Despite a historical association with poor tolerability, a comprehensive review on safety of antileishmanial chemotherapies is lacking. We carried out an update of a previous systematic review of all published clinical trials in visceral leishmaniasis (VL) from 1980 to 2019 to document any reported ...serious adverse events (SAEs).
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Una Colaboración en Investigación entre el Refugee Law Initiative y Save the Children
La participación de las poblaciones afectadas y las
metodologías participativas han surgido como una
tendencia dominante en el discurso de la rendición
de cuentas humanitaria de una amplia gama de
organiz...aciones de asistencia y sus donantes. Este
estudio analiza cómo Save the Children Colombia
puede trabajar en el fomento de la participación
significativa de los niños, de las niñas y de los
adolescentes en todas las etapas de su programa,
y cómo esto se puede poner en práctica para el
aprendizaje organizacional, la adaptación y el
programa de rendición de cuentas.
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Los Marcos de Referencia para la Formación en Residencias Médicas constituyen una herramienta central del proceso de armonización de la formación en residencias en tanto establecen los componentes mínimos que tienen que estar presentes en la formación.
accessed on 22.08.2022
Plan nacional de salud mental 2021-2025
Combination therapy is a cornerstone of modern malaria treatment, particularly in the context of widespread multidrug resistance. Using two or more antimalarial drugs with different mechanisms simultaneously enhances efficacy, shortens treatment duration, improves compliance and delays the developme...nt of resistance. Artemisinin-based combination therapies (ACTs), such as artemether–lumefantrine, artesunate–amodiaquine and artesunate–sulfadoxine/pyrimethamine, are highly effective in rapidly clearing parasites and reducing gametocyte carriage. They are also generally well tolerated. Non-artemisinin combinations, quinine-based regimens and novel combinations (e.g. piperaquine–dihydroartemisinin) offer alternative therapeutic options, although clinical experience with these remains limited. Although ACTs are the preferred first-line treatment, factors such as cost, local drug resistance patterns, safety during pregnancy and paediatric use must inform implementation and policy decisions.
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Antimalarial chemotherapy is crucial for reducing morbidity, mortality, and drug resistance, and is the cornerstone of malaria control. Existing antimalarial drugs act at different stages of the parasite’s life cycle. These drugs range from classic agents such as chloroquine and quinine to newer a...rtemisinin derivatives. They include tissue schizonticides, blood schizonticides, gametocytocides, and sporontocides. Artemisinin and its derivatives are the most effective and fastest-acting treatment against drug-resistant Plasmodium falciparum, achieving rapid parasite clearance and reducing transmission potential. Other key drugs include mefloquine, halofantrine, proguanil, sulfadoxine–pyrimethamine, atovaquone–proguanil, tetracyclines, clindamycin and azithromycin. Each of these drugs has a specific mechanism of action, pharmacokinetics, efficacy, safety profile and contraindications. Rational drug combinations and adherence to national treatment guidelines are essential for managing resistance, ensuring safety in vulnerable populations such as children and pregnant women, and optimising therapeutic outcomes in cases of both uncomplicated and severe malaria.
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Malaria and HIV, two of the world’s most deadly diseases, are widespread, but their distribution overlaps greatly in sub-Saharan Africa. Consequently, malaria and HIV coinfection (MHC) is common in the region. In this paper, pertinent publications on the prevalence, impact, and treatment strategie...s of MHC obtained by searching major electronic databases (PubMed, PubMed Central, Google Scholar, ScienceDirect, and Scopus) were reviewed, and it was found that the prevalence of MHC in SSA was 0.7%–47.5% overall. Prevalence was 0.7%–47.5% in nonpregnant adults, 1.2%–27.8% in children, and 0.94%–37% in pregnant women. MHC was associated with an increased frequency of clinical parasitemia and severe malaria, increased parasite and viral load, and impaired immunity to malaria in nonpregnant adults, children, and pregnant women, increased in placental malaria and related outcomes in pregnant women, and impaired antimalarial drug efficacy in nonpregnant adults and pregnant women. Although a few cases of adverse events have been reported in coinfected patients receiving antimalarial and antiretroviral drugs concurrently, available data are very limited and have not prompted major revision in treatment guidelines for both diseases. Artemisinin-based combination therapy and cotrimoxazole are currently the recommended drugs for treatment and prevention of malaria in HIV-infected children and adults. However, concurrent administration of cotrimoxazole and sulfadoxine–pyrimethamine in HIV-infected pregnant women is not recommended, because of high risk of sulfonamide toxicity. Further research is needed to enhance our understanding of the impact of malaria on HIV, drug–drug interactions in patients receiving antimalarials and antiretroviral drugs concomitantly, and the development of newer, safer, and more cost-effective drugs and vaccines to prevent malaria in HIV-infected pregnant women.
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