24 research outputs found

    Early treatment failure during treatment of Plasmodium falciparum malaria with atovaquone-proguanil in the Republic of Ivory Coast

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    The increased spread of drug-resistant malaria highlights the need for alternative drugs for treatment and chemoprophylaxis. The combination of atovaquone‐proguanil (Malarone®) has shown high efficacy against Plasmodium falciparum with only mild side-effects. Treatment failures have been attributed to suboptimal dosages or to parasite resistance resulting from a point mutation in the cytochrome b gene. In this paper, a case of early treatment failure was reported in a patient treated with atovaquone-proguanil; this failure was not associated with a mutation in the parasite cytochrome b gene, with impaired drug bioavailability, or with re-infection

    Polymorphism of Plasmodium falciparum Na+/H+ exchanger is indicative of a low in vitro quinine susceptibility in isolates from Viet Nam

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    <p>Abstract</p> <p>Background</p> <p>The <it>Plasmodium falciparum </it>NA+/H+ exchanger (<it>pfnhe1</it>, gene PF13_0019) has recently been proposed to influence quinine (QN) susceptibility. However, its contribution to QN resistance seems to vary geographically depending on the genetic background of the parasites. Here, the role of this gene was investigated in <it>in vitro </it>QN susceptibility of isolates from Viet Nam.</p> <p>Method</p> <p>Ninety-eight isolates were obtained from three different regions of the Binh Phuoc and Dak Nong bordering Cambodia provinces during 2006-2008. Among these, 79 were identified as monoclonal infection and were genotyped at the microsatellite <it>pfnhe1 </it>ms4760 locus and <it>in vitro </it>QN sensitivity data were obtained for 51 isolates. Parasite growth was assessed in the field using the HRP2 immunodetection assay.</p> <p>Results</p> <p>Significant associations were found between polymorphisms at <it>pfnhe1 </it>microsatellite ms4760 and susceptibility to QN. Isolates with two or more DNNND exhibited much lower susceptibility to QN than those harbouring zero or one DNNND repeats (median IC<sub>50 </sub>of 682 nM <it>versus </it>median IC<sub>50 </sub>of 300 nM; <it>p </it>= 0.0146) while isolates with one NHNDNHNNDDD repeat presented significantly reduced QN susceptibility than those who had two (median IC<sub>50 </sub>of 704 nM <it>versus </it>median IC<sub>50 </sub>of 375 nM; p < 0.01). These QNR associated genotype features were mainly due to the over representation of profile 7 among isolates (76.5%). The majority of parasites had <it>pfcrt76T </it>and wild-type <it>pfmdr1 </it>(> 95%) thus preventing analysis of associations with these mutations. Interestingly, area with the highest median QN IC<sub>50 </sub>showed also the highest percentage of isolates carrying the <it>pfnhe1 </it>haplotype 7.</p> <p>Conclusions</p> <p>The haplotype 7 which is the typical Asian profile is likely well-adapted to high drug pressure in this area and may constitute a good genetic marker to evaluate the dissemination of QNR in this part of the world.</p

    Antimalarial drug use in general populations of tropical Africa

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    <p>Abstract</p> <p>Background</p> <p>The burden of <it>Plasmodium falciparum </it>malaria has worsened because of the emergence of chloroquine resistance. Antimalarial drug use and drug pressure are critical factors contributing to the selection and spread of resistance. The present study explores the geographical, socio-economic and behavioural factors associated with the use of antimalarial drugs in Africa.</p> <p>Methods</p> <p>The presence of chloroquine (CQ), pyrimethamine (PYR) and other antimalarial drugs has been evaluated by immuno-capture and high-performance liquid chromatography in the urine samples of 3,052 children (2–9 y), randomly drawn in 2003 from the general populations at 30 sites in Senegal (10), Burkina-Faso (10) and Cameroon (10). Questionnaires have been administered to the parents of sampled children and to a random sample of households in each site. The presence of CQ in urine was analysed as dependent variable according to individual and site characteristics using a random – effect logistic regression model to take into account the interdependency of observations made within the same site.</p> <p>Results</p> <p>According to the sites, the prevalence rates of CQ and PYR ranged from 9% to 91% and from 0% to 21%, respectively. In multivariate analysis, the presence of CQ in urine was significantly associated with a history of fever during the three days preceding urine sampling (OR = 1.22, p = 0.043), socio-economic level of the population of the sites (OR = 2.74, p = 0.029), age (2–5 y = reference level; 6–9 y OR = 0.76, p = 0.002), prevalence of anti-circumsporozoite protein (CSP) antibodies (low prevalence: reference level; intermediate level OR = 2.47, p = 0.023), proportion of inhabitants who lived in another site one year before (OR = 2.53, p = 0.003), and duration to reach the nearest tarmacked road (duration less than one hour = reference level, duration equal to or more than one hour OR = 0.49, p = 0.019).</p> <p>Conclusion</p> <p>Antimalarial drug pressure varied considerably from one site to another. It was significantly higher in areas with intermediate malaria transmission level and in the most accessible sites. Thus, <it>P. falciparum </it>strains arriving in cross-road sites or in areas with intermediate malaria transmission are exposed to higher drug pressure, which could favour the selection and the spread of drug resistance.</p

    Présentation

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    Baratin Marc, Desbordes Françoise. Présentation. In: Langages, 16ᵉ année, n°65, 1982. Signification et référence dans l'antiquité et au moyen âge, sous la direction de Marc Baratin et Françoise Desbordes. pp. 5-8

    Sémiologie et métalinguistique chez saint Augustin

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    Baratin Marc, Desbordes Françoise. Sémiologie et métalinguistique chez saint Augustin. In: Langages, 16ᵉ année, n°65, 1982. Signification et référence dans l'antiquité et au moyen âge, sous la direction de Marc Baratin et Françoise Desbordes. pp. 75-89

    Présentation

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    Baratin Marc, Desbordes Françoise. Présentation. In: Langages, 16ᵉ année, n°65, 1982. Signification et référence dans l'antiquité et au moyen âge, sous la direction de Marc Baratin et Françoise Desbordes. pp. 5-8

    Main drivers for the settlement of creative industries in Toulouse : the manager's view

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    ISBN / 978-90-75246-91-9texte intégral : http://www2.fmg.uva.nl/acre/results/reports.htmlThe objective of this study is to understand why managers of selected sectors of creative knowledge industries chose to start their economic activities in the Urban Area of Toulouse. The report presents a qualitative research based on interviews with 20 managers and 7 experts of the following sectors: business and management consultancy, motion picture, video, television and radio, electronic publishing, web design and computer games. Results show that the managers' location decision is mostly related to personal trajectory factors as well as to "hard" factors, such as the size of the metropolis, providing markets opportunities, and the quality of the labour force. "Soft" factors such as the natural environment and the urban atmosphere do not play an overwhelming role in the decision to settle in Toulouse, which puts some current theories(Richard Florida's notably) into perspective

    Analysis of clinical pharmacist interventions in the COVID-19 units of a French university hospital.

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    International audienceObjectives The objectives were to compare clinical pharmacist interventions between two care groups: COVID-19-positive and COVID-19-negative patients, and to identify drugs that require particular attention, especially those involved in COVID-19 management.Methods A prospective cohort study was conducted on patients with positive and negative COVID-19 statuses admitted to Lille University Hospital over 1 month. Pharmaceutical analysis instigated interventions to rectify drug-related errors. For each pharmaceutical intervention (PI), the anatomical therapeutic chemical classification of the drug and the outcome of such an intervention were specified.Results The study included 438 patients. Prescription analysis led to 188 PIs performed on 118 patients (64 COVID-19-positive patients and 54 COVID-19-negative patients). Most drug-related problems were incorrect dosage representing 36.7% (69/188) of all interventions: 27.9% (29/104) for the COVID-19-positive group and 47.6% (40/84) for the COVID-19-negative group. The most frequent PI in 34% (64/188) of cases was terminating a drug: 27.9% (29/104) for the COVID-19-positive group and 47.6% (40/84) for the COVID-19-negative group. The main drug classes involved were antithrombotic agents (20.7%, 39/188), antibacterials for systemic use (13.8%, 26/188) and drugs for gastric acid-related disorders (6.4%, 12/188). Study population was limited to a single centre over 1 month.Conclusion No difference in PI was noted between the two groups. The presence of pharmacists led to a reduction in drug-related prescription problems, especially for antithrombotic and antibacterial drugs for both groups. Clinical pharmacy commitment in such a pandemic is therefore important
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