Malaria

The aim was to the study clinical evaluation and
outcome of patients with febrile thrombocytopenia.
Methodology:100 patients of fever with thrombocytopenia.
Malaria was  the commonest cause of  febrile thrombocytopenia.
followed by Dengue and viral fever.Maximum percent of
bleeding seen at 5×103 to 10×103/cumm platelet count, then
11×103 to 20×103/cumm followed by 21×103 to
30×103/cumm.Out of 100 patients 23 patients showd bleeding
manifestations. The Commonest form of  bleeding manifestation
was petechiae in 17 patients  followed by hematuria, per rectal
bleeding and epistaxis in 3,2 and 1 patient respectively.Good
recovery was noted in 95% patients and mortality noted in 5%
patients. Septicemia accounted for 75% mortality. We conclude
that the febrile illness patients should be investigated for platelet
count whether they have bleeding manifestations or not. Strong
probability of dengue fever or other common causes like malaria,
viral fever and leptospirosis should be kept in mind in any case
of fever and thrombocytopenia as a decreased platelet count can
be severe without external manifestation and lead to a bad
prognosis if not treated with platelet transfusion early.

Background: Low rates of adherence to artemisinin-based combination therapy (ACT) regimens increase the risk of
treatment failure and may lead to drug resistance, threatening the sustainability of current anti-malarial efforts. We assessed
the impact of text message reminders on adherence to ACT regimens.

Methods: Health workers at hospitals, clinics, pharmacies, and other stationary ACT distributors in Tamale, Ghana provided
flyers advertising free mobile health information to individuals receiving malaria treatment. The messaging system
automatically randomized self-enrolled individuals to the control group or the treatment group with equal probability;
those in the treatment group were further randomly assigned to receive a simple text message reminder or the simple
reminder plus an additional statement about adherence in 12-hour intervals. The main outcome was self-reported
adherence based on follow-up interviews occurring three days after treatment initiation. We estimated the impact of the
messages on treatment completion using logistic regression.

Results: 1140 individuals enrolled in both the study and the text reminder system. Among individuals in the control group,
61.5% took the full course of treatment. The simple text message reminders increased the odds of adherence (adjusted OR 1.45, 95% CI [1.03 to 2.04], p-value 0.028). Receiving an additional message did not result in a significant change in
adherence (adjusted OR 0.77, 95% CI [0.50 to 1.20], p-value 0.252).

Conclusion: The results of this study suggest that a simple text message reminder can increase adherence to antimalarial
treatment and that additional information included in messages does not have a significant impact on completion of ACT treatment. Further research is needed to develop the most effective text message content and frequency.

Trial Registration: ClinicalTrials.gov NCT01722734

Ontology which focuses entirely on malaria diseases or on any of the diseases that affect the tropical region of the world is hard to come by due to the economic condition of the countries in this region. Furthermore, the type of access provided by some of the existing medical ontology is a somewhat cumbersome process and the data that might be
provided at the end is often not comprehensive and concise
enough to be understood by a non-professional seeking
knowledge, may be on a specific concept or aspect and how
they are linked to other concepts. Hence, the need for a
semantic medical ontology that addresses the issues raised.

The methodology used for this project work involve the gathering of adequate and correct information on malaria from recognized bodies i.e. the parasites, the mode of treatment, Malaria type, symptoms, etc., developing an ontology model from the information given and providing a means of remote or online access for individuals or groups that require information that is well represented.

In this work, an ontology model that is completely devoted to the malaria parasite along with the establishment of a semantic
website that enables a less cumbersome mode of access to relevant information gathered on malaria was developed.

Abstract
West and East Africa experience high variability
of rainfall that is expected to increase with climate
change. This results in fluctuations in water availability for
food production and other socioeconomic activities. Water
harvesting and storage can mitigate the adverse effects of
rainfall variability. But past studies have shown that when
investments in water storage are not guided by environmental
health considerations, the increased availability of
open water surface may increase the transmission of water related diseases. This is demonstrated for schistosomiasis
associated with small reservoirs in Burkina Faso, and for
malaria in Ethiopia around large dams, small dams, and
water harvesting ponds. The concern is that the rush to
develop water harvesting and storage for climate change
adaptation may increase the risk for already vulnerable
people, in some cases more than canceling out the benefits
of greater water availability. Taking health issues into
account in a participatory approach to planning, design,
and management of rainwater harvesting and water storage,
as well as considering the full range of water storage
options would enable better opportunities for enhancing
resilience against climate change in vulnerable populations
in sub-Saharan Africa.

Despite growing concern about the effect of environmental degradation on human health, little effort has been made to quantify the effect of ecosystem damage on the incidence and burden of infectious diseases. Using village-level administrative panel data and satellite data on forest cover, I find that deforestation from 2001-2008 in Indonesia can explain 360,000-880,000 additional malaria infections. The evidence is consistent with an ecological response and the effect of deforestation on malaria cannot be explained by post-deforestation land use change, anti-malarial programs or migration. The effect is specific to malaria, with deforestation having no discernible effect on other diseases with disease ecologies different from that of malaria. Back of the envelope calculations suggest that the local health benefits from avoided deforestation are 6-31 times the global carbon benefits, underscoring a large, yet previously ignored and unquantified cost of deforestation.

Plasmodium and dengue virus, the causative agents of the two most devastating vector-borne diseases, malaria and dengue, are transmitted by the two most important mosquito vectors, Anopheles gambiae and Aedes aegypti, respectively. Insect-bacteria associations have been shown to influence vector competence for human pathogens through multi-faceted actions that include the elicitation of the insect immune system, pathogen sequestration by microbes, and bacteria-produced anti-pathogenic factors. These influences make the mosquito microbiota highly interesting from a disease control perspective. Here we present a bacterium of the genus Chromobacterium (Csp_P), which was isolated from the midgut of field-caught Aedes aegypti. Csp_P can effectively colonize the mosquito midgut when introduced through an artificial nectar meal, and it also inhibits the growth of other members of the midgut microbiota. Csp_P colonization of the midgut tissue activates mosquito immune responses, and Csp_P exposure dramatically reduces the survival of both the larval and adult stages. Ingestion of Csp_P by the mosquito significantly reduces its susceptibility to Plasmodium falciparum and dengue virus infection, thereby compromising the mosquito's vector competence. This bacterium also exerts in vitro anti-Plasmodium and anti-dengue activities, which appear to be mediated through Csp_P -produced stable bioactive factors with transmission-blocking and therapeutic potential. The anti-pathogen and entomopathogenic properties of Csp_P render it a potential candidate for the development of malaria and dengue control strategies.

Population subgroups of the African malaria vector Anopheles gambiae have not been comprehensively characterized owing to the lack of unbiased sampling methods. In the arid savanna zone of West Africa, where potential oviposition sites are scarce, widespread collection from larval pools in the peridomestic human habitat yielded a comprehensive genetic survey of local A. gambiae population subgroups, independent of adult resting behavior and ecological preference. A previously unknown subgroup of exophilic A. gambiae is sympatric with the known endophilic A. gambiae in this region. The exophilic subgroup is abundant, lacks differentiation into M and S molecular forms, and is highly susceptible to infection with wild Plasmodium falciparum. These findings might have implications for the epidemiology of malaria transmission and control.

Plasmodium vivax is the leading cause of human malaria in Asia and Latin America, but is almost completely absent from central Africa due to the near fixation of a mutation that inhibits the expression of its receptor, the Duffy antigen, on erythrocytes1,2. The emergence of this protective allele is not understood2,3 since P. vivax is widely considered to have originated in Southeast Asia4,5. Here, we provide an explanation for this paradox by showing that wildliving apes in central Africa are endemically infected with parasites that are genetically nearly identical to human P. vivax. Testing over 5,000 faecal samples from 78 different field sites for parasite DNA, we found P. vivax-like sequences in chimpanzees (Pan troglodytes), western (Gorilla gorilla) and eastern gorillas (Gorilla beringei), but not bonobos (Pan paniscus). Ape P. vivax was highly prevalent in wild communities, exhibiting infection rates consistent with stable parasite transmission. To examine the evolutionary relationships of ape and human parasites, we used single genome amplification to generate sequences from wild and sanctuary apes, as well as from a global sampling of human P. vivax infections. Phylogenetic analyses of more than 2,600 mitochondrial, apicoplast and nuclear sequences revealed that the ape and human parasites were very closely related. However, ape parasites exhibited considerably greater genetic diversity and did not cluster according to their host species. In contrast, the human parasites formed a monophyletic lineage that fell within the radiation of ape sequences. These findings indicate that P. vivax is of African, not Asian origin, and that all extant human parasites evolved from a single ancestor that spread out of Africa. The high prevalence of P. vivax in wild-living apes, along with the recent finding of ape P. vivax in a European traveller6, indicates the existence a substantial zoonotic reservoir, which has implications for malaria eradication efforts.

Background

Many small studies have been done in Honduras estimating soil-transmitted helminthiasis (STH) prevalence but a country-wide study was last done in 2005. The country has the highest burden of malaria among all Central American countries. The present study was done to estimate country-wide STH prevalence and intensity, malaria prevalence and nutritional status in school going children.

Methods and Findings

A cross-sectional study was conducted following PAHO/WHO guidelines to select a sample of school going children of 3rd to 5th grades, representative of ecological regions in the country. A survey questionnaire was filled; anthropometric measurements, stool sample for STH and blood sample for malaria were taken. Kato-Katz method was used for STH prevalence and intensity and rapid diagnostic tests, microscopy, and polymerase chain reaction (PCR) were used for malaria parasite detection. A total of 2554 students were studied of which 43.5% had one or more STH. Trichuriasis was the most prevalent (34%) followed by ascariasis (22.3%) and hookworm (0.9%). Ecological regions II (59.7%) and VI (55.6%) in the north had the highest STH prevalence rates while IV had the lowest (10.6%). Prevalence of one or more high intensity STH was low (1.6%). Plasmodium vivax was detected by PCR in only 5 students (0.2%), all of which belonged to the same municipality; no P. falciparum infection was detected. The majority of children (83%) had normal body mass index for their respective age but a significant proportion were overweight (10.42%) and obese (4.35%).

Conclusions

Biannual deworming campaigns would be necessary in ecological regions II and VI, where STH prevalence is >50%. High prevalence of obesity in school going children is a worrying trend and portends of future increase in obesity related diseases. Malaria prevalence, both symptomatic and asymptomatic, was low and provides evidence for Honduras to embark on elimination of the disease.

Introduction: Kutch area in Gujrat state of India is high endemic area for BT malaria. After devastating earthquake of 26 Jan
2001 in the region, number of malaria cases increased in the region. A closed campus of defence establishment witnessed an
outbreak of BT malaria in 2005 due to local transmission confirmed by epidemiological investigation.
Material and methods: On receiving the information of an abnormal rise in the number of cases a team headed by a senior
epidemiologist was sent to investigate the outbreak. On submission of report the team was asked to implement control
measures to prevent its further transmission.
Results: A large number of cases reported in the campus with a high slide positivity rate of 27.07 percent and API of 75.12
per thousand population in 2005. Majority of them (99.17 percent) were BT malaria cases. Family members were affected
most (API 106.66) as compared to the Air Force employees (API 33.57). A spleen rate of 1.04 percent and an infant parasite
rate of 10.81 percent revealed a high transmission among the children.
Discussion: Population residing in the campus had BT malaria epidemic with very high percentage of cases among younger
population. The main cause of epidemic was failure of the measures for prevention and control. Local transmission of malaria
was caused by An. stephensi which was found to breed heavily in pools, ditches, overhead tanks and static tanks. Clinical
cases reported with fever and confirmed by blood smear examination were neither treated nor reported to higher authorities.
Antimalarial activities were also not conducted as per the guidelines mentioned in the directives of defence services. The
epidemic was controlled effectively by adopting the measures advised by the investigating team.

Malaria, an infectious disease begins with the introduction of protists into blood circulation and may cause death in severe cases. Development of resistance in Plasmodium parasites is major obstacle and emphasizes the need of novel strategy to combat the prevalent of disease. Fenofibrate, an agonist of peroxisome proliferator-activated receptor alpha (PPAR-α) is well known to treat hypertriglyceridaemia and mixed dyslipidaemia from decades. Recent studies reports possibility of its activity against the malarial parasite as well. Here we explore the Fenofibrate for activity against malaria in Plasmodium berghei infected mice The infected erythrocytes (IE) from control and treated mice was subjected to microscopic examination for analyse the mean percent parasitemia on day 4th, 7th, 10th, 14th and 21st after infection. The results of present study illustrate the activity of fenofibrate against Plasmodium berghei malaria parasite in-vivo. Significant distinction was observed in percent parasitemia of fenofibrate and vehicle treated mice. Treatment with 320mg/kg was found to be most suppressing amongst the entire treatments of fenofibrate.

In the summer of 1943 Allied troops began their invasion
of southern Italy, and by April of 1945, the countryside from Sicily to the Roman Campagna was pockmarked by craters from bomb shells and artillery. This scarred landscape, along with villages and cities devastated by battle, became an ideal habitat for rodents and insects and perfect breeding grounds for mosquitoes. Soldiers and civilians across the peninsula were contracting typhus, tuberculosis, dysentery, and especially malaria, with many of these ills being spread by the vermin and parasites who were the immediate victors of every battle. As the dust settled and the front moved northward, villages such as Castel Volturno (which lies north of Naples)
and then the Tiber Delta became the first places in Europe where health officials would experiment with dichloro-
diphenyl-trichloroethane,or DDT, as a means to kill mosquitoes and thus control the spread of malaria (map 6.1). The next spring, following heavy winter rains, spray crews and airplane dusters began fumigating the soggy, war-torn
countryside, testing out the miracle insecticide that had already proved itself so effective in the South Pacific. Warfare disrupted the ecosystems that kept malaria in check, but it also led to the development of new technologies that might enable eradication of this disease. In this Italian case of war and environment, I offer examples of how malaria modified combat and its outcomes, as well as examples of how warfare modified malaria. As we ponder other wars—past, present,
and future—it behooves us to consider the multiple, though seldom-studied effects of linking belligerent humans with infectious microbes.

Malaria is second only to tuberculosis as the world's most deadly killer. Yet malaria is an environmental issue as well as a health concern. Because malaria parasites are transmitted by mosquito vectors, any measure that kills mosquitoes, disrupts mosquito habitat or prevents their contact with humans has been tested alongside a variety of drug treatments. Human efforts to control malaria mean that wetlands have been drained, rivers channeled, and pesticides sprayed, often through massively financed campaigns.  The Rockefeller Foundation's Sardinian Project, lasting from 1946 to 1951, utilized 32,000 DDT workers to spray 10,000 tons of DDT mixture over an area two-thirds the size of Switzerland, finally liberating the island of malaria. The environmental implications were enormous.