DHP was more effective and better tolerated than AAQ against multidrug-resistant P. falciparum and P. vivax infections. The prolonged therapeutic effect of piperaquine delayed the time to P. falciparum reinfection, decreased the rate of recurrence of P. vivax infection, and reduced the risk of P. vivax gametocyte carriage and anemia.

Dihydroartemisinin-piperaquine (DHP) is an important new treatment for drug-resistant malaria, although pharmacokinetic studies on the combination are limited. In Papua, Indonesia, we assessed determinants of the therapeutic efficacy of DHP for uncomplicated malaria. Plasma piperaquine concentrations were measured on day 7 and day 28, and the cumulative risk of parasitological failure at day 42 was calculated using survival analysis. Of the 598 patients in the evaluable population 342 had infections with Plasmodium falciparum, 83 with Plasmodium vivax, and 173 with a mixture of both species. The unadjusted cumulative risks of recurrence were 7.0% (95% confidence interval [CI]: 4.6 to 9.4%) for P. falciparum and 8.9% (95% CI: 6.0 to 12%) for P. vivax. After correcting for reinfections the risk of recrudescence with P. falciparum was 1.1% (95% CI: 0.1 to 2.1%). The major determinant of parasitological failure was the plasma piperaquine concentration. A concentration below 30 ng/ml on day 7 was observed in 38% (21/56) of children less than 15 years old and 22% (31/140) of adults (P ‫؍‬ 0.04), even though the overall dose (mg per kg of body weight) in children was 9% higher than that in adults (P < 0.001). Patients with piperaquine levels below 30 ng/ml were more likely to have a recurrence with P. falciparum (hazard ratio [HR] ‫؍‬ 6.6 [95% CI: 1.9 to 23]; P ‫؍‬ 0.003) or P. vivax (HR ‫؍‬ 9.0 [95% CI: 2.3 to 35]; P ‫؍‬ 0.001). The plasma concentration of piperaquine on day 7 was the major determinant of the therapeutic response to DHP. Lower plasma piperaquine concentrations and higher failure rates in children suggest that dose revision may be warranted in this age group.

Amodiaquine retains efficacy against infection by chloroquine-resistant Plasmodium falciparum; however, little information is available on its efficacy against infection by chloroquine-resistant Plasmodium vivax. Patients presenting to a rural clinic with a pure P. vivax infection that recurred after recent antimalarial treatment were retreated, this time with amodiaquine monotherapy, and the risk of further recurrence within 4 weeks was assessed. Of the 87 patients with pure P. vivax infection, 15 patients did not complete a full course of treatment, 4 of whom were intolerant to treatment. In the 72 patients completing treatment, 91% (63 of 69) had cleared their parasitemia within 48 h with no early treatment failure. Follow-up to day 28 or recurrent parasitemia was achieved for 56 patients (78%). The cumulative incidence of treatment failure by day 28 was 22.8% (95% confidence interval, 7.3 to 38%). The in vitro sensitivity profile was determined for a separate set of isolates from outpatients with pure P. vivax infection. The median 50% inhibitory concentration of amodiaquine was 11.3 nM (range, 0.37 to 95.8) and was correlated significantly with that of chloroquine (Spearman rank correlation coefficient, 0.602; P < 0.001). Although amodiaquine results in a rapid clinical response, the risk of recurrence by day 28 is unacceptably high, reducing its suitability as an alternative treatment of infection by chloroquine-resistant P. vivax in this region.

The purpose of this study was to determine the antimicrobial activity of rosella infusa (Hibiscus sabdariffa L.). Antimicrobial inhibition test using infusa of rosella (Hibiscus sabdariffa L.) against Staphylococcus aureus and Escherichia coli bacteria at a concentration of infusa 100%; 75%; and 50%. The concentration has highest potential antibacterial of infusa for Staphylococcus aureus is 100% witch has diameter of 13.6 mm and for Escherichia coli bacteria is 100%, its show that diameter of zone inhibitory zone is 13.3 mm. The Results of phytochemical screening show that infusa of rosella (Hibiscus sabdariffa L.) contains flavonoids, saponins, and tannins. Based on the data above show that the infusa of rosella flower has high antibacterial potential.

A study was conducted on the utilization of oil palm wood waste in the production of porous ceramics, which were then used as a motor vehicle exhaust gas filter. The porosity, hardness, and morphology of the resulting ceramics were all measured. Using the gas analysis approach, ceramics with a higher porosity value were also examined for their exhaust gas filtration power. The study's findings show that the particle size of oil palm sawdust has a significant impact on porosity, hardness, and ceramic morphology. The porosity of the ceramic decreases as the particle size decreases, but the hardness increases. Porous ceramics have porosity levels of 60, 57, and 56 percent. Porous ceramics have hardness values of 221, 62, 302, 83, and 363, 46 MPa. And Filtration of exhaust CO gas 1.88%, CO2 1.1%, and HC 1123 ppm.