BackgroundThis study was conducted to determine the efficacy of the antimalarial artemisinin-based combination therapy (ACT) artesunate +sulfamethoxypyrazine/pyrimethamine (As+SMP), administered in doses used for malaria, to treat Schistosoma haematobium in school aged children.Methodology/Principal FindingsThe study was conducted in Djalakorodji, a peri-urban area of Bamako, Mali, using a double blind setup in which As+SMP was compared with praziquantel (PZQ). Urine samples were examined for Schistosoma haematobium on days −1, 0, 28 and 29. Detection of haematuria, and haematological and biochemical exams were conducted on day 0 and day 28. Clinical exams were performed on days 0, 1, 2, and 28. A total of 800 children were included in the trial. The cure rate obtained without viability testing was 43.9% in the As+SMP group versus 53% in the PZQ group (Chi2 = 6.44, p = 0.011). Egg reduction rates were 95.6% with PZQ in comparison with 92.8% with As+SMP, p = 0.096. The proportion of participants who experienced adverse events related to the medication was 0.5% (2/400) in As+SMP treated children compared to 2.3% (9/399) in the PZQ group (p = 0.033). Abdominal pain and vomiting were the most frequent adverse events in both treatment arms. All adverse events were categorized as mild.Conclusions/SignificanceThe study demonstrates that PZQ was more effective than As+SMP for treating Schistosoma haematobium. However, the safety and tolerability profile of As+SMP was similar to that seen with PZQ. Our findings suggest that further investigations seem justifiable to determine the dose/efficacy/safety pattern of As+SMP in the treatment of Schistosoma infections.Trial RegistrationClinicalTrials.gov NCT00510159

Summary:Purpose: Epilepsy is a major public-health problem in Africa. The quality of available drugs is a limiting factor for an adequate management. The aim of this study was to describe the proportion of poor-quality phenobarbital (PB) soliddosage forms and evaluate the factors associated with its quality in Nouakchott (Mauritania).Methods: A cross-sectional study was carried out within pharmacies, hospitals, and on the parallel market in March 2003. PB samples were bought by a native person and then assayed by a liquid chromatography method. A package was considered to be of good quality if the active-substance average content was between 85 and 115% of the stated content printed on the packet.Results: Forty-five pharmaceutical stores were visited, enabling us to collect 146 samples of PB. Three brand names were available in Nouakchott. They originated from France, Morocco, Senegal, and Egypt.Results: A prevalence of 13.7% [95% confidence interval (CI), 8.8-20.0] of poor-quality PB was found. All samples from Morocco were underdosed. The generic active content was satisfactory, but saccharose, an excipient with a potential side effects, was identified. Two factors associated with the good quality of PB have been put forward: tablets manufactured in France and loose packaging as generics conditioned in such a way were of good quality.Conclusions: This study shows that the quality of antiepileptic drugs in Africa is still worrying. The setting up of medicine quality control in Mauritania is legitimate. Considering the good quality of generic PB and its lower cost, this type of medicine should be promoted in this region.

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Background: Because of the emergence of chloroquine resistance in Mali, artemether-lumefantrine (AL) or artesunateamodiaquine (AS+AQ) are recommended as first-line therapy for uncomplicated malaria, but have not been available in Mali until recently because of high costs.

Résumé: Summary: Zusammenfassung 403 relevés, dont 152 en 1988 et 251 en 1989, effectués essentiellement dans des cultures de sorgho, de mil et de mais dans 37 localités du Burkina Faso, ont permis de recenser 272 especes adventices, dont 60% communes aux deux annees. 56 especes nouvelles pour la flore du Burkina Faso ont été mises en Evidence. Une analyse des spectres floristique et biologique ainsi que de la repartition géographique des especes rélève quelques caractéristiques de la flore adventice. L'etude de la fréquence et du recouvrement des especes permet de dégager les principales mauvaises herbes des cultures annuelles du Burkina Faso. Weeds of annual crops in Burkina Faso A survey was made of weeds in fields of sorghum, millet and maize at 37 localities in Burkina Faso. The survey covered 403 fields, 152 in 1988 and 251 in 1989. A total of 272 adventive species were recorded, 60% of them in both years. Fifty‐six species were found which were new to the Burkina Faso flora. An analysis of the floristic and biological spectra, together with the geographical distribution, revealed certain characteristic features of the weed flora. The information obtained with regard to the frequency and abundance of the species makes it possible to define the principal weeds of annual crops in Burkina Faso. Die Unkrautflora der Getreidefelder von Burkina Faso Es wurden 403 Aufnahmen (1988: 152, 1989: 251) hauptsächlich in Sorghum‐Hirse, Hirse und Mais an 37 Orten von Burkina Faso gemacht, wobei 272 Unkrautarten gefunden wurden, davon 60% in beiden Jahren. 56 Arten konnten fur die Flora von Burkina Faso erstmals nachgewiesen werden. Mit einer biologischen, floristischen und geographischen Analyse der Arten wurde die Unkrautflora charakterisiert. Die Untersuchung der Frequenz und des Deckungsgrads der Arten erlaubte, die wichtigsten Unkräuter der einjährigen Kulturen von Burkina Faso zu nennen.