Saúde na Comunidade de Paises de Língua Portuguesa: Aspectos de internacionalização da pesquisa na malária

A internacionalização através da língua pode em muito facilitar a execução de um programa de apoio ao desenvolvimento de um País, sobretudo a nível do ensino superior. A velocidade com que a tecnologia social tem servido o mundo, inclui também o denominado terceiro mundo/em desenvolvimento em que a pobreza e a falta de condições sanitárias são causa de elevada morbidade e mortalidade, ressurgimento de epidemias por agentes conhecidos, e onde as doenças respiratórias/nutrição são das maiores causas de mortalidade.Equilibrar os diversos factores em jogo na saúde inclui a necessidade de criar redes de interacção entre departamentos governamentais diferentes, sejam secretarias de Estado sejam ministérios, das quais obviamente citamos os da Saúde, Educação Superior, Ciência e Tecnologia, Industria e Ambiente. Nestas redes deve-se integrar as instituições e fundações privadas e mesmo as missões religiosas com enorme papel nas regiões por vezes remotas.Raramente estão estes serviços em sintonia pelo que o trabalho do pesquisador que deseja ver aplicado seu conhecimento na melhoria da saúde dos povos se torna difícil. Alguns destes aspectos serão apresentados com comentários sobre a experiência do autor na criação de Rede de Pesquiza e Desenvolvimento tendo por base a Língua Portuguesa

Real-time quantitative PCR with SYBR Green I detection for estimating copy numbers of nine drug resistance candidate genes in Plasmodium falciparum

BACKGROUND: Evaluating copy numbers of given genes in Plasmodium falciparum parasites is of major importance for laboratory-based studies or epidemiological surveys. For instance, pfmdr1 gene amplification has been associated with resistance to quinine derivatives and several genes involved in anti-oxidant defence may play an important role in resistance to antimalarial drugs, although their potential involvement has been overlooked. METHODS: The (ΔΔ)Ct method of relative quantification using real-time quantitative PCR with SYBR Green I detection was adapted and optimized to estimate copy numbers of three genes previously indicated as putative candidates of resistance to quinolines and artemisinin derivatives: pfmdr1, pfatp6 (SERCA) and pftctp, and in six further genes involved in oxidative stress responses. RESULTS: Using carefully designed specific RT-qPCR oligonucleotides, the methods were optimized for each gene and validated by the accurate measure of previously known number of copies of the pfmdr1 gene in the laboratory reference strains P. falciparum 3D7 and Dd2. Subsequently, Standard Operating Procedures (SOPs) were developed to the remaining genes under study and successfully applied to DNA obtained from dried filter blood spots of field isolates of P. falciparum collected in São Tomé & Principe, West Africa. CONCLUSION: The SOPs reported here may be used as a high throughput tool to investigate the role of these drug resistance gene candidates in laboratory studies or large scale epidemiological surveys

Analysis of genetic mutations associated with anti-malarial drug resistance in Plasmodium falciparum from the Democratic Republic of East Timor

<p>Abstract</p> <p>Background</p> <p>In response to chloroquine (CQ) resistance, the policy for the first-line treatment of uncomplicated malaria in the Democratic Republic of East Timor (DRET) was changed in early 2000. The combination of sulphadoxine-pyrimethamine (SP) was then introduced for the treatment of uncomplicated falciparum malaria.</p> <p>Methods</p> <p>Blood samples were collected in two different periods (2003–2004 and 2004–2005) from individuals attending hospitals or clinics in six districts of the DRET and checked for <it>Plasmodium falciparum </it>infection. 112 PCR-positive samples were inspected for genetic polymorphisms in the <it>pfcrt</it>, <it>pfmdr1</it>, <it>pfdhfr </it>and <it>pfdhps </it>genes. Different alleles were interrogated for potential associations that could be indicative of non-random linkage.</p> <p>Results</p> <p>Overall prevalence of mutations associated with resistance to CQ and SP was extremely high. The mutant form of <it>Pfcrt </it>(76T) was found to be fixed even after five years of alleged CQ removal. There was a significant increase in the prevalence of the <it>pfdhps </it>437G mutation (X²= 31.1; p = 0.001) from the first to second survey periods. A non-random association was observed between <it>pfdhfr</it>51/<it>pfdhps</it>437 (p = 0.001) and <it>pfdhfr </it>59/<it>pfdhps </it>437 (p = 0.013) alleles.</p> <p>Conclusion</p> <p>Persistence of CQ-resistant mutants even after supposed drug withdrawal suggests one or all of the following: local <it>P. falciparum </it>may still be inadvertently exposed to the drug, that mutant parasites are being "imported" into the country, and/or reduced genetic diversity and low parasite transmission help maintain mutant haplotypes. The association between <it>pfdhfr</it>51/<it>pfdhps</it>437 and <it>pfdhfr </it>59/<it>pfdhps </it>437 alleles indicates that these are undergoing concomitant positive selection in the DRET.</p

Managing creative industries in the context of knowledge-based urban development

The advent of the knowledge economy has put the focus on innovation, creativity and networks as drivers of competitiveness and economic growth. This has shifted development perspectives from tangibles-based competitiveness to knowledge-driven competitiveness transforming the way the economy is organised and putting emphasis on the emergence of a new type of capital. Creative industries represent a form of capital that provides economic benefits and the links between creative capital, quality of life and competitiveness has made the creative industries a serious economic factor that needs to be considered in regard to cities and regions viability. The two issues, creative industries and knowledge-based urban development (KBUD) remain not only challenging fields of research but also the key elements for discussions on the competitiveness of cities and regions. The purpose of this paper is to explore the ‘creative industry’ concept to relate it to the ongoing process of creating knowledge-based urban developments.publishersversionpublishe

Exploring Lean and Green Supply Chain Performance Using Balanced Scorecard Perspective

Authors would like to acknowledge Fundação para a Ciência e Tecnologia for its support (project MIT-Pt/EDAMIASC/0033/2008). Susana Duarte was supported by a PhD fellowship from Fundação para a Ciência e Tecnologia (SFRH/BD/60969/2009).Going lean/green is a trend more manufacturers are beginning to recognize as important in an era of economic aus-terity and environmental responsibility. Unlike lean supply chain, which focuses on ways to improve operations and cut wastes from the customer's perspective, green initiatives look at ways to eliminate waste from the environment's perspective. Looking at operations from a ‘lean/green' perspective has benefits to not only the environment, but to manufacturers and customers as well. Based on the literature review we developed a conceptual model incorporating lean and green supply chain into a performance measurement system, using the balanced scorecard approach.publishersversionpublishe

Evaluation of prevalence's of pfdhfr and pfdhps mutations in Angola

<p>Abstract</p> <p>Background</p> <p>Malaria is the major cause of morbidity and mortality in Angola. The most vulnerable groups to <it>Plasmodium falciparum </it>infection are pregnant women and children under five years of age. The use of an intermittent preventive treatment (IPT) with sulphadoxine/pyrimethamine (SP) in pregnant women was introduced in Angola in 2006 by the National Malaria Control Programme, and currently this strategy has been considered to be used for children malaria control. Considering the previous wide use of SP combination in Angola, together to the reported cases of SP treatment failure it is crucial the evaluation of the prevalence of five mutations in <it>pfdhfr </it>and <it>pfdhps </it>genes associated to <it>P</it>. <it>falciparum </it>resistance to SP before the introduction of S/P IPT in children.</p> <p>Methods</p> <p>The study was conducted in five provinces, with different transmission intensities: Huambo, Cabinda, Uíge, Kwanza Norte, and Malanje. The detection of the mutations in <it>pfdhfr </it>and <it>pfdhps </it>genes was carried out in 452 <it>P</it>. <it>falciparum </it>blood samples by PCR RFLP.</p> <p>Results</p> <p>For <it>pfdhfr </it>gene, 90,3% of the samples carried the mutation 51<b>I</b>, with 7.5% of mixed infections; 51% carried wild type allele 59<b>C</b>, with 29.2% mixed infections and; 99.1% of isolates harboured the mutant allele 108<b>N</b>. Concerning, <it>pfdhps </it>gene, 83,1% were mutant type 437<b>G </b>with 11% mixed infections , while 87% of the studied isolates were wild type for codon 540.</p> <p>Discussion</p> <p>This is the first representative epidemiological study of the whole Angola country on the prevalence of the genotypes associated with SP chemoresistance. A high frequency of individual mutations in both genes (51<b>I </b>and 108<b>N </b>in <it>pfdhfr</it>, and 437<b>G </b>in <it>pfdhps</it>) was found, besides a low prevalence of the quintuple mutation.</p> <p>Conclusion</p> <p>The data showed that the implementation IPT using SP in children needs to be reviewed.</p

Antimalarial activity of medicinal plants used in traditional medicine in S. Tomé and Prí­ncipe islands

The present study investigates the antimalarial activity of 13 medicinal plants used in traditional medicine in S. Tomé and Prí­ncipe (STP) islands in the Gulf of Guinea, aiming at identifying the most effective plants for further research. Fieldwork was carried out with the collaboration of 37 traditional healers from both islands, during an ethnobotanical study, which was conducted from 1993 to 1999. Our results indicate that the traditional healers in STP use several medicinal plants against fever and/or [`]malaria' which reveal strong antiparasitic activity in vitro: four of the plant extracts have evident antiplasmodial activity against chloroquine resistant Plasmodium falciparum, with IC50 values <10 [mu]g/ml, and also revealed hepatic schizontocidal activity (<5-35 [mu]g/ml). In vivo, the extracts caused partial reduction of Plasmodium berghei parasitaemia in mice.http://www.sciencedirect.com/science/article/B6T8D-452WHB8-3/1/6a9a0385ccbedbaacf74ee6a1ac9521

NOTA CIENTÍFICA - Rede Internacional de Pesquisa, História e Saúde

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Detection of atovaquone-proguanil resistance conferring mutations in Plasmodium falciparum cytochrome b gene in Luanda, Angola

BACKGROUND: The fixed dose combination atovaquone-proguanil is a recently introduced antimalarial for treatment and prophylaxis of Plasmodium falciparum malaria. It is highly effective with a good tolerability profile and a convenient prophylactic regimen. Nevertheless, cases of treatment failure have already been reported, which have been associated to mutations in the cytochrome b gene of the Plasmodium (pfcytb). The presence of atovaquone-proguanil in vivo resistance conferring mutations in pfcytb gene in Luanda, Angola, was investigated, in order to make recommendations on prescribing this antimalarial as prophylaxis for travellers. METHODS: Two hundred and forty nine blood samples from children hospitalized at Luanda Pediatric Hospital for malaria were studied. The PCR-RFLP methodology was used in order to identify pfcytb wild type codon 268 and two point mutations: T802A and A803C. RESULTS: All samples were identified as wild type for pfcytb gene at codon 268. In the studied population, no mutations associated to atovaquone-proguanil treatment failure were found. Prevalence of the studied mutations in the region was estimated to be less than 0.77% (99% significance level). CONCLUSION: Atovaquone-proguanil can be recommended for use by travellers to Luanda with expected high efficacy. This represents an improvement compared to other currently used prophylatic antimalarials in this region. However, it is imperative to continue surveillance

Epidemiological characterization of Plasmodium falciparum in the Republic of Cabo Verde: implications for potential large-scale re-emergence of malaria

BACKGROUND: Malaria has come near eradication at archipelago of Cabo Verde in 1970. Infections are now only observed in Santiago, where outbreaks occur. In these islands, malaria is considered by the international community as being of limited risk and, therefore, no prophylaxis is recommended. Since the understanding of factors that determine malaria outbreaks are crucial for controlling the disease, the present study aimed to investigate if the malaria infections observed in Santiago Island are maintained in isolated foci and in asymptomatic individuals. METHODS: The occurrence of asymptomatic carriers in villages with history of malaria as well as the level of exposure of these populations were investigated using PCR and serological analyses. RESULTS: Results indicate that malaria is maintained as asymptomatic and sub-patent infections and that the majority of the circulating parasite populations harbour chloroquine-resistant mutations. CONCLUSION: These observations highlight the alarming prospect of malaria to become a serious public health problem and underscore the need for a tighter surveillance