Pub Date : 2002-04-01DOI: 10.1179/000349802125000772
S. Ehrhardt, F. Mockenhaupt, P. Agana-Nsiire, A. Mathieu, S. Anemana, K. Stark, R. Otchwemah, U. Bienzle
Abstract Chloroquine (CQ) resistance in Plasmodium falciparum contributes to growing malaria-attributable morbidity and mortality in sub-Saharan Africa. However, the extent and degree of such resistance vary considerably between endemic areas. Data on CQ resistance in northern Ghana are almost entirely lacking. The therapeutic efficacy of CQ in uncomplicated malaria was therefore assessed, in a standard, 14-day protocol, in 225 children aged <5 years in Tamale, in the Northern region of Ghana. Early treatment failure (ETF) was observed in 11% of the children and late treatment failure in 18%. High initial parasite density and young age were independent predictors for ETF. Resistant parasitological responses (RI-RIII) were seen in 57% of the cases that could be classified. More than half of these responses occurred in children fulfilling the criteria for adequate clinical response (ACR), indicating a considerable lack of agreement between parasitological and clinical outcome. During the follow-up period, haemoglobin levels increased by approximately 1g/dl not only in patients with ACR but also in those who experienced clinical failure more than 1 week post-treatment. As CQ-treatment failure occurred in >25% of the children and more than half of the parasitological responses indicated resistance, current recommendations for the treatment of uncomplicated malaria in young children in northern Ghana have to be reconsidered.
{"title":"Efficacy of chloroquine in the treatment of uncomplicated, Plasmodium falciparum malaria in northern Ghana","authors":"S. Ehrhardt, F. Mockenhaupt, P. Agana-Nsiire, A. Mathieu, S. Anemana, K. Stark, R. Otchwemah, U. Bienzle","doi":"10.1179/000349802125000772","DOIUrl":"https://doi.org/10.1179/000349802125000772","url":null,"abstract":"Abstract Chloroquine (CQ) resistance in Plasmodium falciparum contributes to growing malaria-attributable morbidity and mortality in sub-Saharan Africa. However, the extent and degree of such resistance vary considerably between endemic areas. Data on CQ resistance in northern Ghana are almost entirely lacking. The therapeutic efficacy of CQ in uncomplicated malaria was therefore assessed, in a standard, 14-day protocol, in 225 children aged <5 years in Tamale, in the Northern region of Ghana. Early treatment failure (ETF) was observed in 11% of the children and late treatment failure in 18%. High initial parasite density and young age were independent predictors for ETF. Resistant parasitological responses (RI-RIII) were seen in 57% of the cases that could be classified. More than half of these responses occurred in children fulfilling the criteria for adequate clinical response (ACR), indicating a considerable lack of agreement between parasitological and clinical outcome. During the follow-up period, haemoglobin levels increased by approximately 1g/dl not only in patients with ACR but also in those who experienced clinical failure more than 1 week post-treatment. As CQ-treatment failure occurred in >25% of the children and more than half of the parasitological responses indicated resistance, current recommendations for the treatment of uncomplicated malaria in young children in northern Ghana have to be reconsidered.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"3 1","pages":"239 - 247"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78745700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1179/000349802125000808
W. Zhu, G. Baggerman, W. Secor, F. Casares, S. Pryor, G. Fricchione, E. Ruiz-Tiben, M. Eberhard, L. Bimi, G. Stefano
Abstract The results of analysis, by high-performance liquid chromatography coupled with electrochemical detection and by nano-electrospray-ionization, double quadrupole/orthogonal-acceleration, time-of-flight mass spectrometry, indicate that adult Dracunculus medinensis and Schistosoma mansoni both contain the opiate alkaloid morphine and that D. medinesis also contains the active metabolite of morphine, morphine 6-glucuronide. From these and previous observations, it would appear that many helminths are probably using opiate alkaloids as potent immunosuppressive and antinociceptive signal molecules, to down-regulate immunosurveillance responsiveness and pain signalling in their hosts.
{"title":"Dracunculus medinensis and Schistosoma mansoni contain opiate alkaloids","authors":"W. Zhu, G. Baggerman, W. Secor, F. Casares, S. Pryor, G. Fricchione, E. Ruiz-Tiben, M. Eberhard, L. Bimi, G. Stefano","doi":"10.1179/000349802125000808","DOIUrl":"https://doi.org/10.1179/000349802125000808","url":null,"abstract":"Abstract The results of analysis, by high-performance liquid chromatography coupled with electrochemical detection and by nano-electrospray-ionization, double quadrupole/orthogonal-acceleration, time-of-flight mass spectrometry, indicate that adult Dracunculus medinensis and Schistosoma mansoni both contain the opiate alkaloid morphine and that D. medinesis also contains the active metabolite of morphine, morphine 6-glucuronide. From these and previous observations, it would appear that many helminths are probably using opiate alkaloids as potent immunosuppressive and antinociceptive signal molecules, to down-regulate immunosurveillance responsiveness and pain signalling in their hosts.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"16 1","pages":"309 - 316"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79783982","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1179/000349802125000781
C. A. Marra, A. Zaidenberg, M. J. D. de Alaniz, H. Buschiazzo
Abstract The fatty-acid composition of liver lipids from mice infected with Trypanosoma cruzi (clone H510C8C3) or uninfected mice was investigated. The infected animals were treated orally for 30 days, with trifluralin (TFL) or benznidazole (BNZ), each at 100mg/kg.day, or only with the peanut oil used as the drug vehicle. The uninfected mice were also given the peanut oil. The treatments were stopped 10 days before the animals were killed. The liver microsomal lipids of each mouse were isolated and then analysed by gas-liquid chromatography. In terms of the total lipids, untreated infection evoked a significant increase in saturated fatty acids and the members of the n-9 fatty-acid family, with a concomitant decrease in the polyenoates of the n-3 and n-6 fatty-acid series. Each lipid subclass was affected to a different extent, the phospholipids being affected most. All lipid fractions, apart from the cholesterol esters, showed a significant increase in the proportion of n-9 isomers. Infection also produced a marked increase in the absolute amounts of triacylglycerides, cholesterol and cholesterol esters in liver microsomal membranes. After BNZ or TFL treatment, the fatty-acid pattern of mice that had been infected was indistinguishable from that of the control mice. The possible role of desaturase activity in the alterations observed is discussed.
{"title":"The restoring effect of trifluralin and benznidazole on the abnormal fatty-acid pattern induced by Trypanosoma cruzi in the liver microsomes of infected mice","authors":"C. A. Marra, A. Zaidenberg, M. J. D. de Alaniz, H. Buschiazzo","doi":"10.1179/000349802125000781","DOIUrl":"https://doi.org/10.1179/000349802125000781","url":null,"abstract":"Abstract The fatty-acid composition of liver lipids from mice infected with Trypanosoma cruzi (clone H510C8C3) or uninfected mice was investigated. The infected animals were treated orally for 30 days, with trifluralin (TFL) or benznidazole (BNZ), each at 100mg/kg.day, or only with the peanut oil used as the drug vehicle. The uninfected mice were also given the peanut oil. The treatments were stopped 10 days before the animals were killed. The liver microsomal lipids of each mouse were isolated and then analysed by gas-liquid chromatography. In terms of the total lipids, untreated infection evoked a significant increase in saturated fatty acids and the members of the n-9 fatty-acid family, with a concomitant decrease in the polyenoates of the n-3 and n-6 fatty-acid series. Each lipid subclass was affected to a different extent, the phospholipids being affected most. All lipid fractions, apart from the cholesterol esters, showed a significant increase in the proportion of n-9 isomers. Infection also produced a marked increase in the absolute amounts of triacylglycerides, cholesterol and cholesterol esters in liver microsomal membranes. After BNZ or TFL treatment, the fatty-acid pattern of mice that had been infected was indistinguishable from that of the control mice. The possible role of desaturase activity in the alterations observed is discussed.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"49 1","pages":"249 - 264"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89570357","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1179/000349802125000790
M. Jamjoom, R. Ashford, P. Bates, S. Kemp, H. Noyes
Abstract The investigation of microsatellite markers has recently superseded that of isoenzymes for many population-biology applications. Microsatellites have the advantages of being dominant, neutral, highly polymorphic and easily scored by high-throughput methods. However, it is necessary to develop a new panel of markers for each group of organisms of interest. Previously, only about 5% of the markers that amplify Leishmania major microsatellite loci were also found to amplify L. donovani loci. A panel of 20 microsatellite markers that are polymorphic in L. donovani and L. infantum has now been developed, using a rapid-enrichment method that will be suitable for developing libraries of markers for other trypanosomatid species. This is the first panel of polymorphic microsatellite markers, to be isolated de novo from any species of Leishmania, that is large enough for population-biology applications.
{"title":"Towards a standard battery of microsatellite markers for the analysis of the Leishmania donovani complex","authors":"M. Jamjoom, R. Ashford, P. Bates, S. Kemp, H. Noyes","doi":"10.1179/000349802125000790","DOIUrl":"https://doi.org/10.1179/000349802125000790","url":null,"abstract":"Abstract The investigation of microsatellite markers has recently superseded that of isoenzymes for many population-biology applications. Microsatellites have the advantages of being dominant, neutral, highly polymorphic and easily scored by high-throughput methods. However, it is necessary to develop a new panel of markers for each group of organisms of interest. Previously, only about 5% of the markers that amplify Leishmania major microsatellite loci were also found to amplify L. donovani loci. A panel of 20 microsatellite markers that are polymorphic in L. donovani and L. infantum has now been developed, using a rapid-enrichment method that will be suitable for developing libraries of markers for other trypanosomatid species. This is the first panel of polymorphic microsatellite markers, to be isolated de novo from any species of Leishmania, that is large enough for population-biology applications.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"62 1","pages":"265 - 270"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78666834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1179/000349802125001032
G. Matar, D. Abdo, I. Khneisser, M. Youssef, H. Zouheiry, G. Abdelnour, H. Harakeh
Abstract In several hospitals in Beirut, Lebanon, 77 isolates of Escherichia coli were successfully derived from the stools of patients with diarrhoeal diseases, by culture on MacConkey or MacConkey-sorbitol agar. When the isolates were screened, using a multiplex PCR, 14 (from 14 different patients) were each found positive for one of the various genes defining the enterotoxigenic (five), enteroinvasive (four), enteroaggregative (three) or enteropathogenic (two) groups. Genotyping of these 14 diarrhoeagenic isolates, by pulsed-field gel electrophoresis, indicated that all were genomically distinct with the exception of two of the enteroaggregative isolates (which were of the same genotype). The E. coli apparently involved in diarrhoeal disease in Beirut therefore belong to at least four different diarrhoeagenic groups and show strain variation within each group. Diarrhoea in the absence of diarrhoeagenic E. coli may be the result of infection with bacteria other than E. coli or viral or parasitic enteropathogens.
{"title":"The multiplex-PCR-based detection and genotyping of diarrhoeagenic Escherichia coli in diarrhoeal stools","authors":"G. Matar, D. Abdo, I. Khneisser, M. Youssef, H. Zouheiry, G. Abdelnour, H. Harakeh","doi":"10.1179/000349802125001032","DOIUrl":"https://doi.org/10.1179/000349802125001032","url":null,"abstract":"Abstract In several hospitals in Beirut, Lebanon, 77 isolates of Escherichia coli were successfully derived from the stools of patients with diarrhoeal diseases, by culture on MacConkey or MacConkey-sorbitol agar. When the isolates were screened, using a multiplex PCR, 14 (from 14 different patients) were each found positive for one of the various genes defining the enterotoxigenic (five), enteroinvasive (four), enteroaggregative (three) or enteropathogenic (two) groups. Genotyping of these 14 diarrhoeagenic isolates, by pulsed-field gel electrophoresis, indicated that all were genomically distinct with the exception of two of the enteroaggregative isolates (which were of the same genotype). The E. coli apparently involved in diarrhoeal disease in Beirut therefore belong to at least four different diarrhoeagenic groups and show strain variation within each group. Diarrhoea in the absence of diarrhoeagenic E. coli may be the result of infection with bacteria other than E. coli or viral or parasitic enteropathogens.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"22 1","pages":"317 - 324"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79989524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-04-01DOI: 10.1179/000349802125000826
M. Murdoch, M. Asuzu, M. Hagan, W. Makunde, P. Ngoumou, K. Ogbuagu, D. Okello, G. Ozoh, J. H. Remme
Abstract An attempt was made to assess the true public-health importance of onchocercal skin disease throughout the African region and hence provide an objective basis for the rational planning of onchocerciasis control in the area. The seven collaborative centres that participated in the study (three in Nigeria and one each in Ghana, Cameroon, Tanzania and Uganda) were all in areas of rainforest or savannah-forest mosaic where onchocercal blindness is not common. A cross-sectional dermatological survey was undertaken at each site following a standard protocol. At each site, the aim was to examine at least 750 individuals aged 5 years and living in highly endemic communities and 220-250 individuals aged 5 years and living in a hypo-endemic (control) community. Overall, there were 5459 and 1451 subjects from hyper-and hypo-endemic communities, respectively. In the highly endemic communities, the prevalence of itching increased with age until 20 years and then plateaued, affecting 42% of the population aged 20 years. There was a strong correlation between the prevalence of itching and the level of endemicity (as measured by the prevalence of nodules; r=0.75; P<0.001). The results of a multivariate logistic regression analysis showed that, at the individual level, the presence of onchocercal reactive skin lesions (acute papular onchodermatitis, chronic papular onchodermatitis and/or lichenified onchodermatitis) was the most important risk factor for pruritus, with an odds ratio (OR) of 18.3 and 95% confidence interval (CI) of 15.19-22.04, followed by the presence of palpable onchocercal nodules (OR=4.63; CI=4.05-5.29). In contrast, non-onchocercal skin disease contributed very little to pruritus in the study communities (OR=1.29; CI=1.1–1.51). Onchocercal skin lesions affected 28% of the population in the endemic villages. The commonest type was chronic papular onchodermatitis (13%), followed by depigmentation (10%) and acute papular onchodermatitis (7%). The highest correlation with endemicity was seen for the prevalence of any onchocercal skin lesion and/or pruritus combined (r=0.8; P<0.001). Cutaneous onchocerciasis was found to be a common problem in many endemic areas in Africa which do not have high levels of onchocercal blindness. These findings, together with recent observations that onchocercal skin disease can have major, adverse, psycho–social and socio–economic effects, justify the inclusion of regions with onchocercal skin disease in control programmes based on ivermectin distribution. On the basis of these findings, the World Health Organization launched a control programme for onchocerciasis, the African Programme for Onchocerciasis Control (APOC), that covers 17 endemic countries in Africa.
{"title":"Onchocerciasis: the clinical and epidemiological burden of skin disease in Africa","authors":"M. Murdoch, M. Asuzu, M. Hagan, W. Makunde, P. Ngoumou, K. Ogbuagu, D. Okello, G. Ozoh, J. H. Remme","doi":"10.1179/000349802125000826","DOIUrl":"https://doi.org/10.1179/000349802125000826","url":null,"abstract":"Abstract An attempt was made to assess the true public-health importance of onchocercal skin disease throughout the African region and hence provide an objective basis for the rational planning of onchocerciasis control in the area. The seven collaborative centres that participated in the study (three in Nigeria and one each in Ghana, Cameroon, Tanzania and Uganda) were all in areas of rainforest or savannah-forest mosaic where onchocercal blindness is not common. A cross-sectional dermatological survey was undertaken at each site following a standard protocol. At each site, the aim was to examine at least 750 individuals aged 5 years and living in highly endemic communities and 220-250 individuals aged 5 years and living in a hypo-endemic (control) community. Overall, there were 5459 and 1451 subjects from hyper-and hypo-endemic communities, respectively. In the highly endemic communities, the prevalence of itching increased with age until 20 years and then plateaued, affecting 42% of the population aged 20 years. There was a strong correlation between the prevalence of itching and the level of endemicity (as measured by the prevalence of nodules; r=0.75; P<0.001). The results of a multivariate logistic regression analysis showed that, at the individual level, the presence of onchocercal reactive skin lesions (acute papular onchodermatitis, chronic papular onchodermatitis and/or lichenified onchodermatitis) was the most important risk factor for pruritus, with an odds ratio (OR) of 18.3 and 95% confidence interval (CI) of 15.19-22.04, followed by the presence of palpable onchocercal nodules (OR=4.63; CI=4.05-5.29). In contrast, non-onchocercal skin disease contributed very little to pruritus in the study communities (OR=1.29; CI=1.1–1.51). Onchocercal skin lesions affected 28% of the population in the endemic villages. The commonest type was chronic papular onchodermatitis (13%), followed by depigmentation (10%) and acute papular onchodermatitis (7%). The highest correlation with endemicity was seen for the prevalence of any onchocercal skin lesion and/or pruritus combined (r=0.8; P<0.001). Cutaneous onchocerciasis was found to be a common problem in many endemic areas in Africa which do not have high levels of onchocercal blindness. These findings, together with recent observations that onchocercal skin disease can have major, adverse, psycho–social and socio–economic effects, justify the inclusion of regions with onchocercal skin disease in control programmes based on ivermectin distribution. On the basis of these findings, the World Health Organization launched a control programme for onchocerciasis, the African Programme for Onchocerciasis Control (APOC), that covers 17 endemic countries in Africa.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"29 1","pages":"283 - 296"},"PeriodicalIF":0.0,"publicationDate":"2002-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87342584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-03-01DOI: 10.1179/000349802125000295
W. Saksirisampant, K. Kulkaew, S. Nuchprayoon, S. Yentakham, V. Wiwanitkit
Abstract The livers were separated from the viscera of 2738 swamp eels (Monopterus alba) purchased from Klong Toey market, the largest market in Bangkok, between June 1999 and May 2000. When these livers were digested in artificial gastric juice, 524 (19.1%) were found to be infected with the human-infective, third-stage larvae (L3) of Gnathostoma spp. All the identified larvae were confirmed morphologically to be G. spinigerum. Prevalence of the infection varied with season, from a high of 38.3% in September to a low of 7.0% in April, being generally high during the rainy season and winter (June-February). The mean (S.E.) number of L3 recovered/infected liver, which was 3.99 (0.52) overall, also varied with the season, peaking at 5.38 (1.89) in January, but the month-on-month variation was not statistically significant. Although the results of an earlier study had indicated that the prevalence of eel infection decreased in November, after the rainy season, the most abrupt decrease observed in the present study occurred at the beginning of summer (March). However, the period covered by the present study was unusually wet, and the prevalence of eel infection may depend on rainfall more than season.
{"title":"A survey of the infective larvae of Gnathostoma spinigerum in swamp eels bought in a local market in Bangkok, Thailand","authors":"W. Saksirisampant, K. Kulkaew, S. Nuchprayoon, S. Yentakham, V. Wiwanitkit","doi":"10.1179/000349802125000295","DOIUrl":"https://doi.org/10.1179/000349802125000295","url":null,"abstract":"Abstract The livers were separated from the viscera of 2738 swamp eels (Monopterus alba) purchased from Klong Toey market, the largest market in Bangkok, between June 1999 and May 2000. When these livers were digested in artificial gastric juice, 524 (19.1%) were found to be infected with the human-infective, third-stage larvae (L3) of Gnathostoma spp. All the identified larvae were confirmed morphologically to be G. spinigerum. Prevalence of the infection varied with season, from a high of 38.3% in September to a low of 7.0% in April, being generally high during the rainy season and winter (June-February). The mean (S.E.) number of L3 recovered/infected liver, which was 3.99 (0.52) overall, also varied with the season, peaking at 5.38 (1.89) in January, but the month-on-month variation was not statistically significant. Although the results of an earlier study had indicated that the prevalence of eel infection decreased in November, after the rainy season, the most abrupt decrease observed in the present study occurred at the beginning of summer (March). However, the period covered by the present study was unusually wet, and the prevalence of eel infection may depend on rainfall more than season.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"321 1","pages":"191 - 195"},"PeriodicalIF":0.0,"publicationDate":"2002-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77940073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-03-01DOI: 10.1179/000349802125000673
M. Homeida, E. Braide, E. Elhassan, U. Amazigo, B. Liese, B. Benton, M. Noma, D. Etya'alé, K. Dadzie, O. Kale, A. Sékétéli
Abstract Since its inauguration in 1995, the African Programme for Onchocerciasis Control (APOC) has made significant progress towards achieving its main objective: to establish sustainable community-directed treatment with ivermectin (CDTI) in onchocerciasis-endemic areas outside of the remit of the Onchocerciasis Control Programme in West Africa (OCP). In the year 2000, the programme, in partnership with governments, non-governmental organizations and the endemic communities themselves, succeeded in treating 20,298,138 individuals in 49,654 communities in 63 projects in 14 countries. Besides the distribution of ivermectin, the programme has strengthened primary healthcare (PHC) through capacity-building, mobilization of resources and empowerment of communities. The community-directed-treatment approach is a model that can be adopted in developing other community-based health programmes. The approach has also made it possible to bring to the poor some measure of intervention in some other healthcare programmes, such as those for malaria control, eye care, maternal and child health, nutrition and immunization. CDTI presents, at all stages of its implementation, a unique window of opportunity for promoting the functional integration of healthcare activities. For this to be done successfully and in a co-ordinated manner, adequate funding of CDTI within PHC is as important as an effective sensitization of the relevant policy-makers, healthworkers and communities on the value of integration (accompanied by appropriate training at all levels). Evaluation of the experiences in integration of health services, particularly at community level, is crucial to the success of the integration.
{"title":"APOC’s strategy of community-directed treatment with ivermectin (CDTI) and its potential for providing additional health services to the poorest populations","authors":"M. Homeida, E. Braide, E. Elhassan, U. Amazigo, B. Liese, B. Benton, M. Noma, D. Etya'alé, K. Dadzie, O. Kale, A. Sékétéli","doi":"10.1179/000349802125000673","DOIUrl":"https://doi.org/10.1179/000349802125000673","url":null,"abstract":"Abstract Since its inauguration in 1995, the African Programme for Onchocerciasis Control (APOC) has made significant progress towards achieving its main objective: to establish sustainable community-directed treatment with ivermectin (CDTI) in onchocerciasis-endemic areas outside of the remit of the Onchocerciasis Control Programme in West Africa (OCP). In the year 2000, the programme, in partnership with governments, non-governmental organizations and the endemic communities themselves, succeeded in treating 20,298,138 individuals in 49,654 communities in 63 projects in 14 countries. Besides the distribution of ivermectin, the programme has strengthened primary healthcare (PHC) through capacity-building, mobilization of resources and empowerment of communities. The community-directed-treatment approach is a model that can be adopted in developing other community-based health programmes. The approach has also made it possible to bring to the poor some measure of intervention in some other healthcare programmes, such as those for malaria control, eye care, maternal and child health, nutrition and immunization. CDTI presents, at all stages of its implementation, a unique window of opportunity for promoting the functional integration of healthcare activities. For this to be done successfully and in a co-ordinated manner, adequate funding of CDTI within PHC is as important as an effective sensitization of the relevant policy-makers, healthworkers and communities on the value of integration (accompanied by appropriate training at all levels). Evaluation of the experiences in integration of health services, particularly at community level, is crucial to the success of the integration.","PeriodicalId":8038,"journal":{"name":"Annals of Tropical Medicine & Parasitology","volume":"4 1","pages":"S104 - S93"},"PeriodicalIF":0.0,"publicationDate":"2002-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77080307","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2002-03-01DOI: 10.1179/000349802125000655
L. Clemmons, U. Amazigo, A. Bissek, M. Noma, U. Oyene, U. Ekpo, J. Msuya-Mpanju, S. Katenga, A. Sékétéli
Abstract This paper reviews the issues relating to compliance and participation among the men and women of three countries within the remit of the African Programme for the Control of Onchocerciasis (APOC): Cameroon, Nigeria and Tanzania. Project-monitoring data from 109 focus-group discussions, 6069 household-survey respondents and 89 interviews with ivermectin distributors were analysed to gain an insight into the attitudes and behaviours of men and women in relation to ivermectin treatment and their participation in the programme. Although there are no statistically significant gender diVerences in coverages for ivermectin treatment, culturally prescribed gender relationships influence the ways in which men and women express and experience treatmentrelated behaviours. Gender roles also aVect participation in the programme. Decision-making in communities on the selection of distributors tends to follow socio–cultural hierarchies based upon patriarchy and gerontocracy. Relatively few ivermectin distributors (21%) are women. Although they receive less support than their male counterparts, the female distributors are just as willing to continue ivermectin distribution in the community, and they perform as well or better than men in this regard. The terms ‘community-directed’, ‘community participation’ and even ‘compliance’ obfuscate important gender diVerences that are inherent in the implementation of onchocerciasis control. Development of strategies that recognize these gender diVerences will have important implications for long-term adherence to treatment and for the overall quality and sustainability of the programme.
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Pub Date : 2002-03-01DOI: 10.1179/000349802125000600
P. A. Meléndez, V. A. Capriles
Abstract Overall, 173 tropical plants from 72 different families, collected from the north-western and western regions of Puerto Rico, were screened for their molluscicidal properties against Biomphalaria glabrata, the intermediate host of Schistosoma mansoni. Six plant extracts were effective at 50 ppm. The two most effective extracts were those from the leaves of Didymopanax morototoni (Araliaceae) and Mammea americana (Guttiferae), which, at 50 ppm, killed all snails after 24 h of exposure and a day for recovery. Under the same conditions, extracts of Furcraea tuberosa, Argemone mexicana and Paullinia pinnata killed 50% of the snails and that of Solanum americanum killed 33%. The most effective extracts (or their active components or compounds based on them) may have potential as molluscides for the relatively cheap control of human schistosomiasis.
摘要/ Abstract摘要:对采自波多黎各西北和西部地区的72科173种热带植物进行了对曼氏血吸虫中间寄主光生Biomphalaria glabrata的杀虫性能研究。六种植物提取物在50ppm时有效。两种最有效的提取物是来自Didymopanax morototoni (Araliaceae)和Mammea americana (gutiferae)的叶子，在50 ppm的浓度下，暴露24 h和一天恢复后杀死所有蜗牛。在相同的处理条件下，龙葵提取物、墨西哥银杏提取物和凤尾莲提取物对钉螺的杀伤率分别为50%和33%。最有效的提取物(或其活性成分或以其为基础的化合物)可能有潜力作为杀螺剂，以相对廉价的方式控制人类血吸虫病。
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