Drug resistance in Plasmodium falciparum from the Chittagong Hill Tracts, Bangladesh.

OBJECTIVE: To assess the efficacy of antimalarial treatment and molecular markers of Plasmodium falciparum resistance in the Chittagong Hill Tracts of Bangladesh. METHODS: A total of 203 patients infected with P. falciparum were treated with quinine 3 days plus sulphadoxine/pyrimethamine (SP) combination therapy, and followed up during a 4-week period. Blood samples collected before treatment were genotyped for parasite mutations related to chloroquine (pfcrt and pfmdr1 genes) or SP resistance (dhfr and dhps). RESULTS: Of 186 patients who completed follow-up, 32 patients (17.2%) failed to clear parasitaemia or became positive again within 28 days after treatment. Recurring parasitaemia was related to age (chi(2) = 4.8, P < 0.05) and parasite rates on admission (t = 3.1, P < 0.01). PCR analysis showed that some of these cases were novel infections. The adjusted recrudescence rate was 12.9% (95% CI 8.1-17.7) overall, and 16.6% (95% CI 3.5-29.7), 15.5% (95% CI 8.3-22.7) and 6.9% (95% CI 0.4-13.4) in three age groups (<5 years, 5-14, > or =15). The majority of infections carried mutations associated with chloroquine resistance: 94% at pfcrt and 70% at pfmdr. Sp-resistant genotypes were also frequent: 99% and 73% of parasites carried two or more mutations at dhfr and dhps, respectively. The frequency of alleles at dhfr, dhps and pfmdr was similar in cases that were successfully treated and those that recrudesced. CONCLUSIONS: The clinical trial showed that quinine 3-days combined to SP is still relatively effective in the Chittagong Hill Tracts. However, if this regimen is continued to be widely used, further development of SP resistance and reduced quinine sensitivity are to be expected. The genotyping results suggest that neither chloroquine nor SP can be considered a reliable treatment for P. falciparum malaria any longer in this area of Bangladesh

Conflict and Livelihood Decisions in the Chittagong Hill Tracts of Bangladesh

__Abstract__ We analyse rural household livelihood and child school enrolment decisions in the post-conflict setting of the Chittagong Hill Tracts (CHT) region of Bangladesh. What makes this paper innovative is the use of current subjective perceptions regarding the possibility of violence in the future and past actual experiences of violence in explaining household economic decision-making. Preferences are endogenous in line with behavioural economics. Regression results show that heightened subjective perceptions of future violence and past actual experiences of conflict influence current consumption and child enrolment and could encourage risky mixed crop cultivation. The trauma emanating from past experiences combined with current high perceptions of risk of violence may induce bolder and riskier behaviour in line with prospect theories of risk. Furthermore, a postconflic

Venture funding for science-based African health innovation

<p>Abstract</p> <p>Background</p> <p>While venture funding has been applied to biotechnology and health in high-income countries, it is still nascent in these fields in developing countries, and particularly in Africa. Yet the need for implementing innovative solutions to health challenges is greatest in Africa, with its enormous burden of communicable disease. Issues such as risk, investment opportunities, return on investment requirements, and quantifying health impact are critical in assessing venture capital’s potential for supporting health innovation. This paper uses lessons learned from five venture capital firms from Kenya, South Africa, China, India, and the US to suggest design principles for African health venture funds.</p> <p>Discussion</p> <p>The case study method was used to explore relevant funds, and lessons for the African context. The health venture funds in this study included publicly-owned organizations, corporations, social enterprises, and subsidiaries of foreign venture firms. The size and type of investments varied widely. The primary investor in four funds was the International Finance Corporation. Three of the funds aimed primarily for financial returns, one aimed primarily for social and health returns, and one had mixed aims. Lessons learned include the importance of measuring and supporting both social and financial returns; the need to engage both upstream capital such as government risk-funding and downstream capital from the private sector; and the existence of many challenges including difficulty of raising capital, low human resource capacity, regulatory barriers, and risky business environments. Based on these lessons, design principles for appropriate venture funding are suggested.</p> <p>Summary</p> <p>Based on the cases studied and relevant experiences elsewhere, there is a case for venture funding as one support mechanism for science-based African health innovation, with opportunities for risk-tolerant investors to make financial as well as social returns. Such funds should be structured to overcome the challenges identified, be sustainable in the long run, attract for-profit private sector funds, and have measurable and significant health impact. If this is done, the proposed venture approach may have complementary benefits to existing initiatives and encourage local scientific and economic development while tapping new sources of funding.</p

Riverine plastic pollution from fisheries: Insights from the Ganges River system

This is the author accepted manuscript. The final version is available from Elsevier via the DOI in this recordAbandoned, lost or otherwise discarded fishing gear represents a substantial proportion of global marine plastic pollution and can cause significant environmental and socio-economic impacts. Yet little is known about its presence in, and implications for, freshwater ecosystems or its downstream contribution to plastic pollution in the ocean. This study documents fishing gear-related debris in one of the world's largest plastic pollution contributing river catchments, the Ganges. Riverbank surveys conducted along the length of the river, from the coast in Bangladesh to the Himalaya in India, show that derelict fishing gear density increases with proximity to the sea. Fishing nets were the main gear type by volume and all samples examined for polymer type were plastic. Illegal gear types and restricted net mesh sizes were also recorded. Socio-economic surveys of fisher communities explored the behavioural drivers of plastic waste input from one of the world's largest inland fisheries and revealed short gear lifespans and high turnover rates, lack of appropriate end-of-life gear disposal methods and ineffective fisheries regulations. A biodiversity threat assessment identified the air-breathing aquatic vertebrate species most at risk of entanglement in, and impacts from, derelict fishing gear; namely species of threatened freshwater turtle and otter, and the endangered Ganges river dolphin. This research demonstrates a need for targeted and practical interventions to limit the input of fisheries-related plastic pollution to this major river system and ultimately, the global ocean. The approach used in this study could be replicated to examine the inputs, socio-economic drivers and ecological impacts of this previously uncharacterised but important source of plastic pollution in other major rivers worldwide.European CommissionEngineering and Physical Sciences Research Council (EPSRC

Screening of Bangladeshi medicinal plants for their effects on pentobarbital-induced sleeping time in mice

Se analizó la actividad en el sistema nervioso central de los extractos acuosos de cuarenta plantas medicinales de Bangladesh mediante el estudio de la duración del sueño inducido por pentobarbital. Doce de las plantas mostraron un aumento signifi cativo de la duración del sueño, mientras que seis mostraron una disminución signifi cativa. Woodfordia fruticosa y Uraria lagopodioides presentaron un mayor efecto depresor que el diazepam.Aqueous extracts of forty medicinal plants of Bangladesh have been screened for central nervous system activity by pentobarbital-induced sleeping time test. While twelve plants showed signifi cant increase in sleeping time, six plants showed signifi cant decrease. Woodfordia fruticosa and Uraria lagopodioides exhibited a better depressant effect than diazepam