Malaria Control & Elimination

The emerging resistance of Plasmodium species to currently available antimalarial drugs remains a public health problem, hence the need for new effective, safe and affordable drugs. Plant extracts remain a reliable source of drugs. Bauhinia strychnifolia (Yha-nang dang) is widely distributed and has been traditionally used in Thailand to treat fever, alcoholic toxication and allergy. The leaf extract of B. strychnifolia had potent antioxidant, anti-cancer and anti-microbial activities. The aim of the study was at investigating antimalarial activities of B. strychnifolia in malaria infected rodent models. Acute toxicity of ethanolic crude extract of B. strychnifolia leaves was assessed in mice up to a dose of 6,000 mg/kg. ICR mice were inoculated with Plasmodium berghei ANKA and treated with the extracts (500, 1500 and 3000 mg/kg) orally by gavage. Four day suppressive and curative effect against established infection and prophylactic models of antimalarial studies were carried out. The extract did not show any toxic effect because doses up to 3,000 mg/kg caused no death or alter the behavior of the tested normal mice. For antimalarial studies, the extract (3,000 mg/kg) exerted significant (P < 0.01) effects of prophylactic, suppressive, and curative with percent inhibition of 59%, 84%, and 68%, respectively. However, antimalarial effect of chloroquine at 5 mg/kg was higher than the extract in all test models. These results indicate that ethanolic crude extract of B. strychnifolia leaves has excellent in vivo antimalarial activities against P. berghei ANKA. Hence, this plant extract represents a promising source of new antimalarial agents.

Malaria is a tropical parasitic disease that triggers severe social and economic problems worldwide and causes thousands of deaths each year. Early diagnosis enables proper treatment. People from non-endemic areas who travel to areas of transmission are often exposed to late or incorrect diagnosis because healthcare professionals have great difficulty in conceiving malaria as a diagnostic hypothesis. In addition, technicians skilled in recognizing malaria etiologic agent are not abundant. This paper addresses the case of a child from a non-endemic malaria region in Brazil, with a prior hypothetic diagnosis of visceral leishmaniasis, however bone marrow aspirate revealed Plasmodium instead of Leishmania. A retrospective epidemiological investigation showed a history of a recent trip to a malaria area and the review of blood smears obtained on admission disclosed a large number of trophozoites and gametocytes of Plasmodium falciparum that had been unnoticed, suggesting that diagnosis could have been possible earlier. Malaria clinical picture is easily mistaken for other febrile infectious diseases, thus the possibility of its occurrence cannot be ruled out. There is a need to increasingly train the microscopy technicians, both in endemic and non-endemic areas, so as to minimize the false diagnoses and decrease morbidity and mortality of the disease.

Background: Malaria is the commonest cause of fever, morbidity and mortality in the tropics. A good number of people are able to recognize the symptoms and initiate treatment. However lack of clinical evaluation of the patients by trained health professionals, may delay appropriate treatment and promote drug resistant. Objective: To determine the prevalence of self-treatment of malaria among the people with regard to knowledge and factors that may influence health seeking behavior. Method: Community based cross section descriptive study carried among 365patients buying medicines from local drugstores. A structured questionnaire was used to gather data entered in Epi Data 3.1 and analysis done using SPSS version 16.0. To ascertain association between dependent and independent variables, binary logistic regression and variables with p-value of less than or equal to 0.05 were entered into multivariate regression analysis. Results: Among the 365 patients interviewed 150 bought antimalarials 150/365 (41.1%). The overall knowledge was 44.7% and significantly associated with income, education and occupation. Compared to respondents with income > K1000, respondents with income < K500 were 94% (AOR=0.06; 95% CI [0.01, 0.21]) less likely to be knowledgeable. Respondents with tertially education were 2.73 (95% CI [1.50, 4.89]) times more likely to be knowledgeable compared to respondents with primary education. Compared to respondents with othersa occupations, professionals were 5.97 (95% CI [2.27, 15.7]) times more likely to be knowledgeable. Sulfadoxine-pyrimethamine (fansidar) is by far the antimalaria drug that was used 51.3%. About 66.7% attributed to overcrowding and 72.7% to not being attended to in less than 2 hours upon arrival at health facility as reasons for not seeking treatment at government facilities. Conclusion: Prevalence of self-medication was high 41.1% and most people lacked adequate knowledge on malaria. The individual’s level of formal education, income and occupation were determinants knowledge.

The present study has been carried out to investigate antimalarial and anti-hypoglycemic activities of leaf aqueous crude extract of Siamese neem tree (Azadirachta indica) against Plasmodium berghei infected mice. Groups of ICR mice were treated orally with Siamese neem tree extract (500, 1000, and 2000 mg/kg) after infection with P. berghei ANKA. Parasitemia and blood glucose levels were determined. At these doses, Siamese neem tree extract inhibited parasitemia in dose-dependent manner with significance (P < 0.05). In addition, anti-hypoglycemic activity has been observed in infected mice treated with Siamese neem tree extracts. In particularly, the highest activities of Siamese neem tree extract were found at dose 2000 mg/kg. These results indicated that leaf aqueous crude extract of Siamese neem tree have antimalarial and anti-hypoglycemic activities against P. berghei ANKA infected mice.

Liver and renal damage are some causes of deaths in malaria disease. Moreover, hypoglycemia and hypoglycemic shock during malaria infection have also been reported. Therefore, finding new plant extracts to have the activities to protect liver and renal damage as well as hypoglycemia during malaria infection is urgently needed. In this study was aimed to investigate the protective effects of Andrographis paniculata leaf extract on liver and renal damage as well as hypoglycemia induced by Plasmodium berghei ANKA (PbANKA) infection in mice. Aqueous crude extract of A. paniculata leaves was freshly prepared using hot water method. For efficacy test, standard 4-day suppressive test was used. ICR mice were inoculated with 1x107 parasitized erythrocytes of PbANKA by intraperitoneal infected, and given the extract (500, 1000, and 2000 mg/kg) orally by gavage for 4 consecutive days. Aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, blood urea nitrogen (BUN), creatinine, and glucose were measured. It was found that liver and renal damage were developed during malaria infection as indicated by markedly increasing of AST, ALT, BUN, and creatinine, and decreasing of albumin levels. Additionally, hypoglycemia was also found during the infection. Interestingly, A. paniculata extract showed protective effects on liver and renal damage, and presented anti-hypoglycemia in a dose-dependent manner against infected mice treated with this extract. The highest effect was found at dose of 2000 mg/kg. Moreover, no any side effects were observed in normal mice treated with the extract. It can be concluded that A. paniculata leaf extract can be used as alternative drug to protect liver and renal damage as well as hypoglycemia during malaria infection