Invasive bacterial co-infection in African children with Plasmodium falciparum malaria: a systematic review.

Background: Severe malaria remains a major cause of pediatric hospital admission across Africa. Invasive bacterial infection (IBI) is a recognized complication of Plasmodium falciparum malaria, resulting in a substantially worse outcome. Whether a biological relationship exists between malaria infection and IBI susceptibility remains unclear. We, therefore, examined the extent, nature and evidence of this association.Methods: We conducted a systematic search in August 2012 of three major scientific databases, PubMed, Embase and Africa Wide Information, for articles describing bacterial infection among children with P. falciparum malaria using the search string (malaria OR plasmodium) AND (bacteria OR bacterial OR bacteremia OR bacteraemia OR sepsis OR septicaemia OR septicemia). Eligiblity criteria also included studies of children hospitalized with malaria or outpatient attendances in sub-Saharan Africa.Results: A total of 25 studies across 11 African countries fulfilled our criteria. They comprised twenty cohort analyses, two randomized controlled trials and three prospective epidemiological studies. In the meta-analysis of 7,208 children with severe malaria the mean prevalence of IBI was 6.4% (95% confidence interval (CI) 5.81 to 6.98%). In a further meta-analysis of 20,889 children hospitalised with all-severity malaria and 27,641 children with non-malarial febrile illness the mean prevalence of IBI was 5.58 (95% CI 5.5 to 5.66%) in children with malaria and 7.77% (95% CI 7.72 to 7.83%) in non-malaria illness. Ten studies reported mortality stratified by IBI. Case fatality was higher at 81 of 336, 24.1% (95% CI 18.9 to 29.4) in children with malaria/IBI co-infection compared to 585 of 5,760, 10.2% (95% CI 9.3 to 10.98) with malaria alone. Enteric gram-negative organisms were over-represented in malaria cases, non-typhoidal Salmonellae being the most commonest isolate. There was weak evidence indicating IBI was more common in the severe anemia manifestation of severe malaria.Conclusions: The accumulated evidence suggests that children with recent or acute malaria are at risk of bacterial infection, which results in an increased risk of mortality. Characterising the exact nature of this association is challenging due to the paucity of appropriate severity-matched controls and the heterogeneous data. Further research to define those at greatest risk is necessary to target antimicrobial treatment. © 2014 Church and Maitland; licensee BioMed Central Ltd

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Not AvailableCarotenoproteins from four different shrimp shell wastes Penaeus monodon, Parapenaeopsis stylifera, Metapenaeus affinis and Nematopalemon tenuipes were extracted with the aid of papain enzyme and characterized by their protein, amino acid and carotenoid content of the shell wastes and the antioxidant activities like DPPH, FRAP, ABTS radical scavenging activity and reducing power assay of the carotenoprotein. Higher protein content of 9.8 g 100 g−1 and 9.2 g 100 g−1 was recovered from shell waste of Penaeus monodon and Parapenaeopsis stylifera respectively along with highest carotenoid content of 114 ± 0.02 μg g−1 in Parapenaeopsis stylifera followed by 100.6 ± 0.02 μg g−1 from the shell waste of Metapenaeus affinis. Highest antioxidant activity was found in the carotenoprotein extracted from the shell waste of P. stylifera which suggest that the antioxidant activity of carotenoids followed a concentration dependent pattern. The amino acid profile showed that carotenoprotein is a rich source of essential amino acids such as glutamic acid, aspartic acid, lysine and leucine. Among shell wastes, P.stylifera shell waste was calculated to be superior as it contained higher amount of essential amino acids and exhibited higher antioxidant activity in terms of protein, carotenoid as well as radical scavenging and reducing power and it could serve as a supplementary nutritive feed ingredient in animal diets. This would help in utilization of crustacean (shrimp) shell waste for formulating low cost feed for ornamental fish and also encourage shrimp processing industries to utilize of the same in order to control pollution of land and waterNot Availabl

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Not AvailableCarotenoprotein, a complex of carotenoids and protein, extracted from shrimp shell waste can be an effective source of carotenoid as well as antioxidant in fish diets. In the present study, the nutritional potential of carotenoprotein extracted from shell wastes of Parapeneopsis stylifera on growth, physiometabolic changes and coloration in high- value ornamental fish, oscar (Astronotus ocellatus) was assessed in a 120 days feeding trial. Four iso‑nitrogenous (30–31% CP) and isolipidic (11.34–11.55% CL) diets were formulated with graded levels of carotenoprotein in- clusion like 0%, 5%, 10% and 15% and designated as Control, T1, T2 and T3 respectively. At the end of the feeding trial, growth indices such as final body weight, weight gain, and specific growth rate indicated that fish fed with 10 and 15% levels of carotenoprotein incorporated diet showed higher growth compared to control and T1. Oxidative stress enzymes like SOD and Catalase were lower in 15% and 10% carotenoprotein incorporated diets respectively in both gills and liver. Stress indicators like serum glucose and cortisol activity were found to be higher in control than in diets with 10% (T2) as well as 15% (T3), suggesting the stress-reducing ability of the carotenoprotein in fish feed. Relatively higher respiratory burst activity in fishes of T3 group indicated higher immunity status of the fish. Quantitative colour values in terms of redness, chroma in the fin region as well as carotenoid content in scale, skin and muscle of fish were higher in T2 (10% carotenoprotein incorporated diet) as compared to T3 (15% car- otenoprotein incorporated diet). Overall, this study clearly showed that dietary incorporation of as little as 10% carotenoprotein is advisable to ornamental fish farmers for enhanced growth, colouration, as well as antioxidant activity in this popular high value ornamental fish for maximizing their profit.Not Availabl

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Not AvailableThis study investigated the effect of dietary supplemented synthetic, and shrimp shell meal (SSM) derived natural astaxanthin combination on growth, digestive and metabolic enzyme activities, antioxidative status, physio-metabolic responses, and skin colouration of high valued discus (Symphysodon aequifasciatus) advanced juveniles reared in captive condition. Four isonitrogenous (50 % crude protein), isolipidic (9% ether extract), and isocaloric (around 400 kcal digestible energy/100 g) experimental diets viz. Control (only synthetic astaxanthin, without SSM), T1 (15 % SSM + synthetic astaxanthin), T2 (20 % SSM + synthetic astaxanthin), T3 (25 % SSM + synthetic astaxanthin) were prepared and fed to satiation level twice daily for 90 days. Results indicated significantly (P < 0.05) higher weight gain percentage, FER, SGR, and PER and lower FCR in T2 and T3 groups compared to control. Combination effect of synthetic and natural astaxanthin significantly (P < 0.05) enhanced the protease activity, hematological parameters, and levels of serum immune parameters and decreased activities of amylase, hepatic and muscle MDH, LDH, ALT, AST with hepatic and gill SOD, CAT and serum glucose level with the most pronounced effects in T3 group. Significantly (P < 0.05) highest values of L*, a*, b*, chroma, and hue angle in the T3 group indicated their brightest skin colouration. Therefore, the study concluded that synthetic and SSM derived natural astaxanthin combinations at levels of 71.5 and 28.5 mg/kg, respectively, can be effectively supplemented in ornamental fish diets for improving their growth, health status, and skin colouration.Not Availabl