This study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy (ACT) artesunate +sulfamethoxypyrazine/pyrimethamine (As+SMP), administered in doses used ...for malaria, to treat Schistosoma haematobium in school aged children.
The study was conducted in Djalakorodji, a peri-urban area of Bamako, Mali, using a double blind setup in which As+SMP was compared with praziquantel (PZQ). Urine samples were examined for Schistosoma haematobium on days -1, 0, 28 and 29. Detection of haematuria, and haematological and biochemical exams were conducted on day 0 and day 28. Clinical exams were performed on days 0, 1, 2, and 28. A total of 800 children were included in the trial. The cure rate obtained without viability testing was 43.9% in the As+SMP group versus 53% in the PZQ group (Chi(2) = 6.44, p = 0.011). Egg reduction rates were 95.6% with PZQ in comparison with 92.8% with As+SMP, p = 0.096. The proportion of participants who experienced adverse events related to the medication was 0.5% (2/400) in As+SMP treated children compared to 2.3% (9/399) in the PZQ group (p = 0.033). Abdominal pain and vomiting were the most frequent adverse events in both treatment arms. All adverse events were categorized as mild.
The study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium. However, the safety and tolerability profile of As+SMP was similar to that seen with PZQ. Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections.
ClinicalTrials.gov NCT00510159.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Present-day power conversion and conditioning systems focus on transferring energy from a single type of power source into a single type of load or energy storage system (ESS). While these systems ...can be optimized within their specific topology (e.g. MPPT for solar applications and BMS for batteries), the topologies are not easily adapted to accept a wide range of power flow operating conditions. With a hybrid approach to energy storage and power flow, a system can be designed to operate at its most advantageous point, given the operating conditions. Based on the load demand, the system can select the optimal power source and ESS. This work will investigate the feasibility of combining two types of power sources (main utility grid and photovoltaics (PV)) along with two types of ESS (ultra-capacitors and batteries). The simulation results show an optimal and sustainable grid-tied residential microgrid system requires a hybrid ESS to meet the demands of a mixed load scenario. This work also presents a method for optimal sizing of an off-grid hybrid microgrid (MG) system in order to achieve a certain load demand. The hybrid microgrid is made of a solar photovoltaic (PV) system, wind turbine (WT) and ESS. The reliability of the MG system is modeled based on the loss of power supply probability (LPSP). For optimization, an enhanced Genetic Algorithm (GA) is used to minimize the total cost of the system over a 20-year period, while satisfying some reliability, operation and stability constraints. A case study addressing optimal sizing of an off-grid hybrid microgrid in Nigeria is discussed. The result is compared to those obtained from the Brute-Force computation and standard GA optimization. All methods give the same result under the same conditions, showing that the enhanced GA is well suited for optimal MG system sizing, and the proposed method is feasible for sizing PV/WT/ESS hybrid off-grid MG systems.
This article posits that two factors made Islamisation of knowledge (IoK) movement less effective in achieving the objective of Islamising the philosophies of the sciences to permit the emergence of ...novel approaches compatible with the Islamic worldview of tawḥīd. First, the theorists of the movement outlined how knowledge could be Islamised, but they did not lay down the foundations of an innovative intellectual project; and second, the way the project was designed attached its success to institutional support. Therefore, the IoK movement must be revitalised by a new generation of scholars who will focus on synthesising the existing IoK literature and building on it, rediscovering past Islamic scholarly heritage, asking new questions for reshaping the sciences so to produce paradigms, analytical, methodological and interpretive tools compatible with the vision of Islam, and training a critical mass of young scholars to sustain the IoK movement.
In this phase 2 trial in Mali, an antimalarial monoclonal antibody (CIS43LS) at a dose of 40 mg per kilogram was approximately 88% effective at preventing
P. falciparum
infection as compared with ...placebo.
Background. In experimental models of human and mouse malaria, sterilizing liver stage immunity that blocks progression of Plasmodium infection to the symptomatic blood stage can be readily ...demonstrated. However, it remains unclear whether individuals in malaria-endemic areas acquire such immunity. Methods. In Mali, 251 healthy children and adults aged 4–25 years who were free of blood-stage Plasmodium infection by polymerase chain reaction (PCR) were enrolled in a longitudinal study just prior to an intense 6-month malaria season. Subsequent clinical malaria episodes were detected by weekly active surveillance and self-referral. Asymptomatic P. falciparum infections were detected by blood-smear microscopy and PCR analysis of dried blood spots that had been collected every 2 weeks for 7 months. Results. As expected, the risk of clinical malaria decreased with increasing age (log-rank test, P = .0038). However, analysis of PCR data showed no age-related differences in P. falciparum infection risk (log-rank test, P = .37). Conclusions. Despite years of exposure to intense P. falciparum transmission, there is no evidence of acquired, sterile immunity to P. falciparum infection in this population, even as clinical immunity to blood-stage malaria is clearly acquired. Understanding why repeated P. falciparum infections do not induce sterile protection may lead to insights for developing vaccines that target the liver stage in malaria-endemic populations.
Malaria is a major cause of illness worldwide. In a phase 2 trial in Mali, one subcutaneous dose of L9LS, a monoclonal antibody targeting
Plasmodium falciparum
, reduced the incidence of clinical ...malaria among children.
Background Malaria and schistosomiasis often overlap in tropical and subtropical countries and impose tremendous disease burdens; however, the extent to which schistosomiasis modifies the risk of ...febrile malaria remains unclear. Methods We evaluated the effect of baseline S. haematobium mono-infection, baseline P. falciparum mono-infection, and co-infection with both parasites on the risk of febrile malaria in a prospective cohort study of 616 children and adults living in Kalifabougou, Mali. Individuals with S. haematobium were treated with praziquantel within 6 weeks of enrollment. Malaria episodes were detected by weekly physical examination and self-referral for 7 months. The primary outcome was time to first or only malaria episode defined as fever (≥37.5°C) and parasitemia (≥2500 asexual parasites/µl). Secondary definitions of malaria using different parasite densities were also explored. Results After adjusting for age, anemia status, sickle cell trait, distance from home to river, residence within a cluster of high S. haematobium transmission, and housing type, baseline P. falciparum mono-infection (n = 254) and co-infection (n = 39) were significantly associated with protection from febrile malaria by Cox regression (hazard ratios 0.71 and 0.44; P = 0.01 and 0.02; reference group: uninfected at baseline). Baseline S. haematobium mono-infection (n = 23) did not associate with malaria protection in the adjusted analysis, but this may be due to lack of statistical power. Anemia significantly interacted with co-infection (P = 0.009), and the malaria-protective effect of co-infection was strongest in non-anemic individuals. Co-infection was an independent negative predictor of lower parasite density at the first febrile malaria episode. Conclusions Co-infection with S. haematobium and P. falciparum is significantly associated with reduced risk of febrile malaria in long-term asymptomatic carriers of P. falciparum. Future studies are needed to determine whether co-infection induces immunomodulatory mechanisms that protect against febrile malaria or whether genetic, behavioral, or environmental factors not accounted for here explain these findings.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Soil transmitted helminthiasis and schistosomiasis are neglected tropical diseases (NTD), affecting the health status of endemic Malian populations. Mali has a national NTD elimination program using ...the mass drug administration (MDA) strategy combining Albendazole, Ivermectinand Praziquantel. Malaria still remains a public health problem in Mali. The Community health Center (CSCOM) in Kalifabougouvillage in the Kati health district has benefited from such MDA program since 2010.
To evaluate the prevalence rate of malaria, intestinal and urinary parasite infections in the local population.
We conducted a nested cross sectional and cohort study in May 2011 on volunteers aged three months old to 25 years old. Blood smear (blood), Kato-Katz (Stools) and urine filtration techniques were used to evaluate parasite prevalence. Informed consent and assentment were obtained from the volunteers before their inclusion. All volunteers received treatment against the parasite diseases of interest according to the guidelines of national disease control programs.
A total of 688 volunteers were included. The prevalence rates of parasitic infections were 22.1% 95% CI= 22.06 - 22.12 for
, 9% 95% CI: 8.9-9.034 for
; 3.5% 95% CI: 3.48-3.513 for
and 0.1% 95% CI : 0.093-0.107 for
. The prevalence rate of the co-infection
was 2.18% 95% CI= 2.17 - 2.19 in Kalifabougou.
Praziquantel and Albendazole-based MDA and Artemisinin based combined therapy (ACTs) could explain theobserved low prevalence of helminthiasis and malaria in Kalifabougou, Mali.
PDF
