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Christian Desmarchelier Current status of Malaria in South America Cristian Desmarchelier, PhD Fundación Mundo Sano del Libertador Av 1146 Buenos Aires, Argentina www.mundosano.org Malaria in South America Number of cases per 1000 people per country South America Africa Asia Country Per 1000 people Country Per 1000 people Country Per 1000 people Guyanas 36-22 Uganda 478 Afghanistan 25 Ecuador 4.0 Sao Tome & Prince 394 Myanmar 15 Colombia - Belize 3.7 Liberia 302 Yemen 13 Peru 2.9 Tanzania 290 Papua New Guinea 12 Bolivia 2.3 Burundi 274 Cambodia 5.0 Brazil 2.1 Mozambique 270 India – Bhutan 1.7 Source: SocialWatch.org (WHO) Latin America: Malaria Status 2000-2007 4 countries with a >75% decrease in cases • 21 endemic countries 6 countries with 50 - 74% • 11 countries in South America reduction of cases (73% cases are P. vivax) •8 countries in Central America and 5 countries with <50% Mexico (94% cases P. vivax) reduction in total cases •2 countries Hispaniola (almost 100% P. falciparum) •REGION •75% cases P. vivax •25% P.falciparum • <1% P. malariae 6 countries with an increase (Brazil, Colombia, French Guiana, Guyana, Suriname & in malaria Venezuela) 18 countries free of malaria •275 million people at risk in the Americas (1 in 3 people) • 30.5% overall reduction in cases according to preliminary data 2007 (n=797,911) PAHO-WHO • 37% decrease in mortality This slide was kindly provided by Dr Tomás Orduna, CEMPRA-MT, Muñiz Hospital, Buenos Aires Malaria in South America Distribution of vivax - falciparum falciparum / vivax falciparum / vivax Malaria and South American natural products Lessons from the Neotropics Cinchona sp (Rubiaceae) – “Peruvian bark” or “cascarilla” Quinine Malaria and South American natural products Lessons from the Neotropics O H O O Quassinoids (basic structure) - Present in Simarouba spp, Quassia spp, and other neotropical species; Andiroba oil - Potent in vitro antimalarial activity in P. (Carapa guianensis) falciparum chloroquine-resistant strains; Repelent - Novel mechanism of action: inhibition of Protein synthesis via ribosome interaction. Malaria and South American natural products Lessons from the Neotropics 1. 4-nerolidylcatechol (Pothomorphe peltata – “caapeba”) 2. Neoselgeolide (Picrolema sprucei – “caferana”) 3. Ellipticine (Aspidosperma vargasii – “amarelao”) 4. Aspidocarpine (A. desmanthum –“amargoso”) De Andrade-Neto et al. (2007) In vitro inhibition of Plasmodium falciparum by substances isolated from Amazonian antimalarial plants. Mem Inst Oswaldo Cruz 102: 359-365. Malaria and Artemisia annua production in South America Who is Who - UNICAMP: Introduction of A. annua production in the State of Sao Paulo; development of new varieties for low latitudes; phytotherapic remedies bases on A. annua leaves - UTPR: Intensive research on fertilisation, density, pesticides, herbicides, etc; phenology; transfer of small scale productive know-how to small farmers in State of Paraná. - FUNDACION MUNDO SANO: Research on industrial and large scale production; extraction and purification of artemisinin; synthesis of artesunate (2009). Malaria and Artemisia annua production in South America Agricultural ventures Tropic of Capricorn Malaria and ACT Brazil: 1.4 million cases (2006) For 2007: 457,000 cases P. vivax 90,000 cases P. falciparum Source: Ministerio da Saúde do Brasil Malaria and ACT Brazil's Public Policy Suggested treatments for Plasmodium vivax infection: -Chloroquine -Primaquine Suggested treatments for Plasmodium falciparum infection: -Artemether + Lumefantrine (Coartem®) -Quinine + Doxicicline -Primaquine Source: Ministério da Saúde do Brasil Malaria and ACT Brazil: The case of Farmanguinhos - DNDi First ACT developed in Brazil, ASMQ is the first fixed-dose formulation (FACT) of the association of AS and MQ. Each treatment consists of 300 mg AS plus 1200 mg MQ. Source: Ministério da Saúde do Brasil Malaria and Phytotherapics Brazil: The case of UNICAMP - Farmanguinhos Source: Ministério da Saúde do Brasil; ICEI Mercosur Malaria and ACT Colombia and Peru Public Policies Colombia: 0.4 million cases Peru: 0.3 million cases Suggested treatments for Plasmodium vivax infection: -Chloroquine + Primaquine Suggested treatments for Plasmodium falciparum infection: -Artesunate + Mefloquine -Amodiaquine + Sulfadoxine-Pyrimethamine -Artemether + Lumefantrine (Coartem®) -Quinine Source: World Malaria Report 2008 (WHO); Peruvian Ministry of Health Malaria and ACT Argentina: cases of malaria 1980-2008 2500 2076 2000 2000 1620 1521 1529 1500 1065 1000 948 803 774 758 666 643 592 567 535 500 437 441 341 326 339 355 252 222 215 212 125 124 116 72 0 8081828384858687888990919293949596979899012345678 Source: Dr Tomás Orduna, CEMPRA-MT, Muñiz Hospital, Buenos Aires THANK YOU VERY MUCH !!! Fundación Mundo Sano del Libertador Ave 1146 - Buenos Aires, Argentina www.mundosano.org.
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