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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Malaria is assimilated with its cardinal symptom, i.e., fever. Treatment of fever with antimalarial drugs is crucial to the prevention of malaria-related death in Senegal. The objective of this study was to analyze fever-treatment practices as a basis for making realistic recommendations for self-treatment in the northern health district of Dakar, Senegal. This cross-sectional study was conducted from March 1 to April 30, 2003. The population included all patients with body temperature higher or equal to 37.5 degrees C (99.5 degrees F) associated with at least one of the following symptoms: headache, shivering, vomiting and diarrhoea. Study endpoints included demographic data and fever treatment modalities including the nature, dosage, and duration of the drugs used. Malaria was suspected in 180 of the 271 patients enrolled in the study. Treatment had already been undertaken in 134 patients including 108 (81%) who had initiated self-treatment. Drugs included antipyretics, antibiotics, and/or antimalarials. Antimalarial drug dosage was incorrect in 84% of those who initiated self-treatment. Dosage errors involved number of daily doses (55%), duration of treatment (13%), or both (32%). Only 45% of patients fully completed treatment. Medical advice was sought in 30% of the cases and drugs were obtained over the counter in pharmacies in 59%. Patients under the age of 15 years were significantly more likely to initiate self-treatment (p=6.10-6), to treat symptoms early, and to use an antimalarial (p=4.10-6). Although self-treatment shortened the delay between onset of symptoms and initiation of treatment, it is likely that indiscriminate and incomplete treatment is responsible for development of resistance to chloroquine in the northern health district of Dakar. Strategies must be adapted to numerous local factors influencing self-treatment including the availability of health-care services and drugs of quality. Special attention must be given to the improvement of antimalarial drug packaging and of the awareness of people that provide self-treatment drugs.
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PMID:[Self-treatment of fever in the northern district of Dakar, Senegal]. 1661 20

The genetic variability and population structure of Plasmodium falciparum are key factors in malaria control strategies. Studies have suggested no P. falciparum population structure although linkage disequilibrium was observed in some African areas. We have assessed length polymorphism at 6-22 microsatellites in four urban and rural sites (Djibouti, Dakar, Niamey, and Zouan-Hounien, n = 240 blood samples). Results have shown a P. falciparum population structure in Africa (Fst = 0.17-0.24), lower genetic diversity in Djibouti (He = 0.53) than in the other sites (He = 0.73-0.76), and 3) significant linkage disequilibrium in Djibouti. These results could be related to geographic isolation and low flow of parasites between sites. They also suggest a potential effect of rural suburbs to generate genetic diversity in towns. This could affect the dispersal of selected drug resistance and should be considered when adapting urban malaria control strategies.
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PMID:Genetic diversity and structure of African Plasmodium falciparum populations in urban and rural areas. 1676 May 3

The chemosusceptibility and genetic polymorphism of Plasmodium falciparum populations from 48 patients hospitalized for malaria at the Hospital Principal in Dakar, Senegal were investigated during the 2002 malaria transmission season. Sixty-two percent of the isolates collected were from patients with severe malaria and 38% were from patients with mild malaria. In vitro activities of chloroquine, quinine, cycloguanil, atovaquone, mefloquine, halofantrine, and artesunate were evaluated. The prevalence of mutations in the Plasmodium falciparum dihydrofolate reductase (dhfr) and dihyropteroate synthetase (dhps) genes and the P. falciparum chloroquine resistance transporter (Pfcrt) gene associated with cycloguanil, pyrimethamine, sulfadoxine, and chloroquine resistance were estimated. The genetic polymorphism of the parasite populations was evaluated by analysis of the highly polymorphic regions of merozoite surface protein 1 (msp1) block 2 and msp2. Seventy percent of the isolates were assessed by an in vitro assay. Fifty-two percent of the isolates were chloroquine resistant, 45% were cycloguanil resistant, and 24% were atovaquone resistant. Four percent had low susceptibility to quinine. The Pfcrt and dhfr mutations were associated with in vitro chloroquine- and antimetabolic drug-resistant isolates, respectively. Approximately 70% of the isolates contained two or more clones. Genetic diversity of P. falciparum was high. The prevalence of allelic family K1 of msp1 was 68%. Isolates of P. falciparum were highly resistant to chloroquine, cycloguanil and atovaquone. The transmission rate of malaria in Dakar is low but a high degree of genetic polymorphism can increase severe malaria, as shown by persons coming to Dakar from areas highly endemic for malaria. Areas with urban malaria should use vector control measures and efficient chemoprophylaxis for non-immune populations.
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PMID:Urban malaria in Dakar, Senegal: chemosusceptibility and genetic diversity of Plasmodium falciparum isolates. 1683 22

The impact of placental malaria in African urban areas is poorly documented. We therefore conducted a study during the rainy season in Dakar, an area with low malaria transmission. Two groups of delivering women were enrolled according to the detection of PfHRP2 in placental blood. Ten percent of the women were positive for parasites in the placenta, and microscopic examination showed, respectively, 17%, 22%, and 44% of past, acute, and chronic infection. The mean birth weight decreased drastically with the infection of the placenta (2,684 +/- 67 versus 3,085 +/- 66 g for controls), particularly with chronic infection. Chronic infection was not linked with parasiteamia in maternal venous blood. Seventy-six percent of positive women were anemic (46% of the controls). Severe anemia was also associated with chronic infection. Long-lasting infections are the most deleterious to mother and infant and are most likely associated with drug resistance of parasites.
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PMID:High prevalence of placental malaria and low birth weight in Sahelian periurban area. 1683 27

We previously reported a high baseline prevalence of mutations in the dhfr and dhps genes of Plasmodium falciparum throughout Senegal. The highest prevalence of the triple dhfr pyrimethamine associated mutations were found in isolates obtained in the western part of the country near the capital city of Dakar. In this study, we sought out to determine the relatedness of dhfr wild type and mutated strains by analyzing three microsatellite regions upstream of the dhfr locus. Twenty-six of the 31 wild type strains had a unique microsatellite pattern. In contrast, of the 17 isolates containing the triple mutation in dhfr, 11 had an identical microsatellite pattern. Diverse geographical isolates in Senegal containing the triple dhfr mutation have arisen from a limited number of ancestral strains. In addition, we demonstrate that these isolates have shared ancestry with the previously reported triple mutation haplotype found in Tanzania, South Africa, and southeast Asia. This common ancestry may have implications for the malaria control strategy for reducing the spread of sulfadoxine-pyrimethamine resistance in Senegal and elsewhere in Africa.
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PMID:Defining the origin of Plasmodium falciparum resistant dhfr isolates in Senegal. 1690 11

A patient with suspected malaria was hospitalized successively in 2 hospitals, first in Dakar, Senegal, then in Rennes, France, where tests diagnosed Crimean-Congo hemorrhagic fever. An international incident management group was set up in France and Senegal, which traced 181 contacts and analyzed 50 samples from 3 countries. No secondary cases were identified clinically.
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PMID:Lookback exercise with imported Crimean-Congo hemorrhagic fever, Senegal and France. 1707 94

An ethnobotanical study was conducted in the Dakar area of Senegal to investigate the species used in the treatment of malaria. Seven plants are principally used: Cissampelos mucronata, Maytenus senegalensis, Terminalia macroptera, Bidens engleri, Ceratotheca sesamoides, Chrozophora senegalensis and Mitracarpus scaber. From a bibliographic study, it had been shown that the Cissampelos mucronata, Maytenus senegalensis and Terminalia macroptera have already been studied by several authors, and so only Bidens engleri, Ceratotheca sesamoides, Chrozophora senegalensis and Mitracarpus scaber were evaluated in the present study. For each plant, extracts were prepared with different solvents and tested in vitro on two chloroquine-resistant Plasmodium falciparum strains. Crude extracts from the leaves and the stems of Chrozophora senegalensis showed the best in vitro results. The IC(50) value of an aqueous extract of Chrozophora senegalensis was 1.6 microg/ml without cytotoxicity. The in vivo antiplasmodial activity of Chrozophora extracts was determined by both the oral and the intraperitoneal ways. The stages of Plasmodium cycle targeted by Chrozophora were then studied in vitro. These results could justify the traditional use of this plant in malaria treatment.
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PMID:Evaluation of Senegalese plants used in malaria treatment: focus on Chrozophora senegalensis. 1806 30

The Multilateral Initiative on Malaria was created after an international conference on malaria in Africa held in Dakar, Senegal, in early 1997. The main goal of the conference was to "strengthen and sustain, through collaborative research and training, the capability of malaria endemic countries in Africa to carry out research required to develop or improve tools for malaria control." This conference marked the beginning of a new global focus on malaria research and capacity building three decades after a partially successful global malaria eradication program. In addition to promoting research on and institutional strengthening for malaria, the initiative was created to develop mechanisms and systems to facilitate timely communication of information to scientists working in Africa, enhance the capacity to conduct malaria collaborative/multi center research in Africa, and promote application of research results to address malaria control needs. This report summarizes the increased malaria research capacity and empowerment of African researchers facilitated by the Multilateral Initiative on Malaria through the Special Program for Research and Training in Tropical Disease Research at the World Health Organization.
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PMID:Research themes and advances in malaria research capacity made by the Multilateral Initiative on Malaria. 1816 7

This study aimed at describing cerebral malaria cases findings in the Fann Hospital in Dakar. Data were collected from patients files recorded from 2001 to 2005. One hundred and twenty nine cases of cerebral malaria were admitted to the clinic, accounting for 21.4% of all malaria cases. The sex-ratio M/F was 2.48 and the mean age of patients 28.24 years old +/- 13.7 [12-85 years old]. Patients presented with either coma (91.4%) or mental confusion (10.07%) along with fever (80.6%), convulsions (33.3%). Other severe malaria conditions were observed: jaundice (7 cases), severe anaemia (5 cases), acute renal failure (3 cases), and circulatory collapse (3 cases). Acute pulmonary infection (4 cases) and Salmonella bacteraemia (2 cases) occurred as complications during patient's hospitalisation. The case fatality rate was 20.2% (26 deaths). No neurological sequelae were found among survivors. Cerebral malaria lethality is still high enough to urge for the improvement of working conditions in our clinic. Together with promotion of preventive measures in the community better health care services will help to reduce malaria related morbidity and mortality.
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PMID:[Cerebral malaria in adults at the Infectious Diseases Clinic in the Fann Hospital in Dakar, Senegal]. 1843 1

The aims of this study were to determine the place of malaria at the Infectious Disease Clinic in Dakar, Senegal, to identify diseases associated with malaria, and to assess malaria mortality with or without co-morbidity. The files of all patients hospitalized from 2001 to 2003 in whom at least one test for malaria (thick films/spears) was performed to detect malaria parasites were reviewed. Malaria was diagnosed in patients presenting fever and positive thick films demonstrating asexual blood stages of Plasmodium. Data were collected from hospital charts. A total of 416 patients presented malaria (prevalence rate, 25.9%). The male-to-female sex ratio was 1:7 and mean age was 33 +/- 18 years. Of the 416 patients diagnosed with malaria, 273 (65.6%) presented severe forms. The overall mortality rate of malaria with or without co-morbidity was 25.7% (107/416). There was not a statistically significant difference between mortality due to isolated malaria and malaria associated with tuberculosis (23.4% versus 18.5%) (p = 0.7) or tetanus (23.4% versus 17.6%) (p = 0.34). Conversely mortality of malaria in HIV-positive patients was higher (58% versus 19%) (p = 10(-6)). Thus, malaria is of major concern in our department.
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PMID:[The place of malaria in an infectious disease department in Dakar, Senegal]. 1906 80


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