ACT now—with caution—for malaria treatments

Bhasin, Veena; Nair, Lathika

doi:10.1016/s1473-3099(03)00767-9

Cited by 9 publications

(4 citation statements)

References 3 publications

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“…In resource constrained rural communities with geographically sparse health services, CMDs could fill a major gap in access to health care for under-five children [43]. The high level of community acceptability for HMM is likely a result of its convenience, given the fact that malaria risk is often highest in remote rural areas where the quality and coverage of health services is lowest [44]. …”

Section: Discussionmentioning

confidence: 99%

Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

Mukanga

Tibenderana

Kiguli

et al. 2010

Malar J

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BackgroundMany malarious countries plan to introduce artemisinin combination therapy (ACT) at community level using community health workers (CHWs) for treatment of uncomplicated malaria. Use of ACT with reliance on presumptive diagnosis may lead to excessive use, increased costs and rise of drug resistance. Use of rapid diagnostic tests (RDTs) could address these challenges but only if the communities will accept their use by CHWs. This study assessed community acceptability of the use of RDTs by Ugandan CHWs, locally referred to as community medicine distributors (CMDs).MethodsThe study was conducted in Iganga district using 10 focus group discussions (FGDs) with CMDs and caregivers of children under five years, and 10 key informant interviews (KIIs) with health workers and community leaders. Pre-designed FGD and KII guides were used to collect data. Manifest content analysis was used to explore issues of trust and confidence in CMDs, stigma associated with drawing blood from children, community willingness for CMDs to use RDTs, and challenges anticipated to be faced by the CMDs.ResultsCMDs are trusted by their communities because of their commitment to voluntary service, access, and the perceived effectiveness of anti-malarial drugs they provide. Some community members expressed fear that the blood collected could be used for HIV testing, the procedure could infect children with HIV, and the blood samples could be used for witchcraft. Education level of CMDs is important in their acceptability by the community, who welcome the use of RDTs given that the CMDs are trained and supported. Anticipated challenges for CMDs included transport for patient follow-up and picking supplies, adults demanding to be tested, and caregivers insisting their children be treated instead of being referred.ConclusionUse of RDTs by CMDs is likely to be acceptable by community members given that CMDs are properly trained, and receive regular technical supervision and logistical support. A well-designed behaviour change communication strategy is needed to address the anticipated programmatic challenges as well as community fears and stigma about drawing blood. Level of formal education may have to be a criterion for CMD selection into programmes deploying RDTs.

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Section: Discussionmentioning

confidence: 99%

Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

Mukanga

Tibenderana

Kiguli

et al. 2010

Malar J

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“…Artemisinin and its derivatives are now the only compounds effective against drugresistant malaria parasites. 2,21 Combination therapies involving artemisinin and its derivatives hopefully will delay the emergence of resistance to this vital class of antimalarials.…”

Section: Discussionmentioning

confidence: 99%

In Vitro Activity of Artemisinin in Combination with Clotrimazole or Heat-treated Amphotericin B against Plasmodium falciparum

Bhattacharya¹,

Mishra²,

Bhasin³

2008

The American Journal of Tropical Medicine and Hygiene

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Currently available artemisinin-based combination therapies (ACTs) for malaria are inadequate. There remains an enormous unmet need for alternate artemisinin-based combination therapies. One of the fastest methods to identify promising artemisinin-based combination therapies is to look for synergistic or additive antimalarial interaction between artemisinin and an alternate drug against P. falciparum in vitro. Amphotericin B and clotrimazole are known drugs for treatment of human fungal infections. We repurposed clotrimazole or heat-treated amphotericin B in fixed ratio combination with artemisinin for antimalarial properties. Isobologram results show synergistic/additive interaction in both of the cases at therapeutically safe concentrations. Artemisinin, clotrimazole, and their synergistic combinations also decrease hemozoin production in parasitized erythrocytes. New permeation pathways induced in infected cells remain unaffected by drug combinations as indicated by sorbitol lysis. It would be interesting to extend the studies' in vivo system.

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“…Mefloquine was used as an antimalarial drug starting in 1983, but a case of mefloquine resistance emerged in 1995 and 2000 Artesunate-mefloquine and Artesunate-amodiaquine or other combined drugs were used to treat cases of recurrence that appeared to the existing antimalarial drugs [3]. Artemisinin, which is naturally found in the Artemisia annua plant [4] can be used as Artemisinin Combination Therapy (ACT) to reduce the high use of artemisinin as single drug [5]. ACT is used as the main treatment for malaria [6].…”

Section: Introductionmentioning

confidence: 99%

Synthesis <i>N</i>-Phenyl Pyrazoline from Dibenzalacetone and Heme Polymeration Inhibitory Activity (HPIA) Assay

Ekawati

Purwono

Mardjan

2020

KEM

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The synthesis of 1,5-diphenyl-3-styryl-4,5-dihydro-1H-pyrazole (B1) and 5-(3,4-dimethoxyphenyl)-3-(3,4-dimethoxystyryl)-1-phenyl-4,5-dihydro-1H-pyrazole (B2) have been conducted from 1,5-diphenylpenta-1,4-dien-3-on (A1) and 1,5-bis(3,4-dimethoxyphenyl)penta-1,4-dien-3-one (A2). Heme polymerization inhibitory activity (HPIA) assay of the synthesized compounds has also been carried out. The first step of reaction was Claisen-Schmidt condensation of benzaldehyde derivatives and acetone using NaOH 20% and ethanol as solvent. Dibenzalacetone derivatives were reacted with phenylhydrazine using acetic acid to form N-phenylpyrazoline. The structure of products was characterized by FT-IR, GC-MS, DI-MS, 1H- and 13C-NMR The result of heme polymerization inhibitory activity assay showed that IC50 of B1 and B2 1.26 and 0.79 mM while quinine 1.26 mM. The result indicated that compound B2 was more potent as antimalarial than quinine.

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ACT now—with caution—for malaria treatments

Cited by 9 publications

References 3 publications

Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

Community acceptability of use of rapid diagnostic tests for malaria by community health workers in Uganda

In Vitro Activity of Artemisinin in Combination with Clotrimazole or Heat-treated Amphotericin B against Plasmodium falciparum

Synthesis <i>N</i>-Phenyl Pyrazoline from Dibenzalacetone and Heme Polymeration Inhibitory Activity (HPIA) Assay

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