. This case report underscores the need for increased awareness of prophylaxis failure, the challenges of managing severe malaria in non-endemic countries, and the importance of timely and appropriate interventions to improve outcomes in severe malaria cases, particularly those with renal involvement.

In-vitro Cytotoxicity of Extracts of Selected Malaria Medicinal Plants Used by Traditional Healers of Kericho East Sub-county, Kenya

Background: Malaria is a fatal disease which affects people of all ages; especially pregnant women, young children &lt;5 years, and the elderly because of their weakened immune systems. The currently used anti-malarial drugs have been linked to a variety of negative side effects including the parasite resistance. Additionally, the costs associated with the conventional malaria management approach are arguably high, particularly for people living in low-income countries, highlighting the need for alternative and complementary approaches. Medicinal plants therefore are a viable alternative since they are arguably less expensive and easily accessible. However, there is limited information on safety and efficacy of the plants. This study was designed to investigate the cytotoxic activities of polar and non-polar crude extracts solvents of selected plants used by traditional healers in Kericho East Sub-County to treat malaria. Materials and Methods: Plants studied included Pittosporum viridiflorum (stem barks), Phytolacca dodecandra (Leaves), and Gardenia ternifolia (roots barks). Plant parts selected were collected from Kericho East Sub-county; Kapsoit, Kaitui, and Fort-Ternan. Their crude extracts were obtained from hexane, dichloromethane (DCM), Methanol (MeOH), and 5% H2O/MeOH. In vitro cytotoxic effects and safety of the studied plants' extracts were identified using mammalian Vero E6 cells. Results: Most of the plants tested yielded impressive cytotoxicity results, indicating that therapeutic doses could be achieved at safe concentrations. However, P. viridiflorum hexane, DCM, MeOH, and 5% H2O/MeOH crude extracts were toxic to the cultured cells expressing the mean CC50 ± SE of 65.11±0.40, 25.63±0.23, 87.94 ±0.59 and 98.54±0.66 μg/ml, respectively. Conclusion: G. ternifolia and P. dodecandra have offered hope in the treatment of malaria since their crude extracts have demonstrated no toxicity. The study found P. viridiflorum crude extracts to be toxic but there is the possibility of isolating safe nontoxic compound/s because they were less toxic at lower doses. This study therefore identified potential plants that could be used to develop novel anti-plasmodial agents.