A method is described for the determination of proteins with LC-MS/MS enabled by a small molecule (adenosine) barcode and based on a double-recognition sandwich structure. The coagulation protein thrombin was chosen as the model analyte. Magnetic nanoparticles were functionalized with aptamer29 (MNP/apt29) and used to capture thrombin from the samples. MNP/apt29 forms a sandwich with functionalized gold nanoparticles modified with (a) aptamer15 acting as thrombin-recognizing element and (b) a large number of adenosine as mass barcodes. The sandwich formed (MNP/apt29-thrombin-apt15/AuNP/adenosine) can ben magnetically separated from the sample. Mass barcodes are subsequently released from the sandwiched structure for further analysis by adding 11-mercaptoundecanoic acid. Adenosine is then detected by LC-MS/MS as it reflects the level of thrombin with impressively amplified signal. Numerous adenosines introduced into the sandwich proportional to the target concentration further amplify the signal. Under optimized conditions, the response is linearly proportional to the thrombin concentration in the range of 0.02 nM to 10 nM, with a detection limit of 9 fM. The application of this method to the determination of thrombin in spiked plasma samples gave recoveries that ranged from 92.3% to 104.7%. Graphical abstract Schematic representation of a method for the determination of thrombin with LC-MS/MS. The method is based on a double-recognition sandwiched structure. With LC-MS/MS, mass barcodes (adenosine) are detected to quantify thrombin, which amplifies the detection signal impressively.
Introduction Malaria exerts a significant economic burden on health care providers and households and our study attempts to make claims on the cost effectiveness of artesunate against quinine in patients under 14 years of age in Zambia. Also, to find the average total costs involved in the treatment of severe malaria in children and their impact on household expenditure. Methods Cost-effectiveness analysis of severe malaria treatment was conducted from a healthcare provider perspective using a Markov model. Standard costing was performed for the identification, measurement and assessment phases with data from quantification reports for anti-malaria commodities as these documents provides drug procurement costs from suppliers and freight costs. Average and incremental cost-effectiveness ratio were estimated and uncertainties were assessed through probabilistic sensitivity analysis. Results In Zambia severe malaria in children has been shown to account for over 45% of the total monthly curative healthcare costs incurred by households compared to the mean per capita monthly income. The cost of treating severe malaria depleted 7.67% of the monthly average household income. According, to the cost effectiveness analysis the of artesunate with quinine the ICER was $105 per death averted. Conclusion The use of artesunate over quinine in the treatment of severe malaria in children under 14 years is a highly cost-effective strategy for the healthcare provider in Zambia.
Background: Zambia has made profound strides in reducing both the incidence and prevalence of malaria followed by reducing malaria related deaths between 2009 and 2018. The number of partners providing malaria funding has significantly increased in the same period. The increasing number of partners and the subsequent reduction of the number of reported malaria cases in the Ministry of Health main data repository Health Management Information System (HMIS) stimulated this research. The study aimed at (1) identifying major sources of malaria funding in Zambia; (2) describe malaria funding per targeted interventions and (3) relating malaria funding with malaria disease burden.Methods; Data was collected using extensive literature review of institutional strategic document between the year 2009 to 2018. The National’s Health Management Information System (HMIS) provided information on malaria hospitalization data, incidence and mortality data. The statistical package for social sciences (SPSS) alongside Microsoft excel was used to analyze data in the year 2019.Results: The investigation observed that about 30% of the funding came from PMI/USIAD, 26% from the global funds. The government contributed 17% with other partners sharing the remaining 27%. Regression Analysis Model indicated a positive association between reducing malaria disease burden and increasing funding towards ITNs, IRS, MDA, and Case Management r2=77% (r2>0.77; 95% CI: 0.72 - 0.81). Furthermore IRS showed a p-value 0.018 while ITNs, Case Management and MDA having 0.029, 0.030 and 0.040 respectively. Conclusion: Our findings highlight annual funding towards specific malaria intervention produces desired results.
BackgroundMalaria exerts a significant economic burden on health care providers and households. Also, the cost of inpatient care for a case of severe malaria further exerts a heavy financial burden on most countries with already limited recourses. Therefore, it is essential to provide policy makers with relevant economic evidence on economic benefits of health care control, preventive and curative strategies.MethodsCost-effectiveness analysis of severe malaria treatment was conducted from a healthcare provider perspective using a decision tree. Standard costing was performed for the identification, measurement and assessment phases, with data from Zambia annual quantification reports for anti-malaria commodities. The data was collected from Health Management information system, and meta-analysis. Average and incremental cost-effectiveness ratio were estimated. The uncertainties were assessed through probabilistic sensitivity analysis.ResultsSevere Malaria in Children has been shown to account for over 45% of the total monthly curative healthcare costs incurred by households compared to the mean per capita monthly income. The cost of treating severe malaria depleted 7.67% of the monthly average household income. In addition, the cost attributed to loss of income in taking care of a sick child is the highest contributor $10.5 of total cost followed by direct medical costs $7.75. According, to the cost effectiveness analysis the of Artesunate with quinine the ICER was $105 per death averted.ConclusionThe use of Artesunate over Quinine in the treatment of severe malaria in children under 14years is a highly cost-effective strategy for the healthcare provider in Zambia.
Background Zambia has made profound strides in reducing both the incidence and prevalence of malaria followed by reducing malaria related deaths between 2009 and 2018. The number of partners providing malaria funding has significantly increased in the same period. The increasing number of partners and the subsequent reduction of the number of reported malaria cases in the Ministry of Health main data repository Health Management Information System (HMIS) stimulated this research. The study aimed at (1) identifying major sources of malaria funding in Zambia; (2) describe malaria funding per targeted interventions and (3) relating malaria funding with malaria disease burden. Methods Data was collected using extensive literature review of institutional strategic document between the year 2009 to 2018, assuming one-year time lag between investment and the health outcome across all interventions. The National’s Health Management Information System (HMIS) provided information on annual malaria admission cases and outpatient clinic record. The statistical package for social sciences (SPSS) alongside Microsoft excel was used to analyze data in the year 2019. Results The investigation observed that about 30% of the funding came from PMI/USAID, 26% from the global funds, the government of Zambia contributed 17% and other partners sharing the remaining 27%. Multivariate regression analysis suggests a positive correlation between reducing reported malaria disease burden in HMIS 2009–2018 and concurrent increasing program/intervention funding towards ITNs, IRS, MDA, and Case Management with r2 = 77% (r2 > 0.77; 95% CI: 0.72–0.81). Furthermore, IRS showed a p-value 0.018 while ITNs, Case Management and MDA having 0.029, 0.030 and 0.040 respectively. Conclusion Our findings highlight annual funding towards specific malaria intervention reduced the number of malaria admission cases.
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