Vector Borne Diseases ; Intersectoral Collaboration

In vitro drug susceptibility testing of Plasmodium falciparum must be conducted immediately after collecting a sample of the patient‘s blood; otherwise the parasites may weaken and the culture fail. Collecting blood samples from individuals in areas far from the field station or clinic where in vitro testing is conducted requires a reliable method of sample preservation during transportation. We examined and compared three different methods used to preserve blood samples in endemic areas in the Philippines. The three methods are as follows: the on-site method (test is conducted soon after blood sampling), flask culture method (sample is taken to the laboratory in a culture flask with medium) and EDTA tube method (sample is taken to the laboratory in a blood collection tube). The WHO in vitro micro-test for susceptibility of P. falciparum to chloroquine was performed using an AnaeroPack® system and a portable thermostat incubator. Evaluation of the three methods was based on schizont maturation, ease of handling, and risk of contamination during the test. The on-site and flask culture methods, but not the EDTA tube method, were effective for keeping the parasites viable. Furthermore, schizont maturation appeared better with the flask method than with the on-site method, especially in the control wells (drug-free wells). In addition, it was easier to perform the flask method than the on-site method. No contamination was observed using any of the methods. The results of the study suggest that the flask culture method is the most effective and useful way to preserve blood samples for the in vitro test and, moreover, that it aids in providing detailed field evidence of drug-resistant malaria.

OBJECTIVE: Malaria is a life-threatening, mosquito-borne disease that continues to cause numerous deaths worldwide. In the Philippines, malaria remains an important problem, with five provinces having >1000 cases of malaria a year. The objective of this cross-sectional analytical study was to determine the association of selected factors with non-compliance to anti-malarial treatment among malaria patients in Puerto Princesa, Palawan, specifically: perceived susceptibility to malaria, perceived seriousness and severity of malaria, perceived benefits of medication, perceived barriers to treatment compliance and cues to action.

METHODS: Using an interviewer-administered structured questionnaire, 320 individuals diagnosed with and treated for malaria from January to October 2010 were interviewed regarding compliance to anti-malarial treatment and the factors related to compliance. Descriptive statistics and multiple logistic regression were used to analyze the data.

RESULTS: The rate of non-compliance to anti-malaria treatment was 17% (95% Cl 12.1%-21.2%). After multivariate analysis using logistic regression, symptom perception as a cue to action and forgetfulness as a perceived barrier to treatment compliance were found to be significantly associated with non-compliance to treatment. The odds of non-compliance were three times higher for individuals who perceived that an improvement in symptoms implied cure of malaria. An individual who forgot to take at least one dose of medication was 17 times more likely to be non-compliant with treatment compared to someone who did not forget to take a single dose.

CONCLUSION: Given the factors found to be associated with non­compliance to treatment, more effective ways of ensuring compliance with anti-malaria treatment may be explored e.g., doing directly observed treatment and utilizing treatment partners that may help address the problem of forgetfulness. The fact that symptom improvement is not equivalent to cure must be stressed when advising patients. Emphasizing compliance to treatment and the consequences of noncompliance when conducting patient education activities may also help boost treatment compliance.

Human ; Male ; Female ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Malaria-therapeutics, therapy, drug therapy ; Patient Compliance

BACKGROUND: Entamoeba histolytica is an important etiologic agent of diarrhea. Globally, it is estimated to infect 40 to 50 million people and cause 40,000 to 100,000 deaths per year. Metronidazole is effective but can cause adverse reactions in certain individuals. In search of alternatives, traditional medicinal plants are being studied. Several plants in Family Simaroubaceae have shown anti-amoebic activity. Quassia amara, a member of this family has not been tested.
OBJECTIVE: To determine the effect of Q. amara crude extract on Entamoeba histolytica in vitro.
METHODS: Initial testing of 104 µg/ml ethanolic bark extract was performed. Counts were made after 72 hours. Three trials in triplicates were performed.
Nine (9) dilutions of extract were then tested (18.8 to 5,00 µg/ml). Test tubes were checked for viable amoeba after 24-hour and 72-hour incubation. Minimum inhibitory concentrations (MIC) were determined for the two incubation periods. At least two trials in triplicates for each dilution were performed. metronidazole served as positive control.
RESULTS: At 104 µg/ml incubated for 72 hours, no viable amoeba was obtained and counted. The MIC after 24 hours was 5,000 µg/ml, while the MIC at 72 hours was 37.5 µg/ml.
CONCLUSION: Q. amara crude extract has inhibitory effects on E. histolycain vitro.

Human ; Male ; Female ; Aged 80 And Over ; Aged ; Middle Aged ; Adult ; Young Adult ; Adolescent ; Child ; Child Preschool ; Infant ; Infant Newborn ; Quassia ; Metronidazole ; Entamoeba Histolytica ; Plants, Medicinal ; Amoeba ; Simaroubaceae ; Microbial Sensitivity Tests ; Diarrhea

Background: Amoebiasis is a global health problem affecting poor regions in the world. Few drugs such as metronidazole are available to treat this disease; unfortunately, it is associated with several serious side effects. Tsaang gubat and ampalaya have been used by traditional healers from different cultures to treat dysentery. Objective: The aim of this research was to provide evidence to validate the use of tsaang gubat and ampalaya leaf extracts for dysentery by determining their anti-amoebic activity. Methods: The tsaang gubat and ampalaya leaves were sourced from the University of the Philippines at Los Baños and processed into a lyophilized aqueous extract. Anti-amoebic activity was determined in an in vitro assay using Entamoeba histolytica HK-9 strain against 10 dose levels (18-10,000 μg/mL). The amoeba and leaf extracts were incubated for 24, 48, and 72 hours. The trophozoites were stained with Trypan blue and dispensed into chambers of a Neubauer hemocytometer. The live trophozoites (unstained) were counted under a binocular microscope. The MIC and IC50 were determined. Metronidazole and DMSO served as positive and negative controls, respectively. Results: Tsaang gubat and ampalaya leaves failed to show anti-amoebic activity and even had increased growth of amoeba at all dose levels. The IC50 of tsaang gubat and ampalaya leaf extracts were >500 μg/mL at 24, 48, and 72 hours. Metronidazole was able to eradicate the amoeba parasite at 24 and 72 hours, while exposure to DMSO did not result in inhibition nor death of the parasite. Conclusion Tsaang gubat and ampalaya aqueous leaf extracts did not exhibit any anti-amoeba activity.
Momordica charantia ; Antiparasitic Agents