Antibiotic use among patients with febrile illness in a low malaria endemicity setting in Uganda

<p>Abstract</p> <p>Background</p> <p>Uganda embraced the World Health Organization guidelines that recommend a universal 'test and treat' strategy for malaria, mainly by use of rapid diagnostic test (RDT) and microscopy. However, little is known how increased parasitological diagnosis for malaria influences antibiotic treatment among patients with febrile illness.</p> <p>Methods</p> <p>Data collection was carried out within a feasibility trial of presumptive diagnosis of malaria (control) and two diagnostic interventions (microscopy or RDT) in a district of low transmission intensity. Five primary level health centres (HCs) were randomized to each diagnostic arm (diagnostic method in a defined group of patients). All 52,116 outpatients (presumptive 16,971; microscopy 17,508; and RDT 17,638) aged 5 months to ninety five years presenting with fever (by statement or measured) were included. Information from outpatients and laboratory registers was extracted weekly from March 2010 to July 2011. The proportion of patients who were prescribed antibiotics was calculated among those not tested for malaria, those who tested positive and in those who tested negative.</p> <p>Results</p> <p>Seven thousand and forty (41.5%) patients in the presumptive arm were prescribed antibiotics. Of the patients not tested for malaria, 1,537 (23.9%) in microscopy arm and 810 (56.2%) in RDT arm were prescribed antibiotics. Among patients who tested positive for malaria, 845 (25.8%) were prescribed antibiotics in the RDT and 273(17.6%) in the microscopy arm. Among patients who tested negative for malaria, 7809 (61.4%) were prescribed antibiotics in the RDT and 3749 (39.3%) in the microscopy arm. Overall the prescription of antibiotics was more common for children less than five years of age 5,388 (63%) compared to those five years and above 16798 (38.6%).</p> <p>Conclusion</p> <p>Prescription of antibiotics in patients with febrile illness is high. Testing positive for malaria reduces antibiotic treatment but testing negative for malaria increases use of antibiotics.</p> <p>Trial Registration</p> <p>ClinicalTrials.gov: <a href="http://www.clinicaltrials.gov/ct2/show/NCT00565071">NCT00565071</a></p

Reason and Future of the Nation-State

Hace una d cada todav a se supon a que los Estados nacionales estar an entrando en declive y disminuir a su influencia en la pol tica global El Estado nacional era una de las entidades afectadas por el proceso de la globalizaci n Ahora ya no es tan clara tal tendencia y ha resurgido la tem tica para darle un tratamiento en condiciones de procesos globales que se detienen y se contienen en los marcos de la pol tica nacional Rastrear en los or genes de los Estados nacionales tiene un sentido importante porque nos ayuda a entender la naturaleza el car cter y el desarrollo de tal formaci n econ mica social pol tica y cultural El Estado naci n moderno se identifica con la modernidad en su forma m s acabada con la Ilustraci n y el racionalismo Adquiere otra dimensi n cuando enraiza con el romanticismo y la importancia de la singularidad hist rica Ya desde entonces quedaba en claro que era una realidad cargada de tensiones y contradicciones internas Rediscutir la naturaleza del Estado naci n es importante para entender su relevancia actual y sus perspectivas al futur

Methyl esters (biodiesel) from and fatty acid profile of Gliricidia sepium seed oil

Abstract Increasing the supply of biodiesel by defining and developing additional feedstocks is important to overcome the still limited amounts available of this alternative fuel. In this connection, the methyl esters of the seed oil of Gliricidia sepium were synthesized and the significant fuel-related properties were determined. The fatty acid profile was also determined with saturated fatty acids comprising slightly more than 35 %, 16.5 % palmitic, 14.5 % stearic, as well as lesser amounts of even longer-chain fatty acids. Linoleic acid is the most prominent acid at about 49 %. Corresponding to the high content of saturated fatty acid methyl esters, cold flow is the most problematic property as shown by a high cloud point of slightly \u3e20 °C. Otherwise, the properties of G. sepium methyl esters are acceptable for biodiesel use when comparing them to specifications in biodiesel standards but the problematic cold flow properties would need to be observed. The 1H- and 13C-NMR spectra of G. sepium methyl esters are reported. © AOCS (outside the USA) 2015