Malaria is still one of the major infectious diseases affecting human health, and the World Health Organization (WHO) has attached special importance to malaria-related technical training for its ...global elimination efforts. The Jiangsu Institute of Parasitic Diseases (JIPD), designated as a WHO Collaborating Centre for Research and Training on Malaria Elimination, has conducted numerous international malaria training programmes during the last 2 decades.
A retrospective analysis of international training programmes organized and facilitated by JIPD in China since 2002 was conducted. A web-based questionnaire was designed to gather respondents' basic information, evaluation of course topics, methodology, trainers, and facilitators, course impact, and suggestions for future trainings. Individuals who participated in the training courses from 2017 to 2019 were invited to participate in this assessment.
Since 2002, JIPD has conducted 62 malaria-related international trainings attended by 1935 participants from 85 countries, covering 73% of malaria endemic countries. Of 752 participants enrolled, 170 responded to the online survey. A majority of respondents (160/170, 94.12%) gave a high evaluation of the training, with an average score of 4.52 (5 maximum score). Also, survey respondents gave a 4.28 score on "knowledge and skills gained in the training useful for the national malaria programme", 4.52 on "topics appropriate to their professional needs", and 4.52 on "knowledge and skills gained in the training useful to their career". Surveillance and response was the most important topic discussed and field visit was the most effective method of training. For future training programmes, with increasing length of training, more field visits and demonstration, improving language barrier, and sharing experience were what the respondents requested most.
JIPD, as a professional institute for malaria control, has conducted a great quantity of training in the past 20 years, providing training opportunities to both malaria and non-malaria endemic countries globally. For future training, survey respondents' suggestions will be considered to provide a more effective capacity building activity to better contribute to global malaria elimination.
Malaria diagnosis has received renewed interest in recent years, associated with the increasing accessibility of accurate diagnosis through the introduction of rapid diagnostic tests and new World ...Health Organization guidelines recommending parasite-based diagnosis prior to anti-malarial therapy. However, light microscopy, established over 100 years ago and frequently considered the reference standard for clinical diagnosis, has been neglected in control programmes and in the malaria literature and evidence suggests field standards are commonly poor. Microscopy remains the most accessible method for parasite quantitation, for drug efficacy monitoring, and as a reference of assessing other diagnostic tools. This mismatch between quality and need highlights the importance of the establishment of reliable standards and procedures for assessing and assuring quality. This paper describes the development, function and impact of a multi-country microscopy external quality assurance network set up for this purpose in Asia.
Surveys were used for key informants and past participants for feedback on the quality assurance programme. Competency scores for each country from 14 participating countries were compiled for analyses using paired sample t-tests. In-depth interviews were conducted with key informants including the programme facilitators and national level microscopists.
External assessments and limited retraining through a formalized programme based on a reference slide bank has demonstrated an increase in standards of competence of senior microscopists over a relatively short period of time, at a potentially sustainable cost. The network involved in the programme now exceeds 14 countries in the Asia-Pacific, and the methods are extended to other regions.
While the impact on national programmes varies, it has translated in some instances into a strengthening of national microscopy standards and offers a possibility both for supporting revival of national microcopy programmes, and for the development of globally recognized standards of competency needed both for patient management and field research.
DIGITAL MALARIA INFORMATION SHARING IN ASIA YAP, Joseph M; MENDOZA, Rogelio T; NAVARRA, Arnel C ...
Southeast Asian journal of tropical medicine and public health,
09/2009, Volume:
40, Issue:
5
Journal Article
In 2001 a project named Mekong Malaria Documentation Center (MMDC) was established in Vietnam to support the information needs of malaria professionals in the Mekong Region. In 2005, MMDC was renamed ...and reorganized into a new database called ACTMalaria Information Resource Center (AIRC). AIRC's goal is to gather all published and unpublished materials, including electronic files, regarding malaria from ACTMalaria member countries. Today, there are eleven member nations. More than 1,500 files have been uploaded and are available for access. Various areas of AIRC still need to be developed, including editing, approvals of files, coordination with publishers, copyright issues, and the architecture of the database. Funding also needs to be secured for the sustainability of AIRC.
The goal to eliminate malaria from the Asia-Pacific by 2030 will require the safe and widespread delivery of effective radical cure of malaria. In October 2017, the Asia Pacific Malaria Elimination ...Network Vivax Working Group met to discuss the impediments to primaquine (PQ) radical cure, how these can be overcome and the methodological difficulties in assessing clinical effectiveness of radical cure. The salient discussions of this meeting which involved 110 representatives from 18 partner countries and 21 institutional partner organizations are reported. Context specific strategies to improve adherence are needed to increase understanding and awareness of PQ within affected communities; these must include education and health promotion programs. Lessons learned from other disease programs highlight that a package of approaches has the greatest potential to change patient and prescriber habits, however optimizing the components of this approach and quantifying their effectiveness is challenging. In a trial setting, the reactivity of participants results in patients altering their behaviour and creates inherent bias. Although bias can be reduced by integrating data collection into the routine health care and surveillance systems, this comes at a cost of decreasing the detection of clinical outcomes. Measuring adherence and the factors that relate to it, also requires an in-depth understanding of the context and the underlying sociocultural logic that supports it. Reaching the elimination goal will require innovative approaches to improve radical cure for vivax malaria, as well as the methods to evaluate its effectiveness.
Hyperglycemia is associated with an increased risk of cardiovascular disease,and the consequences ofintensive therapy may depend on the mechanism of the anti-diabetic agent(s)used to achieve a tight ...control.In animal models,stable analogues of glucagon-like peptide-1(GLP-1)were able to reduce body weight and blood pressure and also had favorable effects on ischemia following coronary reperfusion.In a similar way,dipeptidyl peptidase IV(DPPIV)showed to have favorable effects in animal models of ischemia/reperfusion.This could be due to the fact that DPPIV inhibitors were able to prevent the breakdown of GLP-1 and glucose-dependent insulinotropic polypeptide,but they also decreased the degradation of several vasoactive peptides.Preclinical data for GLP-1,its derivatives and inhibitors of the DPPIV enzyme degradation suggests that these agents may be able to,besides controlling glycaemia,induce cardio-protective and vasodilator effects.Notwithstanding the many favorable cardiovascular effects of GLP-1/incretins reported in different studies,many questions remain unanswered due the limited number of studies in human beings that aim to examine the effects of GLP-1 on cardiovascular endpoints.For this reason,long-term trials searching for positive cardiovascular effects are now in process,such as the CAROLINA and CARMELINA trials,which are supported by small pilot studies performed in humans(and many more animal studies)with incretin-based therapies.On the other hand,selective renal sodium-glucose co-transporter 2 inhibitors were also evaluated in the prevention of cardiovascular outcomes in type 2 diabetes.However,it is quite early to draw conclusions,since data on cardiovascular outcomes and cardiovascular death are limited and long-term studies are still ongoing.In this review,we will analyze the mechanisms underlying the cardiovascular effects of incretins and,at the same time,we will present a critical position about the real value of these compounds in the cardiovascular system and its protection.
Este texto reflete a necessidade de uma reforma profunda nos sistemasjudiciários nos países da América Latina. O autor enumera os mais consideráveis eventos políticos ocorridos na região após a ...década de 60, principalmente durante o período dos governos militares, com ênfase nos modelos judiciários prevalecentes — comumente dependentes, manipulados e frágeis — bem como nos problemas enfrentados pelos juízes e serventuários da justiça em muitos países. Ele também descreve vários movimentos pela reforma legal observados em dois diferentes momentos — do fim da década de 60 e começo da de 70, e depois, durante a década de 80, comparando seus sucessos e fracassos e enumerando uma quantidade de seguidores nacionais e internacionais. Finalmente, o leitor deparar-se-á com uma análise das mudanças econômicas e políticas que têm incentivado esta nova preocupação por justiça e pela reforma das instituições legais, dentre outras, na América Latina, assim como as dificuldades que esse movimento deve enfrentar no sentido de alcançar um Estado descentralizado, eficiente e democrático.
The use of topical and intralesional immunotherapy in the treatment of cutaneous malignant neoplasia in sensitive areas such as the lips and eyelids is discussed. Surgery may not be feasible or may ...result in deformities in these areas, making alternative treatment options necessary. A narrative literature review was conducted using MEDLINE (PubMed) as the main literature database, collecting available evidence of experiences with various topical and intralesional therapies in the aforementioned anatomical locations, ranging from case reports to clinical trials. The clearance rates and potential adverse reactions of therapeutic options such as imiquimod 5%, 5-fluorouracil (5-FU), photodynamic therapy (PDT), ingenol mebutate (IM), diclofenac, intralesional methotrexate, and interferon are reviewed. Although limited by their heterogeneity and the scarcity of clinical trials, these studies point towards promising response rates and minimal adverse effects, making these treatments viable options in selected cases.
Different studies have evidenced that dietary xenobiotics (DXBs) can produce oxidative damage to erythrocytes, which eventually leads to the development of eryptosis and, ultimately hemolysis. ...Increased eryptosis and hemolysis have been implicated in the development and progression of some clinical conditions or chronic diseases, mainly from cardiovascular origin. Therefore, new strategies based on agents with antioxidant properties have emerged as a novel approach to reduce induced oxidative stress in exposed erythrocytes.
Specific food-grade lactic acid bacteria and probiotics have exhibited antioxidant properties, likely related to postbiotics, with positive effects against oxidative damage in human erythrocytes. Hence, the aim of this work was to provide an overview of the current knowledge regarding the possible protective role of food-grade LAB and/or probiotics, as well as their metabolites (postbiotics), against the erythrotoxic effect induced by DXBs. The possible mechanisms underlying this protective activity will also be described.
Key findings and conclusions: In vitro and in vivo studies have shown that food-grade lactic acid bacteria and/or probiotics have the capacity to improve the enzymatic and non-enzymatic antioxidant system of erythrocytes, thereby exhibiting protection against induced-oxidative damage by DXBs. The possible mechanisms involve the enhancement of the bioaccessibility of exogenous antioxidant precursor molecules and/or the bioavailability of endogenous antioxidants. Besides, the increased expression of genes that codify for the production of antioxidant enzymes in the host, induced by bacteria-derived byproducts, is not ruled out.
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•Eryptosis and hemolysis may be indued by different dietary xenobiotics.•Some food-grade LAB/probiotics exhibit erythroprotective effect against induced-oxidative damage.•Enhanced erythrocyte's antioxidant enzymes mitigate physiological changes in cells.•Protective effect involves the enhancement of the bioaccessibility of exogenous antioxidant precursor molecules.
Background: Added sugar consumption seems to trigger a hyperinflammatory state and may result in visceral adiposity, dyslipidemia, and insulin resistance. These conditions are risk factors for ...periodontal disease. However, the role of sugar intake in the cause of periodontal disease has not been adequately studied.Objective: We evaluated the association between the frequency of added sugar consumption and periodontal disease in young adults by using NHANES III data.Design: Data from 2437 young adults (aged 18–25 y) who participated in NHANES III (1988–1994) were analyzed. We estimated the frequency of added sugar consumption by using food-frequency questionnaire responses. We considered periodontal disease to be present in teeth with bleeding on probing and a probing depth ≥3 mm at one or more sites. We evaluated this outcome as a discrete variable in Poisson regression models and as a categorical variable in multinomial logistic regression models adjusted for sex, age, race-ethnicity, education, poverty-income ratio, tobacco exposure, previous diagnosis of diabetes, and body mass index.Results: A high consumption of added sugars was associated with a greater prevalence of periodontal disease in middle prevalence ratio (PR): 1.39; 95% CI: 1.02, 1.89 and upper (PR: 1.42; 95% CI: 1.08, 1.85) tertiles of consumption in the adjusted Poisson regression model. The upper tertile of added sugar intake was associated with periodontal disease in ≥2 teeth (PR: 1.73; 95% CI: 1.19, 2.52) but not with periodontal disease in only one tooth (PR: 0.85; 95% CI: 0.54, 1.34) in the adjusted multinomial logistic regression model.Conclusion: A high frequency of consumption of added sugars is associated with periodontal disease, independent of traditional risk factors, suggesting that this consumption pattern may contribute to the systemic inflammation observed in periodontal disease and associated noncommunicable diseases.
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