Challenges in the concurrent management of malaria and HIV in pregnancy in sub-Saharan Africa

Brentlinger, Paula E.; Behrens, Christopher B.; Micek, Mark A.

doi:10.1016/s1473-3099(06)70383-8

Cited by 72 publications

(50 citation statements)

References 72 publications

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“…Co-morbidity reduces the effectiveness of both antimalarial and antiretroviral drugs, and co-administration can increase the risk of drug-related toxicity (Brentlinger et al, 2006). Given these confounding effects and challenges in the concurrent management of malaria and HIV, it is not surprising, therefore, that only 71.1% of Rundu's inhabitants attend a public health facility for malaria diagnosis and treatment (Alegana et al, 2013); the remainder seek the use of traditional medicines.…”

Section: Discussionmentioning

confidence: 99%

Ethnomedicinal plants used by traditional healers in the management of HIV/AIDS opportunistic diseases in Rundu, Kavango East Region, Namibia

Chinsembu

Hijarunguru

Mbangu

2015

South African Journal of Botany

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Since human immunodeficiency virus (HIV) infected persons seek treatment from traditional healers, there is an urgent need to document plants used by traditional healers to manage acquired immunodeficiency syndrome (AIDS) opportunistic diseases. This study documented plants used to manage AIDS-related opportunistic diseases in Rundu, Kavango East Region, Namibia. Primary, secondary and tertiary samplings of traditional healers were conducted. During the interviews, the following ethnobotanical data were recorded: plant species, parts used, modes of preparation, administration, and diseases treated. Data were analysed by calculating percentage frequencies, familiarity index (F i ), and factor of informant consensus (F IC ). Seventy plant species from 54 genera and 28 families, mostly the Fabaceae, Anacardiaceae, and Combretaceae were used as ethnomedicines. Leaves, followed by roots and bark, were mostly harvested for the treatment of skin diseases, These multi-use plant species may have broad antimicrobial activities but also risk overexploitation. Further work is needed to screen plant extracts for in vitro anti-HIV activity and cytotoxicity.

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Section: Discussionmentioning

confidence: 99%

Ethnomedicinal plants used by traditional healers in the management of HIV/AIDS opportunistic diseases in Rundu, Kavango East Region, Namibia

Chinsembu

Hijarunguru

Mbangu

2015

South African Journal of Botany

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“…Highly active antiretroviral treatment (HAART) 22,23 Elevated risk of myelosuppression in women receiving both zidovudine and SP. Risk of diagnostic confusion should a patient develop severe cutaneous adverse reactions or hepatotoxicity after receiving both SP and daily nevirapine.…”

Section: Treatment Of Syphilismentioning

confidence: 99%

Intermittent preventive treatment of malaria during pregnancy in central Mozambique

Brentlinger

Dgedge

Correia

et al. 2007

Bull. World Health Organ.

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Problem New WHO strategies for control of malaria in pregnancy (MiP) recommend intermittent preventive treatment (IPTp), bednet use and improved case management. Approach A pilot MiP programme in Mozambique was designed to determine requirements for scale-up. Local setting The Ministry of Health worked with a nongovernmental organization and an academic institution to establish and monitor a pilot programme in two impoverished malaria-endemic districts. Relevant changes Implementing the pilot programme required provision of additional sulfadoxine-pyrimethamine (SP), materials for directly observed SP administration, bednets and a modified antenatal card. National-level formulary restrictions on SP needed to be waived. The original protocol required modification because imprecision in estimation of gestational age led to missed SP doses. Multiple incompatibilities with other health initiatives (including programmes for control of syphilis, anaemia and HIV) were discovered and overcome. Key outputs and impacts were measured; 92.5% of 7911 women received at least 1 dose of SP, with the mean number of SP doses received being 2.2. At the second antenatal visit, 13.5% of women used bednets. In subgroups (1167 for laboratory analyses; 2600 births), SP use was significantly associated with higher haemoglobin levels (10.9 g/dL if 3 doses, 10.3 if none), less malaria parasitaemia (prevalence 7.5% if 3 doses, 39.3% if none), and fewer low-birth-weight infants (7.3% if 3 doses, 12.5% if none). Lessons learned National-level scale-up will require attention to staffing, supplies, bednet availability, drug policy, gestationalage estimation and harmonization of vertical initiatives.

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“…Hence, malaria patients are likely to be at high risk for drug-drug interactions (DDIs). 4,5 Membrane transporters play a crucial role in the modulation of absorption, distribution, metabolism, and excretion of antimalarial agents and other drugs. 6,7 ATP-binding cassette transporters are known to function as barrier proteins to extrude toxins and xenobiotics from cells.…”

Section: Introductionmentioning

confidence: 99%

Potential P-Glycoprotein-Mediated Drug-Drug Interactions of Antimalarial Agents in Caco-2 cells

Oga

Sekine²,

Shitara³

et al. 2012

The American Society of Tropical Medicine and Hygiene

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Abstract. Antimalarials are widely used in African and Southeast Asian countries, where they are combined with other drugs for the treatment of concurrent ailments. The potential for P-glycoprotein (P-gp)-mediated drug-drug interactions (DDIs) between antimalarials and P-gp substrates was examined using a Caco-2 cell-based model. Selected antimalarials were initially screened for their interaction with P-gp based on the inhibition of rhodamine-123 (Rho-123) transport in Caco-2 cells. Verapamil (100 μM) and quinidine (1 μM) were used as positive inhibition controls. Lumefantrine, amodiaquin, and artesunate all showed blockade of Rho-123 transport. Subsequently, the inhibitory effect of these antimalarials on the bi-directional passage of digoxin (DIG) was examined. All of the drugs decreased basal-toapical (B-A) P-gp-mediated DIG transport at concentrations of 100 μM and 1 mM. These concentrations may reflect therapeutic doses for amodiaquin and artesunate. Therefore, clinically relevant DDIs may occur between certain antimalarials and P-gp substrates in general.

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Challenges in the concurrent management of malaria and HIV in pregnancy in sub-Saharan Africa

Cited by 72 publications

References 72 publications

Ethnomedicinal plants used by traditional healers in the management of HIV/AIDS opportunistic diseases in Rundu, Kavango East Region, Namibia

Ethnomedicinal plants used by traditional healers in the management of HIV/AIDS opportunistic diseases in Rundu, Kavango East Region, Namibia

Intermittent preventive treatment of malaria during pregnancy in central Mozambique

Potential P-Glycoprotein-Mediated Drug-Drug Interactions of Antimalarial Agents in Caco-2 cells

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