Epidemiology of malaria in endemic areas

Malaria infection is still to be considered a major public health problem in those 106 countries where the risk of contracting the infection with one or more of the Plasmodium species exists. According to estimates from the World Health Organization, over 200 million cases and about 655.000 deaths have occurred in 2010. Estimating the real health and social burden of the disease is a difficult task, because many of the malaria endemic countries have limited diagnostic resources, especially in rural settings where conditions with similar clinical picture may coexist in the same geographical areas. Moreover, asymptomatic parasitaemia may occur in high transmission areas after childhood, when anti-malaria semi-immunity occurs. Malaria endemicity and control activities are very complex issues, that are influenced by factors related to the host, to the parasite, to the vector, to the environment and to the health system capacity to fully implement available anti-malaria weapons such as rapid diagnostic tests, artemisinin-based combination treatment, impregnated bed-nets and insecticide residual spraying while waiting for an effective vaccine to be made availabl

Pathogenesis of malaria in tissues and blood

The clinical manifestations of severe malaria are several and occur in different anatomical sites. Both parasite- and host-related factors contribute to the pathogenicity of the severe forms of the disease. Cytoadherence of infected red blood cells to the vascular endothelium of different organs and rosetting are unique features of malaria parasites which are likely to contribute to the vascular damage and the consequent excessive inflammatory/immune response of the host. In addition to cerebral malaria or severe anaemia, which are quite common manifestation of severe malaria, clinical evidences of thrombocytopenia, acute respiratory distress syndrome (ARDS), liver and kidney disease, are reported. In primigravidae from endemic areas, life threatening placental malaria may also be present. In the following pages, some of the pathogenetic aspects will be briefly reviewed and then data on selected and less frequent manifestation of severe malaria, such as liver or renal failure or ARDS will be discussed

Pathogenesis of malaria in tissues and blood

The clinical manifestations of severe malaria are several and occur in different anatomical sites. Both parasite- and host-related factors contribute to the pathogenicity of the severe forms of the disease. Cytoadherence of infected red blood cells to the vascular endothelium of different organs and rosetting are unique features of malaria parasites which are likely to contribute to the vascular damage and the consequent excessive inflammatory/immune response of the host. In addition to cerebral malaria or severe anaemia, which are quite common manifestation of severe malaria, clinical evidences of thrombocytopenia, acute respiratory distress syndrome (ARDS), liver and kidney disease, are reported. In primigravidae from endemic areas, life threatening placental malaria may also be present.In the following pages, some of the pathogenetic aspects will be briefly reviewed and then data on selected and less frequent manifestation of severe malaria, such as liver or renal failure or ARDS will be discusse

Understanding Total Monte Carlo uncertainty propagation in burn up calculations with Generalized Perturbation Theory

International audienceThe last few years has seen Total Monte Carlo becoming the most used method for uncertainty propagation in burn up calculations.This straightfoward approach allows for the direct observation of output uncertainties (keff, isotopic concentrations etc…)of the coupled Bateman equation (fuel depletion) and Boltzmann equation (neutron transport). The application of GPT in thiscoupled case implies not only the calculation of nuclide adjoint functions but also the calculation of a number of importancefunctions. The coupling is thus almost never done.In this paper, we compare the propagation of Pu239 fission, capture and (n,2n) cross sections’ uncertainties with both TMC andGPT methods in a simple Na-cooled fast reactor assembly. In such a case, the change of spectrum due to the change in in onenuclide’s cross sections is expected to be smaller than in a thermal spectrum where the importance of individual resonances ishigh. We will see that it can’t be negligeted. Thanks to the combined use of TMC and GPT we can separate the effects of uncertaintieson a selection of other heavy nuclide densitities.The power normalisation gives minor, but important contributions. The sensitivities to depletion terms are the dominant termsfor Pu239 and its direct daughters’ evolution. The minor actinide density uncertainties are dominated by the impact of Pu239on neutron spectrum and then on minor actinides’ average cross sections. The results of uncertainty analyses could thereforebe very different if basic uncertainties with complete energy and cross nuclide correlations were available