A phase I trial to evaluate the safety and pharmacokinetics of low-dose methotrexate as an anti-malarial drug in Kenyan adult healthy volunteers

<p>Abstract</p> <p>Background</p> <p>Previous investigations indicate that methotrexate, an old anticancer drug, could be used at low doses to treat malaria. A phase I evaluation was conducted to assess the safety and pharmacokinetic profile of this drug in healthy adult male Kenyan volunteers.</p> <p>Methods</p> <p>Twenty five healthy adult volunteers were recruited and admitted to receive a 5 mg dose of methotrexate/day/5 days. Pharmacokinetics blood sampling was carried out at 2, 4, 6, 12 and 24 hours following each dose. Nausea, vomiting, oral ulcers and other adverse events were solicited during follow up of 42 days.</p> <p>Results</p> <p>The mean age of participants was 23.9 ± 3.3 years. Adherence to protocol was 100%. No grade 3 solicited adverse events were observed. However, one case of transiently elevated liver enzymes, and one serious adverse event (not related to the product) were reported. The maximum concentration (C_max) was 160-200 nM and after 6 hours, the effective concentration (C_eff) was <150 nM.</p> <p>Conclusion</p> <p>Low-dose methotraxate had an acceptable safety profile. However, methotrexate blood levels did not reach the desirable C_effof 250-400-nM required to clear malaria infection <it>in vivo</it>. Further dose finding and safety studies are necessary to confirm suitability of this drug as an anti-malarial agent.</p

Similar efficacy and safety of artemether-lumefantrine (Coartem®) in African infants and children with uncomplicated falciparum malaria across different body weight ranges

<p>Abstract</p> <p>Background</p> <p>Artemisinin-based combination therapy, including artemether-lumefantrine (AL), is currently recommended for the treatment of uncomplicated <it>Plasmodium falciparum </it>malaria. The objectives of the current analysis were to compare the efficacy and safety of AL across different body weight ranges in African children, and to examine the age and body weight relationship in this population.</p> <p>Methods</p> <p>Efficacy, safety and pharmacokinetic data from a randomized, investigator-blinded, multicentre trial of AL for treatment of acute uncomplicated <it>P. falciparum </it>malaria in infants and children in Africa were analysed according to body weight group.</p> <p>Results</p> <p>The trial included 899 patients (intent-to-treat population 886). The modified intent-to-treat (ITT) population (n = 812) comprised 143 children 5 to < 10 kg, 334 children 10 to < 15 kg, 277 children 15 to < 25 kg, and 58 children 25 to < 35 kg. The 28-day PCR cure rate, the primary endpoint, was comparable across all four body weight groups (97.2%, 98.9%, 97.8% and 98.3%, respectively). There were no clinically relevant differences in safety or tolerability between body weight groups. In the three AL body weight dosing groups (5 to < 15 kg, 15 to < 25 kg and 25 to < 35 kg), 80% of patients were aged 10-50 months, 46-100 months and 90-147 months, respectively.</p> <p>Conclusion</p> <p>Efficacy of AL in uncomplicated falciparum malaria is similar across body weight dosing groups as currently recommended in the label with no clinically relevant differences in safety or tolerability. AL dosing based on body weight remains advisable.</p

EXERCISE AS A BOOST FOR THE HEALTH PROMOTION OF THE ELDERLY : Questionnaire survey in three elderly homes in China, Finland and Kenya

Old age is inevitable for everyone in the society. The world elderly population has increased tremendously and special measures are taken to secure their well being. One of the vital steps towards securing elderly health is through participation in exercise. The purpose of this quantitative research was to explore ways in which exercise functions as a boost to elderly health in multicultural environment. The aims are to get an overall view of elderly awareness and experiences about exercise and to find out the role played by nurses in provision of exercise to elderly. Research method of the thesis was quantitative, whereby questionnaires as data collection method were distributed to the elderly in three countries: China (Ri Yuexing nursing home), Kenya (Eldoret and Cherangani nursing home), and Finland (Purola elderly home). Manual way, Microsoft Excel and SPSS programme were used as a descriptive statistics technique to analyze the data and table and graphs were made to reflect the results. The research questions were: What are the elderly experiences about exercise? How do elderly implement exercise? How do the elderly experience the effects of exercise on their health? What is nurses’ role in promotion of exercise among elderly? The results of this research showed most elderly are aware of the importance of exercises. Age is not a limiting factor to exercise since there are different forms of exercises as adopted by the elderly. It also showed the active role played by nurses and families in promoting exercises to the elderly. Through exercise, the quality of elderly life is improved since exercise helps to keep them strong, active and healthy

African Archaeology Without Frontiers: Papers from the 2014 PanAfrican Archaeological Association Congress

Confronting national, linguistic and disciplinary boundaries, contributors to African Archaeology Without Frontiers argue against artificial limits and divisions created through the study of ‘ages’ that in reality overlap and cannot and should not be understood in isolation. Papers are drawn from the proceedings of the landmark 14th PanAfrican Archaeological Association Congress, held in Johannesburg in 2014, nearly seven decades after the conference planned for 1951 was re-located to Algiers following the National Party’s rise to power in South Africa. Contributions by keynote speakers Chapurukha Kusimba and Akin Ogundiran encourage African archaeologists to practise an archaeology that collaborates across many related fields of study to enrich our understanding of the past. The nine papers cover a broad geographical sweep by incorporating material on ongoing projects throughout the continent including South Africa, Botswana, Cameroon, Togo, Tanzania, Kenya and Nigeria. Thematically, the papers included in the volume address issues of identity and interaction, and the need to balance cultural heritage management and sustainable development derived from a continent racked by social inequalities and crippling poverty. Edited by three leading archaeologists, the collection covers many aspects of African archaeology, and a range of periods from the earliest hominins to the historical period

African Archaeology Without Frontiers: Papers from the 2014 PanAfrican Archaeological Association Congress

Confronting national, linguistic and disciplinary boundaries, contributors to African Archaeology Without Frontiers argue against artificial limits and divisions created through the study of ‘ages’ that in reality overlap and cannot and should not be understood in isolation. Papers are drawn from the proceedings of the landmark 14th PanAfrican Archaeological Association Congress, held in Johannesburg in 2014, nearly seven decades after the conference planned for 1951 was re-located to Algiers following the National Party’s rise to power in South Africa. Contributions by keynote speakers Chapurukha Kusimba and Akin Ogundiran encourage African archaeologists to practise an archaeology that collaborates across many related fields of study to enrich our understanding of the past. The nine papers cover a broad geographical sweep by incorporating material on ongoing projects throughout the continent including South Africa, Botswana, Cameroon, Togo, Tanzania, Kenya and Nigeria. Thematically, the papers included in the volume address issues of identity and interaction, and the need to balance cultural heritage management and sustainable development derived from a continent racked by social inequalities and crippling poverty. Edited by three leading archaeologists, the collection covers many aspects of African archaeology, and a range of periods from the earliest hominins to the historical period