Malaria is an infectious and deadly parasitic disease, associated with fever, anaemia and other ailments. Unfortunately the upsurge of plasmodium multidrug resistant constrained researchers to look for new effective drugs. Medicinal plants seem to be an unquenchable source of bioactive principles in the treatment of various diseases. The aim of this study was to assess the antiplasmodial activity of two Ivorian medicinal plants. The in vitro activity was evaluated against clinical isolates and K1 multidrug resistant strain using the fluorescence based SYBR green I assay. The in vivo bioassay was carried out using the classical 4 day suppressive and curative tests on infected mice. Results showed that the in vitro bioassay of both plant extracts were found to exhibit a promising and moderate antiparasitic effects on clinical isolates (5 µg/mL < IC < 15 µg/mL) and multidrug resistant K1 strain (15 µg/mL< IC < 50 µg/mL). Furthermore, the in vivo antiplasmodial screening of both extracts showed a significant decrease in parasitemia, which was dose-dependent. Body temperature in mice treated with both extracts at experimental doses increased, compared to the negative control group and was dose-dependent. As for mice body weight a significant decrease ( < 0.001) was noticed in the negative control group compared to tested groups of animals. The hydroethanolic stem bark extract of A Chev and leaves extract of Lam exhibited anti-malarial activities. Therefore, the bioactive compounds of both plant extracts need to be investigated.
Background: Artemisinin-based treatment in malaria patients with abnormal hemoglobin may be ineffective because of their genetic particularity, which could lead to resistance. The main purpose of this study was to assess the effect of artemisinin derivatives on in vivo parasite clearance according to erythrocyte variants. In vivo response was investigated through retrospective data obtained over a 42-day artemether-lumefantrine/artesunate amodiaquine efficacy protocol conducted from 2012 to 2016. Results: A total of 770 patients in Côte d’Ivoire attending the hospitals of Anonkoua-koute (Abidjan), Petit Paris (Korhogo), Libreville (Man), Dar es salam (Bouaké), Ayamé and Yamoussoukro with acute uncomplicated falciparum malaria were selected for successful hemoglobin typing. HbAS, HbSS, HbAC, and HbSC genotypes were found. Parasite clearance time was obtained for 414 patients. In the population with abnormal hemoglobin, parasite densities on admission and parasite clearance rates were significantly lower in the HbSC group compared to HbAA (p = 0.02 and p = 0.007, respectively). After PCR correction on day 42, the acute treatment rate was 100% for each group. Parasite half-life and time for initial parasitaemia to decline by 50 and 99% were longer for the HbSC group (p < 0.05). The study also investigated the prevalence of K13-propeller polymorphisms across different hemoglobin genotype groups. A total of 185 and 63 samples were sequenced in the HbAA group and patients with abnormal Hb, respectively. Only two nonsynonymous mutations D559N and V510M were found in the HbAA group. Conclusion: Although this study proved good efficacy of artemether-lumefantrine and artesunate amodiaquine in the treatment of uncomplicated Plasmodium falciparum malaria in patients with abnormal hemoglobin, the increased delay of parasite clearance may represent a threat to health in these patients in relation with sickle cell crisis, which could support selection of parasites resistant to artemisinin.
Background: Artemisinin combination therapies have been wildly used in the treatment of uncomplicated falciparum malaria in most endemic countries. This strategy has been implemented in Côte d'Ivoire since 2005 with Artesunate + Amodiaquine (AS + AQ) and Artemether + lumefantrine (AL). The goal of this study was to assess efficacy and safety of these two drugs in two sentinel's sites, Man and Abidjan in Côte d'Ivoire.Methods: An open label, randomized, clinical trial was conducted in Man in the west and Abidjan in the south of Côte d'Ivoire. Patients older than 6 months with uncomplicated falciparum malaria after consent were randomized in AS+AQ and AL group and were followed up for 42 days.The first endpoint was Adequate Clinical and Parasitological Response adjusted by PCR at day 42. The second endpoints were fever and parasite clearance time, crude cure rate at day 42 and safety of the two ACTs.Results: A total of 241 patients were randomized in AS+AQ (120) and AL (121) group. The crude cure rate at day 42 in PP analysis was 95.8% and 87.9% in AS+AQ and AL respectively. After correction by PCR ACPR at day 42 was 99.2% in AS+AQ group and 97.4% in AL group. The two ACTs were well tolerated. Conclusion:AS+AQ and AL remains efficacious in the uncomplicated malaria treatment in the two areas but continue monitoring is needed particularly for AL.
Background. Sickle cell disease (SCD) is an hemoglobin disorder that concerns 300,000 newborns each year around the world. Hemoglobin haplotypes can modulate SCD clinical expression. In Côte d’Ivoire, no study has yet investigated the distribution of hemoglobin haplotypes in the population. The goal of this study was to identify hemoglobin haplotypes for people attending dispensary with mild malaria in Abidjan (Ivory Coast) independently of their SCD status. Methods To determine haplotypes, specific restriction enzyme (RE) method is used after PCR amplification with different couples of primers. According to the digestion profile of PCR products, five hemoglobin haplotypes are found over the world. ResultsIn Abidjan, four different “classical” haplotypes of hemoglobin were detected: Benin (56.5%), Bantou (28.5%), Senegal (4%), Cameroun (1%). In parallel 10% of atypical profiles were described. Heterozygous haplotype (69%) was more frequent than homozygous haplotype (31%). ConclusionsBenin haplotype usually associated with more severe of SCD symptoms was predominant in the study population. However this preliminary study highlights also a high prevalence of atypical and heterozygous haplotypes in the population.
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