Acta tropica
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Randomized Controlled Trial
Therapeutic efficacy of chloroquine and chloroquine plus primaquine for the treatment of Plasmodium vivax in Ethiopia.
Plasmodium vivax is the second most important cause of morbidity in Ethiopia. There is, however, little information on P. vivax resistance to chloroquine and chloroquine plus primaquine treatment although these drugs have been used as the first line treatment for over 50 years. We assessed the efficacy of standard chloroquine and chloroquine plus primaquine treatment for P. vivax infections in a randomized open-label comparative study in Debre Zeit and Nazareth in East Shoa, Ethiopia. ⋯ The study confirms the emergence of CQ and PQ resistance/treatment failure in P. vivax malaria in Ethiopia. Although treatment failures were detected, they were similar between the treatment groups. We recommend regular monitoring and periodic evaluation of the efficacy of these antimalarial drugs in systematically selected sentinel sites to detect further development of resistance and to make timely national antimalarial drug policy changes.
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Sub-Saharan Africa (SSA) is worse off in terms of health indicators than any other region of the world, and suffers badly from the 10/90 gap, whereby 90% of the world's investment in health research addresses only 10% of the global health problems. This anomaly in health research investment in SSA is mainly attributed to rampant poverty, weak educational institutions, deficient health research capacity, feeble communications systems and isolation. Translating research results into action, manufacturing and access are also weak. ⋯ The paper reviews actions taken over the last two decades to resolve the 10/90 gap through: (i) policies prioritizing funding for health research, (ii) developing capacities of credible public and private SSA health research institutions, (iii) activities of international NGOs undertaking research aimed at resolving the gap, and (iv) the setting up of research based mechanisms to ensure access to new effective products for the treatment and prevention of poverty-related diseases. The paper highlights examples for each of the above, and discusses the overall situation. We conclude that despite the many capacity strengthening actions, and achievements made towards resolving the 10/90 gap, the disequilibrium still persists; there is need for greater investments aimed at closing it.
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In trematodiases, shape and size of the fluke eggs shed with faeces are crucial diagnostic features because of their typically reduced intraspecific variability. In fascioliasis, the usual diagnosis during the biliary stage of infection is based on the classification of eggs found in stools, duodenal contents or bile. The aim of the present study is to validate the identification of Fasciola species based on the shape and size of eggs shed by humans, characterizing their morphometric traits using a computer image analysis system (CIAS). ⋯ Measurements of F. hepatica and F. gigantica eggs originating from humans and animals from sympatric areas overlap, and, therefore, they do not allow differential diagnosis when within this overlapping range. In this sense, the new results should aid clinicians since the application of the classic egg size range in human samples may lead to erroneous conclusions. Fasciolid egg size in human stool samples ought to be corrected in books and monographs related to medical parasitology and/or tropical medicine as well as in guides for clinicians and parasitic disease diagnosis analysts.
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To describe clinical profile of patients with dengue virus infection hospitalized at a single center during the first outbreak of dengue in Makkah, Saudi Arabia from April to July 2004. ⋯ Occurrence of dengue virus infection in Makkah, Saudi Arabia is documented. Continued surveillance and effective vector control programs are warranted due to unique population dynamics of Makkah that receives millions of pilgrims annually from all over the world.