| 1. |
- Niemi, MEK, et al.
(författare)
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- 2021
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swepub:Mat__t
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| 2. |
- Kanai, M, et al.
(författare)
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- 2023
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swepub:Mat__t
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| 6. |
- Mansoor, Rashid, et al.
(författare)
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Haematological consequences of acute uncomplicated falciparum malaria : a WorldWide Antimalarial Resistance Network pooled analysis of individual patient data
- 2022
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Ingår i: BMC Medicine. - : Springer Nature. - 1741-7015. ; 20:1
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPlasmodium falciparum malaria is associated with anaemia-related morbidity, attributable to host, parasite and drug factors. We quantified the haematological response following treatment of uncomplicated P. falciparum malaria to identify the factors associated with malarial anaemia.MethodsIndividual patient data from eligible antimalarial efficacy studies of uncomplicated P. falciparum malaria, available through the WorldWide Antimalarial Resistance Network data repository prior to August 2015, were pooled using standardised methodology. The haematological response over time was quantified using a multivariable linear mixed effects model with nonlinear terms for time, and the model was then used to estimate the mean haemoglobin at day of nadir and day 7. Multivariable logistic regression quantified risk factors for moderately severe anaemia (haemoglobin < 7 g/dL) at day 0, day 3 and day 7 as well as a fractional fall >= 25% at day 3 and day 7.ResultsA total of 70,226 patients, recruited into 200 studies between 1991 and 2013, were included in the analysis: 50,859 (72.4%) enrolled in Africa, 18,451 (26.3%) in Asia and 916 (1.3%) in South America. The median haemoglobin concentration at presentation was 9.9 g/dL (range 5.0-19.7 g/dL) in Africa, 11.6 g/dL (range 5.0-20.0 g/dL) in Asia and 12.3 g/dL (range 6.9-17.9 g/dL) in South America. Moderately severe anaemia (Hb < 7g/dl) was present in 8.4% (4284/50,859) of patients from Africa, 3.3% (606/18,451) from Asia and 0.1% (1/916) from South America. The nadir haemoglobin occurred on day 2 post treatment with a mean fall from baseline of 0.57 g/dL in Africa and 1.13 g/dL in Asia. Independent risk factors for moderately severe anaemia on day 7, in both Africa and Asia, included moderately severe anaemia at baseline (adjusted odds ratio (AOR) = 16.10 and AOR = 23.00, respectively), young age (age < 1 compared to >= 12 years AOR = 12.81 and AOR = 6.79, respectively), high parasitaemia (AOR = 1.78 and AOR = 1.58, respectively) and delayed parasite clearance (AOR = 2.44 and AOR = 2.59, respectively). In Asia, patients treated with an artemisinin-based regimen were at significantly greater risk of moderately severe anaemia on day 7 compared to those treated with a non-artemisinin-based regimen (AOR = 2.06 [95%CI 1.39-3.05], p < 0.001).ConclusionsIn patients with uncomplicated P. falciparum malaria, the nadir haemoglobin occurs 2 days after starting treatment. Although artemisinin-based treatments increase the rate of parasite clearance, in Asia they are associated with a greater risk of anaemia during recovery.
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| 7. |
- Adjuik, Martin A., et al.
(författare)
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The effect of dosing strategies on the therapeutic efficacy of artesunate-amodiaquine for uncomplicated malaria : a meta-analysis of individual patient data
- 2015
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Ingår i: BMC Medicine. - : Springer Science and Business Media LLC. - 1741-7015. ; 13
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Tidskriftsartikel (refereegranskat)abstract
- Background: Artesunate-amodiaquine (AS-AQ) is one of the most widely used artemisinin-based combination therapies (ACTs) to treat uncomplicated Plasmodium falciparum malaria in Africa. We investigated the impact of different dosing strategies on the efficacy of this combination for the treatment of falciparum malaria. Methods: Individual patient data from AS-AQ clinical trials were pooled using the WorldWide Antimalarial Resistance Network (WWARN) standardised methodology. Risk factors for treatment failure were identified using a Cox regression model with shared frailty across study sites. Results: Forty-three studies representing 9,106 treatments from 1999-2012 were included in the analysis; 4,138 (45.4%) treatments were with a fixed dose combination with an AQ target dose of 30 mg/kg (FDC), 1,293 (14.2%) with a non-fixed dose combination with an AQ target dose of 25 mg/kg (loose NFDC-25), 2,418 (26.6%) with a non-fixed dose combination with an AQ target dose of 30 mg/kg (loose NFDC-30), and the remaining 1,257 (13.8%) with a co-blistered non-fixed dose combination with an AQ target dose of 30 mg/kg (co-blistered NFDC). The median dose of AQ administered was 32.1 mg/kg [IQR: 25.9-38.2], the highest dose being administered to patients treated with co-blistered NFDC (median = 35.3 mg/kg [IQR: 30.6-43.7]) and the lowest to those treated with loose NFDC-25 (median = 25.0 mg/kg [IQR: 22.7-25.0]). Patients treated with FDC received a median dose of 32.4 mg/kg [IQR: 27-39.0]. After adjusting for reinfections, the corrected antimalarial efficacy on day 28 after treatment was similar for co-blistered NFDC (97.9% [95% confidence interval (CI): 97.0-98.8%]) and FDC (98.1% [95% CI: 97.6%-98.5%]; P = 0.799), but significantly lower for the loose NFDC-25 (93.4% [95% CI: 91.9%-94.9%]), and loose NFDC-30 (95.0% [95% CI: 94.1%-95.9%]) (P < 0.001 for all comparisons). After controlling for age, AQ dose, baseline parasitemia and region; treatment with loose NFDC-25 was associated with a 3.5-fold greater risk of recrudescence by day 28 (adjusted hazard ratio, AHR = 3.51 [95% CI: 2.02-6.12], P < 0.001) compared to FDC, and treatment with loose NFDC-30 was associated with a higher risk of recrudescence at only three sites. Conclusions: There was substantial variation in the total dose of amodiaquine administered in different AS-AQ combination regimens. Fixed dose AS-AQ combinations ensure optimal dosing and provide higher antimalarial treatment efficacy than the loose individual tablets in all age categories.
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| 8. |
- Hagberg, Sten, 1962-, et al.
(författare)
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"Femmes de devant!" : Combat du leadership féminin au Burkina Faso
- 2021
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Cette étude décrit et analyse les contextes, structures et circonstances qui conditionnent la participation des filles et des femmes dans l’espace public, dans les sphères de prise de décision et dans des rôles de leadership au sein des arènes locales au Burkina Faso. Malgré des décennies de campagnes d’information et de sensibilisation menées, de mesures engagées et de décisions prises, l’égalité du genre en ce qui concerne le leadership sociopolitique et la participation politique demeure faible, tandis que les femmes comme mobilisatrices sociales et politiques sont mises en avant.Une équipe des anthropologues a conduit les recherches de terrain sur le leadership féminin dans 14 communes burkinabè. Le thème central est le combat des femmes leaders. Il s’agit de ces « femmes de devant » qui ne se laissent pas faire et qui luttent pour construire un leadership féminin qui peut définitivement changer la donne pour permettre à ce que les femmes puissent percer en politique. Au quotidien, les femmes de devant mènent le combat sur plusieurs fronts : politique, institutionnel, ménager, associatif, financier, social, éducatif, psychologique, culturel, etc.
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| 9. |
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| 10. |
- Hagberg, Sten, 1962-, et al.
(författare)
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Sécurité par le bas : Perceptions et perspectives citoyennes des défis de sécurité au Burkina Faso
- 2019
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Bok (övrigt vetenskapligt/konstnärligt)abstract
- Cette étude porte sur la sécurité par le bas au Burkina Faso, notamment les manières dont les citoyens perçoivent et vivent les défis de sécurité. A travers une entrée par la commune, elle s’intéresse à l’interface entre les enjeux locaux et les insécurités multiples : attaques armées, terrorisme, crime organisé, délinquances, exactions et bavures des forces de sécurité, pauvreté, insécurité alimentaire, etc. L’étude met les nouvelles initiatives de sécurité (Forum national de sécurité, la Force conjointe du G5 Sahel, groupes d’autodéfense, etc.) en perspective, car elle vise à comprendre les réalités et les « vues et vécues » des acteurs socio-politiques locaux et des citoyens ordinaires. L’étude est le fruit d’un travail collectif. Une équipe d’anthropologues a d’abord mené les recherches de terrain dans 13 communes burkinabè pour ensuite analyser les matériaux ethnographiques afin de rédiger le présent document ensemble. Les perspectives citoyennes de sécurité, l’ancien régime, la crise malienne, et la criminalité transfrontalière, sont analysées à côté des perceptions populaires de l’État burkinabè. L’émergence des groupes d’auto-défense, particulièrement les Dozos, Koglweogos et Roughas, est contextualisée, suivie d’une analyse des initiatives locales pour la sécurité, telles que l’engagement contre la radicalisation et la mobilisation des femmes. Comment vivre les insécurités – notamment les questions de sécurité alimentaire, de chômage et d’emploi et gérer la peur – est analysé en détail sur la base des connaissances approfondies des terrains de recherche.
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