The Tragedy Caused by Fake Antimalarial Drugs

Counterfeit antimalarials (mainly artemisinin derivatives) is a crucial health problem in developing countries, particularly in Africa. The illegal production, sale and distribution of fake drugs is a huge market evaluated to several billion of dollars and represents more than 50% of the pharmaceutical market in several African countries. Fake drugs have led to a very great number of deaths from untreated malaria or fatality provoked by toxic ingredients. These fake medicines increase the risk of artemisinin resistance developed by the use of sub therapeutic dosages of antimalarials. Tackling this criminal traffic is the objective of an international program created by WHO and involves the international police and custom organizations like INTERPOL. Several very important and encouraging results have been obtained, but the problem will be completely solved if genuine antimalarials, free-of-charge, are handed-over to populations in sub Sahara African countries

Hum.an cryptosporidiosis: an emerging parasitic disease of increasing importance in public health

Due à un protozoaire parasitant diverses espèces de mammifères, la cryp tosporidiose est une parasitose d’apparition récente en pathologie humaine mais qui a provoqué d’importantes épidémies dans différents pays. Habituellement asymptomatique chez les patients immunocompetents, elle est au contraire généralement très grave chez les immunodéprimés et en particulier chez les sidéens ou chez les transplantés, avec des formes intestinales pures qui peuvent se compliquer de localisations respiratoires. De diagnostic parfois difficile, la cryptosporidiose n’a pas de traitement spécifique réellement efficace. Sa pro phylaxie est particulièrement difficile, les formes infestantes (oocystes) généra lement véhiculées par l’eau de boisson résistant aux procédés habituels de désinfection industrielle. La mise au point de nouveaux procédés de purification et de tests permettant d’en vérifier les résultats est donc une urgence de santé publique. Sur un plan plus général, on ignore quels ont été les mécanismes de son passage de l’animal à l’homme. Certaines souches se sont d’ailleurs com plètement adaptées à ce nouvel hôte et sont génétiquement très différentes des souches d’origine animale. Elles sont responsables de transmissions interhu maines et jouent un rôle probablement essentiel dans les contaminations noso comiales.Cryptosporidiosis in human is an emerging parasitosis due to an intestinal and opportunistic protozoan : Cryptosporidium parvum. This parasite was described 100 years ago in calves and lambs. This zoonosis had emerged as a global public health problem in industrial countries for essentially two reasons. One is linked to its potentially life threatening evolution which remains practiccaly incurable, in severely immunocompromised patients (AIDS patients, transplant patients, young children with immature immunological system...). The other is the important warterbome outbreaks in industrial countries. Clinical forms of cryptosporidiosis range from asymptomatic to acute intestinal illness in immunocompetent host. In immunocompromised host, chronic or severe diarrhoeal diseases increase the morbidity and mortality. Moreover extra intestinal dissemination of parasites can accured (cholangitis) and pulmonary cryptosporidiosis are also frequently di scribed. This parasitosis is also caracterized by the lack of efficient therapy and insuffisant prophylactic measures. Numerical standard and legal regulation of Cryptosporidium was proposed. Furthermore the oocyts are extremelly resistant to conventional disinfectants. The control of water treatment is necessary to determine the efficiency of prophylactic measures. The significance of different Cryptosporidium parvum isolates could suggested the existence of different transmission cycles in human and merits futher investigations. The virulent potential of Cryptosporidium strains as well as individual susceptibility need further works to a better undestanding of epidemiological risk

Infrastructure expansion challenges sustainable development in Papua New Guinea

The island of New Guinea hosts the third largest expanse of tropical rainforest on the planet. Papua New Guinea—comprising the eastern half of the island—plans to nearly double its national road network (from 8,700 to 15,000 km) over the next three years, to spur economic growth. We assessed these plans using fine-scale biophysical and environmental data. We identified numerous environmental and socioeconomic risks associated with these projects, including the dissection of 54 critical biodiversity habitats and diminished forest connectivity across large expanses of the island. Key habitats of globally endangered species including Goodfellow's tree-kangaroo (Dendrolagus goodfellowi), Matchie's tree kangaroo (D. matschiei), and several birds of paradise would also be bisected by roads and opened up to logging, hunting, and habitat conversion. Many planned roads would traverse rainforests and carbon-rich peatlands, contradicting Papua New Guinea's international commitments to promote low-carbon development and forest conservation for climate-change mitigation. Planned roads would also create new deforestation hotspots via rapid expansion of logging, mining, and oil-palm plantations. Our study suggests that several planned road segments in steep and high-rainfall terrain would be extremely expensive in terms of construction and maintenance costs. This would create unanticipated economic challenges and public debt. The net environmental, social, and economic risks of several planned projects—such as the Epo-Kikori link, Madang-Baiyer link, Wau-Malalaua link, and some other planned projects in the Western and East Sepik Provinces—could easily outstrip their overall benefits. Such projects should be reconsidered under broader environmental, economic, and social grounds, rather than short-term economic considerations

Plasmodium falciparum Adhesion on Human Brain Microvascular Endothelial Cells Involves Transmigration-Like Cup Formation and Induces Opening of Intercellular Junctions

Cerebral malaria, a major cause of death during malaria infection, is characterised by the sequestration of infected red blood cells (IRBC) in brain microvessels. Most of the molecules implicated in the adhesion of IRBC on endothelial cells (EC) are already described; however, the structure of the IRBC/EC junction and the impact of this adhesion on the EC are poorly understood. We analysed this interaction using human brain microvascular EC monolayers co-cultured with IRBC. Our study demonstrates the transfer of material from the IRBC to the brain EC plasma membrane in a trogocytosis-like process, followed by a TNF-enhanced IRBC engulfing process. Upon IRBC/EC binding, parasite antigens are transferred to early endosomes in the EC, in a cytoskeleton-dependent process. This is associated with the opening of the intercellular junctions. The transfer of IRBC antigens can thus transform EC into a target for the immune response and contribute to the profound EC alterations, including peri-vascular oedema, associated with cerebral malaria