Patterns of anti-malarial drug treatment among pregnant women in Uganda

BACKGROUND: Prompt use of an effective anti-malarial drug is essential for controlling malaria and its adverse effects in pregnancy. The World Health Organization recommends an artemisinin-based combination therapy as the first-line treatment of uncomplicated malaria in the second and third trimesters of pregnancy. The study objective was to determine the degree to which presumed episodes of uncomplicated symptomatic malaria in pregnancy were treated with a recommended anti-malarial regimen in a region of Uganda. METHODS: Utilizing a population-based random sample, we interviewed women living in Jinja, Uganda who had been pregnant in the past year. RESULTS: Self-reported malaria during the index pregnancy was reported among 67% (n = 334) of the 500 participants. Among the 637 self-reported episodes of malaria, an anti-malarial drug was used for treatment in 85% of the episodes. Use of a currently recommended treatment in the first trimester was uncommon (5.6%). A contraindicated anti-malarial drug (sulphadoxine-pyrimethamine and/or artemether-lumefantrine) was involved in 70% of first trimester episodes. Recommended anti-malarials were used according to the guidelines in only 30.1% of all second and third trimester episodes. CONCLUSIONS: Self-reported malaria was extremely common in this population and adherence to treatment guidelines for the management of malaria in pregnancy was poor. Use of artemether-lumefantrine combined with non-recommended anti-malarials was common practice. Overuse of anti-malarial drugs, especially ones that are no longer recommended, undermines malaria control efforts by fueling the spread of drug resistance and delaying appropriate treatment of non-malarial febrile illnesses. Improved diagnostic capacity is essential to ultimately improving the management of malaria-like symptoms during pregnancy and appropriate use of currently available anti-malarials

Range Expansion Drives Dispersal Evolution In An Equatorial Three-Species Symbiosis

A-09-14International audienceBackground Recurrent climatic oscillations have produced dramatic changes in species distributions. This process has been proposed to be a major evolutionary force, shaping many life history traits of species, and to govern global patterns of biodiversity at different scales. During range expansions selection may favor the evolution of higher dispersal, and symbiotic interactions may be affected. It has been argued that a weakness of climate fluctuation-driven range dynamics at equatorial latitudes has facilitated the persistence there of more specialized species and interactions. However, how much the biology and ecology of species is changed by range dynamics has seldom been investigated, particularly in equatorial regions. Methodology/Principal Findings We studied a three-species symbiosis endemic to coastal equatorial rainforests in Cameroon, where the impact of range dynamics is supposed to be limited, comprised of two species-specific obligate mutualists –an ant-plant and its protective ant– and a species-specific ant parasite of this mutualism. We combined analyses of within-species genetic diversity and of phenotypic variation in a transect at the southern range limit of this ant-plant system. All three species present congruent genetic signatures of recent gradual southward expansion, a result compatible with available regional paleoclimatic data. As predicted, this expansion has been accompanied by the evolution of more dispersive traits in the two ant species. In contrast, we detected no evidence of change in lifetime reproductive strategy in the tree, nor in its investment in food resources provided to its symbiotic ants. Conclusions/Significance Despite the decreasing investment in protective workers and the increasing investment in dispersing females by both the mutualistic and the parasitic ant species, there was no evidence of destabilization of the symbiosis at the colonization front. To our knowledge, we provide here the first evidence at equatorial latitudes that biological traits associated with dispersal are affected by the range expansion dynamics of a set of interacting species

The Lichen-GIS Project, Teaching Students How to Use Bioindicator Species to Assess Environmental Quality

A content-driven biology course for preservice, K-8 teachers has been developed. This course uses the constructivist approach, where instructors engage students by organizing information around concept-based problems. To this end a semester-long inquiry-based project was introduced where students studied lichen populations on trees located on their campus to monitor air quality. Data were incorporated into a geographical information systems (GIS) database to demonstrate how it can be used to map communities. Student teams counted the number of each lichen type within a grid placed on each tree trunk sampled and entered this information into a GIS database. The students constructed maps of lichen populations at each sample site and wrote abstracts about their research. Student performance was assessed by preparation of these abstracts as well as scores on pre- and posttests of key content measures. Students also completed a survey to determine whether the project aided in their comprehension as well as their interest in incorporating this activity into their own curricula. The students’ pre- and posttest results showed an eightfold improvement in the total score after the semester project. Additionally, correct responses to each individual content measure increased by at least 35%. Total scores for the abstract ranged from 12 to 20 points out of 20 total points possible (60% to 100%) with a mean score of 15.8 points (78%). These results indicate that this exercise provided an excellent vehicle to teach students about lichens and their use as bioindicators and the application of geospatial technologies to map environmental data