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Research: Plasmodium falciparum malaria in northern Côte d’Ivoire: prevalence in the general hospital of Tanda sanitary district

January 7, 2016 - 15:46 -- Bart G.J. Knols
Author(s): 
Thomas Y. Aba, Raoul Moh, Lassina Cissé, Gisele C. Yapo-Kouadio, Frederic N. Ello, Chrysostome Mossou, Zelica Diallo, Ouffoue Kra, Emmanuel Bissagnené
Reference: 
MWJ2016, 7, 1
Article type: 
Research
Abstract: 
 
Until about 2010, the majority of data collected on malaria in Côte d’Ivoire were based on presumptive cases, particularly in the northern part of the country, where parasitological research had rarely been carried out. The purpose of this study was to determine the actual malaria prevalence amongst presumptive cases admitted to one of the general hospitals in the Northern part of the country, where malaria diagnosis is suboptimal. A cross-sectional study was conducted in the general medicine, maternity and paediatric wards between January and August 2010. Patients of all ages, suspected of having malaria, were included after giving their informed oral consent. Several parameters were investigated: the presence of Plasmodium using thick blood film, HIV/ Plasmodium co-infection, signs of severity, aspects of malaria treatment and other associated factors. Of 379 patients included, with a median age of 4 yrs [range 1 month - 71 yrs], 9% were HIV-positive, 74% were ≤ 15 yrs of age, 60% were urbanised and 23% were using long-lasting insecticide-treated nets. Malaria prevalence was 67.5% and was significantly associated with the rainy season (p < 0.001), age ≤ 5 yrs (p = 0.004) and no cotrimoxazole chemoprophylaxis in HIV-infected patients (p = 0.04). Only P. falciparum was detected, with a mean density of 12,523 trophozoites/μl of blood, but with 12,610 trophozoites/μl of blood in HIV-positive patients and 7,055 trophozoites/μl of blood in HIV-negative patients (p < 0.001). Severe malaria accounted for 77% of cases. Prescribed antimalarial drugs were: IM artemether (56%), quinine (28%), artemether + lumefantrine (10%) and artesunate + amodiaquine (6%). Apyrexia and parasite clearance were observed at day 2-3 post treatment in 87% of patients. Adverse events were reported among 60 patients (17%). The outcome was marked by: a healing rate of 90%, a rate of 5% lost to follow-up and a 7% lethality for severe malaria, significantly associated with the age ≤ 5 yrs (p=0.02), hyperparasitaemia >20% (p=0.004), neurological disorders (p < 0.001) and respiratory distress (p=0.007). Malaria prevalence in the general hospital of Tanda remains high, with a predominance of severe malaria affecting children under the age of 5 yrs. 

 
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Comments

Submitted by Camille Brou (not verified) on
The Investigative Research disseminated by Dr Gisele Yapo and her peers on the stipulated Malaria subject matter deserves a special appreciation with request of exchange of experiences jointly the United States of America Schools of Public Health and Medicine and the Urban Agriculture International Program initially innovated in Cote D Ivoire based isolated communities or families including individuals living with children in urban, peri urban and rural areas facing emergency medical assistance need. The Urban Agriculture International Program, Multi Disciplinary and Inter Continental Research Development Program with one of its 12 research develop!ent projects in Health Care stipulated : TeleMedicine ATM-Asymchronous Transfer Mode in its Legal Framework is considering this research program to be connected to Harvard School of Public Health and Medicine as much as to the University of Virginia Health System in TeleMedicine Pediatry based communities in Cote D Ivoire where Malaria is a critical case of devastation to isolated individuals living with children as much as unemployed and or low income or simply disadvantaged targets facing to emergency medical needs requiring some remote technologies wor new technologies of information and telecommunication applied medicales sciences research developmwnt. Above all, this here above stipulated abstract or dissertation shall be used within law schools for a joint program in Law, Medicine and Public Health in its Legal, institutional Framework approach of consideration. Every one and specifically disadvantaged individuals living with Children in Cote D Ivoire shall benefit from this TeleMedicine ATM indicated project in terms of TeleMedicine Pediatry and Malaria Epidemic Alleviation or Eradication remotely from the United States Of America to Cote D Ivoire Camille Brou, International Humanitarian Lawyer, Founder and President Urban Agriculture International Program Speaker TeleMedicine ATM-FIME Florida International Medical Expos Google Camille Brou President e E

Submitted by Camille Brou (not verified) on
According to several investigative reports of fundamental data considerations disseminated,in most countries, specifically in Cote d' Ivoire with endemic disease caused by the Plasmodium Falciparum/anopheles-female mosquitos, seven (7) major but not cumulative natural, techno preventive and therapeutic approach are stipulated as : (1) Inovative TeleMedicine ATM Cellphone Telescopic implementation (2) Artemisinin traitment, (3) targeted individuals window screening, (4) stagnant waters removed project or non drained waters/ponds, (5) aircarafts-helicopters use for insecticide spray as much as (6) in-house insecticide spray, (7) mosquito nets use. This here above stipulated consideration in seven point is not exhaustive as the World Health Organization WHO new medecine/drug recommended for Malaria traitment which specifies that Artemisinin in priority, as well. My previous comment on February 22, 2016 mentionned briefly the TeleMedicine ATM/BONAPARTE-cellular phone integrative telescopy in the Plasmodium Falciparum Malaria Prevention, Traitment, Therapy, Alleviation and or Eradication. As reminder, the Telemedicine ATM Program comstitute a new and or renewal technology of information and telecommunication applied Health/Medical Sciences Research Education and Development in the diagnostic, prevention and therapeutic procedures. Telemedicine ATM cellular Telescopy for Malaria reponds to a medical safety evaluative and health protective strategic plan. This Telemedicine shall be implemented in a systemic and systematic analysis of fundamental data consideration in the integrative value of the artemisinin which is purely and simply a medecine or drug of a cost effective based combination therapies. Artemisnin is recommended first-line in the traitment with the inovative Telemedicine ATM/BONAPARTE- cellular phone Telescopy project implementation in the symptomatic P. Falciparum Malaria pronostic, analysis, diagnostic, therapic, preventive and eradicatif base Cote D'Ivoire targeted communities and communities around the world underserved, isolated, in time of emergency, in a disaster situation and in real time. Camille Brou, CLE Certified Health Law American Bar Association Fellow Health Law Section Harvard Law School Petrie-Flom Center Founder President Urban Agriculture International Program/MultiDisciplinary Lawyers Research Program Speaker TeleMedicine ATM