Vol 3-1 Mini Review

A NEW DAWN FOR FIGHT AGAINST MALARIA IN THE AFRICAN REGION

Bartholomew Dicky Akanmori1, Joseph Okeibunor1*, and Matshidiso Rebecca Moeti2

1WHO Regional Office for Africa, Brazzaville, Congo

2WHO Regional Director for Africa, Brazzaville, Congo

The WHO Regional Office for Africa is systematically taking steps to realize the goals of malaria control in the Region. One of such steps is the pursuit for the development of malaria vaccine, which is being tested in three countries in the Region, namely Ghana, Kenya and Malawi. This paper reviews the potential contributions of a vaccine against malaria in endemic regions like sub-Saharan Africa beyond just coming as another intervention for malaria control. The injectable vaccine, RTS,S, was developed to protect young children from the most deadly form of malaria, Plasmodium falciparum, which is endemic in the Region. However, sceptics argued that this could be unlikely outside of rigorously controlled clinical trials, as well as waning efficacy over time. There has been calls for cautious optimism and emphasized that “the vaccine is just an additional tool in the current limited armamentarium for making progress against malaria”. This review demonstrates the benefits of having the malaria vaccine are numerous, including strengthening national immunization and malaria control programmes; stimulating and boosting the scale-up of the existing interventions which have so far made significant reductions in malaria burden across several countries of the region.

DOI: 10.29245/2572-9411/2018/1.1141 Read More
Vol 3-2 Mini Review

Congenital Generalized Lipodystrophy

Josivan Gomes Lima1*, Marcel Catão Ferreira dos Santos1, Julliane Tamara Araújo de Melo Campos2

1Departamento de medicina clínica, disciplina de endocrinologia e metabologia. Hospital Universitário Onofre Lopes, Universidade Federal do Rio Grande do Norte (UFRN), Natal, RN, Brazil

2Faculty of Health Sciences of Trairi, Federal University of Rio Grande do North (UFRN), Natal, RN, Brazil

Congenital Generalized Lipodystrophy (CGL) is a rare and severe autosomal recessive disease. Patients are defective in the storage of body fat and, consequently, they deposit fat in ectopic tissues, mainly liver, and can develop cirrhosis. Insulin resistance is a typical finding, causing diabetes that require high daily doses of insulin. In the state of Rio Grande do Norte, Brazil, we have one of the largest cohorts of patients with CGL. In this article, we review pathophysiology, clinical picture and treatment of this disease.

DOI: 10.29245/2572-9411/2018/2.1147 Read More
Vol 3-1 Mini Review

Autonomic nervous system dysfunction in motor neuron diseases

Alexandra Prufer de Queiroz Campos Araujo1*, Igor Prufer de Queiroz Campos Araujo2, Abelardo de Queiroz Campos Araujo3

1Institute of Pediatrics, Federal University of Rio de Janeiro (UFRJ). Rua Bruno Lobo 50, Cidade Universitária, Rio de Janeiro, RJ 21941-912, Brazil

2School of Medicine, Federal University of Rio de Janeiro (UFRJ) Rua Bruno Lobo 50, Cidade Universitária, Rio de Janeiro, RJ 21044-020, Brazil

3The Institute of Neurology, Federal University of Rio de Janeiro (UFRJ). Av Venceslau Braz, 215, Botafogo, Rio de Janeiro, RJ 22290-160, Brazil

Background: Motor neuron disorders predominately result in progressive weakness. Nevertheless a wider expression of symptoms and signs point to a more multisystemic involvement. Autonomic nervous system findings have been reported in animal models, adult and child motor neuron diseases.

Objective: Review the literature on autonomic findings in motor neuron diseases.

Method: A PubMed literature search.

Results: In the present review, we will discuss the neuropathological and clinical features of dysautonomia reported in motor neuron disease in humans and animal models.

Conclusion: The literature points to considering careful autonomic evaluation and management in patients with motor neuron disorders.

DOI: 10.29245/2572-9411/2018/1.1136 Read More
Vol 3-1 Mini Review

New approaches for integrated and cost-effective malaria vector control

Peter Dambach1*

1Institute of Public Health, University of Heidelberg, Germany

In most parts of sub-Saharan Africa, malaria is still the most important vector borne disease, severely affecting people´s lives and causing economic loss. Malaria vector control to date almost exclusively relies on long lasting insecticide treated nets (LLINs) and indoor residual spraying (IRS), while other approaches such as larviciding are less implemented. Rising resistances against commonly used insecticides and changes in vector behavior and genetics slow down further reductions in malaria transmission. There is an urgent need for the implementation of additional approaches to appropriately react to vector adaptations. One promising option is the targeting of vector larvae with biological larvicides. During a three-year field trial (EMIRA – Ecologic Malaria Reduction for Africa), evidence was generated on the feasibility, effectiveness, acceptability, and cost of biological larviciding in North-Western Burkina Faso. Here, possible ways on how to further increase cost effectiveness and community support for future programs are presented. Reducing the need for frequent retreatment of vector larvae habitats is a major cost saver for material and workforce. Additional expenditure reductions could be achieved through targeting multiple disease vectors, which in some cases share vector breeding and resting sites. Due to limited overlap in mosquito breeding preference, major cost savings are expected to originate in infrastructural synergy effects. The development of new approaches to further cut down program costs could be a powerful contributor to promote vector larvae control and techniques that target several diseases at once.

DOI: 10.29245/2572-9411/2018/1.1144 Read More
Vol 3-1 Mini Review

Atypical Mycobacterial Keratitis: A Negligent and Emerging Thread for Blindness

Thet Tun Aung1, Roger W Beuerman1,2,3*

1Singapore Eye Research Institute, Singapore 169856

2SRP Neuroscience and Behavioral Disorders, Duke-NUS, Singapore 169857

3Department of Ophthalmology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228

Atypical mycobacteria are wide spread in the environment; they are now known to be a cause of a variety of infections including corneal infections especially after refractive surgery. The diagnosis and clinical management are often unsatisfactory due to misdiagnosis and requirement of prolonged combination of antibiotics. Evolving drug resistance is known to be a unique feature in managing atypical mycobacterial keratitis due to the propensity for the development of biofilms. In this article, we provide an etiology of atypical mycobacterial keratitis, mycobacterial biofilm pathogenesis, and the importance of mycobacterial biofilm matrix component (extracellular DNA) in maintaining mycobacterial biofilm matrix maintenance. Current treatment options for atypical mycobacterial keratitis are summarized and suggestions are made for the new treatment strategies targeting on the mycobacterial biofilm pathogenesis pathway.

DOI: 10.29245/2572-9411/2018/1.1143 Read More