Medicine and Health Sciences Commons^™

Safety Of A Single Low-Dose Of Primaquine In Addition To Standard Artemether-Lumefantrine Regimen For Treatment Of Acute Uncomplicated Plasmodium Falciparum Malaria In Tanzania, Richard Mwaiswelo, Billy Ngasala, Irina Jovel, Roland Gosling, Zul Premji, Eugenie Poirot, Bruno Mmbando, Anders Björkman, Andreas Mårtensson

Pathology, East Africa

Background: This study assessed the safety of the new World Health Organization (WHO) recommendation of adding a single low-dose of primaquine (PQ) to standard artemisinin-based combination therapy (ACT), regardless of individual glucose-6-phosphate dehydrogenase (G6PD) status, for treatment of acute uncomplicated Plasmodium falciparum malaria in Tanzania.

Methods: Men and non-pregnant, non-lactating women aged ≥1 year with uncomplicated P. falciparum malaria were enrolled and randomized to either standard artemether-lumefantrine (AL) regimen alone or with a 0.25 mg/kg single-dose of PQ. PQ was administered concomitantly with the first AL dose. All drug doses were supervised. Safety was evaluated between days 0 and 28. …

Bone Marrow Examination Findings At Aga Khan University Hospital, Nairobi, Nancy Okinda, Riyat Malkit

Pathology, East Africa

Objective: To establish the bone marrow examination findings and determine the indication for bone marrow examination.

Design: A retrospective audit.

Setting: Aga Khan University Hospital, Nairobi.

Subjects: All bone marrow aspirates done at Aga Khan University for the period comprising February 2003 to February 2006 were retrieved and analysed.

Results: A total of 356 patient’s case histories including bone marrow examination results were analysed. Ages of the patients ranged from 18 months to 91 years. Males were 180 (50.6%) and females were 176 (49.4%). Nutritional anaemia as a group was the most common haematological disorder found on bone marrow …

Age, Temperature, And Parasitaemia Predict Chloroquine Treatment Failure And Anaemia In Children With Uncomplicated Plasmodium Falciparum Malaria, D.H. Hamer, W.B. Macleod, E. Addo-Yobo, C.P Duggan, B. Estrella, W.W. Fawzi, J.K. Konde-Lule, V. Mwanakasale, Zul Premji, F. Sempertegui, F.P. Ssengooba, K. Yeboah-Antwi, J.L. Simon

Pathology, East Africa

The prevalence of chloroquine-resistant Plasmodium falciparum malaria has been increasing in sub-Saharan Africa and parts of South America over the last 2 decades, and has been associated with increased anaemia-associated morbidity and higher mortality rates. Prospectively collected clinical and parasitological data from a multicentre study of 788 children aged 6-59 months with uncomplicated P. falciparum malaria were analysed in order to identify risk factors for chloroquine treatment failure and to assess its impact on anaemia after therapy. The proportion of chloroquine treatment failures (combined early and late treatment failures) was higher in the central-eastern African countries (Tanzania, 53%; Uganda, 80%; …

Micronutrient And Iron Supplementation And Effective Anti-Malarial Treatment Synergistically Improve Childhood Anaemia, H. Ekvall, Zul Premji, A. Bjorkman

Pathology, East Africa

The control of childhood anaemia in malaria holoendemic areas is a major public health challenge for which an optimal strategy remains to be determined. Malaria prevention may compromise the development of partial immunity. Regular micronutrient supplementation has been suggested as an alternative but its effectiveness remains unsettled. We therefore conducted a randomised placebo-controlled intervention trial with 207 Tanzanian children aged 5 months to 3 years on the efficacy of supervised supplementation of low-dose micronutrients including iron (Poly Vi-Sol with iron) three times per week, with an average attendance of ≥ 90%. The mean haemoglobin (Hb) level increased by 8 g/l …

Prevalence Of Iron Deficiency Anaemia In Children Of The Urban Slums Of Karachi, Ayesha Molla, Mohammad Khurshid, A. Majid Molla

Department of Pathology and Laboratory Medicine

A preliminary baseline survey was conducted to estimate the prevalence of anaemia in a group of 391 children aged 6-60 months, randomly selected from three urban slums of Karachi. Haemoglobin and the red cell indices including haematocrit, MCV, MCH, MCHC, ABC and red cell distribution width (RDW) were estimated for each of the selected children. Ferritin estimation was done on 354 (9 1%) children to assess the iron storage status. According to WHO criteria, the accepted cut-off point for anaemia screening in children is set at 11 gm/dl, 70 fI and 20 pg for haemoglobin, MCV and MCH respectively. Following …