8 research outputs found

    Lack of allele-specific efficacy of a bivalent AMA1 malaria vaccine

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    Abstract Background Extensive genetic diversity in vaccine antigens may contribute to the lack of efficacy of blood stage malaria vaccines. Apical membrane antigen-1 (AMA1) is a leading blood stage malaria vaccine candidate with extreme diversity, potentially limiting its efficacy against infection and disease caused by Plasmodium falciparum parasites with diverse forms of AMA1. Methods Three hundred Malian children participated in a Phase 2 clinical trial of a bivalent malaria vaccine that found no protective efficacy. The vaccine consists of recombinant AMA1 based on the 3D7 and FVO strains of P. falciparum adjuvanted with aluminum hydroxide (AMA1-C1). The gene encoding AMA1 was sequenced from P. falciparum infections experienced before and after immunization with the study vaccine or a control vaccine. Sequences of ama1 from infections in the malaria vaccine and control groups were compared with regard to similarity to the vaccine antigens using several measures of genetic diversity. Time to infection with parasites carrying AMA1 haplotypes similar to the vaccine strains with respect to immunologically important polymorphisms and the risk of infection with vaccine strain haplotypes were compared. Results Based on 62 polymorphic AMA1 residues, 186 unique ama1 haplotypes were identified among 315 ama1 sequences that were included in the analysis. Eight infections had ama1 sequences identical to 3D7 while none were identical to FVO. Several measures of genetic diversity showed that ama1 sequences in the malaria vaccine and control groups were comparable both at baseline and during follow up period. Pre- and post-immunization ama1 sequences in both groups all had a similar degree of genetic distance from FVO and 3D7 ama1. No differences were found in the time of first clinical episode or risk of infection with an AMA1 haplotype similar to 3D7 or FVO with respect to a limited set of immunologically important polymorphisms found in the cluster 1 loop of domain I of AMA1. Conclusion This Phase 2 trial of a bivalent AMA1 malaria vaccine found no evidence of vaccine selection or strain-specific efficacy, suggesting that the extreme genetic diversity of AMA1 did not account for failure of the vaccine to provide protection.</p

    Use of a pLDH-based dipstick in the diagnostic and therapeutic follow-up of malaria patients in Mali

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    Abstract Background Malaria is a major public health problem in Mali and diagnosis is typically based on microscopy. Microscopy requires a well trained technician, a reliable power source, a functioning microscope and adequate supplies. The scarcity of resources of community health centres (CHC) does not allow for such a significant investment in only one aspect of malaria control. In this context, Rapid Diagnostic Tests (RDTs) may improve case management particularly in remote areas. Methods This multicentre study included 725 patients simultaneously screened with OptiMal-IT test and thick smears for malaria parasite detection. While evaluating the therapeutic efficacy of choroquine in 2 study sites, we compared the diagnostic values of thick smear microscopy to OptiMal-IT test applying the WHO 14 days follow-up scheme using samples collected from 344 patients. Results The sensitivity and the specificity of OptiMal-IT compared to thick smear was 97.2% and 95.4%, whereas the positive and negative predictive values were 96.7 and 96.1%, respectively. The percent agreement between the two diagnostic tests was 0.93. The two tests were comparable in detecting malaria at day 0, day 3 and day 14. The only difference was observed at day 7 due to high gametocytemia. Subjectively, health care providers found OptiMal-IT easier to use and store under field conditions. Conclusion OptiMal-IT test revealed similar results when compared to microscopy which is considered the gold standard for malaria diagnostics. The test was found to have a short processing time and was easier to use. These advantages may improve malaria case management by providing a diagnostic and drug efficacy follow-up tool to peripheral health centres with limited resources.</p

    Artemisinin-based combinations versus amodiaquine plus sulphadoxine-pyrimethamine for the treatment of uncomplicated malaria in Faladje, Mali

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    Abstract Background Because of the emergence of chloroquine resistance in Mali, artemether-lumefantrine (AL) or artesunate-amodiaquine (AS+AQ) are recommended as first-line therapy for uncomplicated malaria, but have not been available in Mali until recently because of high costs. Methods From July 2005 to January 2006, a randomized open-label trial of three oral antimalarial combinations, namely AS+AQ, artesunate plus sulphadoxine-pyrimethamine (AS+SP), and amodiaquine plus sulphadoxine-pyrimethamine (AQ+SP), was conducted in Faladje, Mali. Parasite genotyping by polymerase chain reaction (PCR) was used to distinguish new from recrudescent Plasmodium falciparum infections. Results 397 children 6 to 59 months of age with uncomplicated Plasmodium falciparum malaria were enrolled, and followed for 28 days to assess treatment efficacy. Baseline characteristics were similar in all three treatment groups. The uncorrected rates of adequate clinical and parasitologic response (ACPR) were 55.7%, 90.8%, and 97.7% in AS+AQ, AS+SP, and AQ+SP respectively (p Conclusion The combination of AQ+SP provides a potentially low cost alternative for treatment of uncomplicated P. falciparum infection in Mali and appears to have the added value of longer protective effect against new infection.</p

    Impact of a malaria intervention package in schools on Plasmodium infection, anaemia and cognitive function in schoolchildren in Mali: a pragmatic cluster-randomised trial.

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    BACKGROUND: School-aged children are rarely targeted by malaria control programmes, yet the prevalence of Plasmodium infection in primary school children often exceeds that seen in younger children and could affect haemoglobin concentration and school performance. METHODS: A cluster-randomised trial was carried out in 80 primary schools in southern Mali to evaluate the impact of a school-based malaria intervention package. Intervention schools received two interventions sequentially: (1) teacher-led participatory malaria prevention education, combined with distribution of long-lasting insecticidal nets (LLINs), followed 7 months later at the end of the transmission season by (2) mass delivery of artesunate and sulfadoxine-pyrimethamine administered by teachers, termed intermittent parasite clearance in schools (IPCs). Control schools received LLINs as part of the national universal net distribution programme. The impact of the interventions on malaria and anaemia was evaluated over 20 months using cross-sectional surveys in a random subset of 38 schools(all classes), with a range of cognitive measures (sustained attention, visual search, numeracy, vocabulary and writing) assessed in a longitudinal cohort of children aged 9-12 years in all 80 schools. RESULTS: Delivery of a single round of IPCs was associated with dramatic reductions in malaria parasitaemia (OR 0.005, 95% CI 0.002 to 0.011, p<0.001) and gametocyte carriage (OR 0.02, 95% CI 0.00 to 0.17, p<0.001) in intervention compared with control schools. This effect was sustained for 6 months until the beginning of the next transmission season. IPCs was also associated with a significant decrease in anaemia (OR 0.56, 95% CI 0.40 to 0.78, p=0.001), and increase in sustained attention (difference +0.23, 95% CI 0.10 to 0.36, p<0.001). There was no evidence of impact on other cognitive measures. CONCLUSION: The combination of malaria prevention education, LLINs and IPCs can reduce anaemia and improve sustained attention of school children in areas of highly seasonal transmission. These findings highlight the impact of asymptomatic malaria infection on cognitive performance in schoolchildren and the benefit of IPCs in reducing this burden. Additionally, malaria control in schools can help diminish the infectious reservoir that sustains Plasmodium transmission

    Micronutrient Powders Combined With Malaria Chemoprevention to Improve Anaemia and Cognitive Function in Early Childhood in Mali: A Cluster-Randomised Trial.

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    A cluster-randomised controlled trial was conducted in 60 communities in southern Mali to evaluate the impact of micronutrient powders (MNP) combined with seasonal malaria chemoprevention (SMC) on anaemia (primary endpoint), Plasmodium infection, stunting and cognitive function in children < 5 years. The 60 communities were randomly allocated to the intervention or control arm, and cross-sectional biomedical and cognitive surveys were conducted after 1 and 3 years in a random sample of 3 and 5 years olds (1052 and 1081 children, respectively). All children aged 3-59 m in intervention and control communities received two rounds of SMC each year during the peak malaria season, and in intervention communities, all children aged 6-59 m additionally received 4 months of daily MNP after the peak malaria season. Despite a high baseline prevalence of anaemia and good fidelity to intervention, this trial found no evidence of impact on study outcomes. The prevalence of anaemia was similar in both arms for both age groups after 1 and 3 years of intervention-after 3 years, the prevalence of anaemia amongst 3-year olds was 57.6% in the intervention arm versus 60.1% in the control group (p = 0.352). For 5-year olds, it was 51.3% and 53.0%, respectively (p = 0.607). No effect was observed on stunting or cognitive function either

    A randomized and controlled Phase 1 study of the safety and immunogenicity of the AMA1-C1/Alhydrogel®+CPG 7909 vaccine for Plasmodium falciparum malaria in semi-immune Malian adults

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    A double blind, randomized and controlled Phase 1 clinical trial was conducted to assess the safety and immunogenicity in malaria-exposed adults of the Plasmodium falciparum blood stage vaccine candidate Apical Membrane Antigen 1-Combination 1 (AMA1-C1)/Alhydrogel(R) with and without the novel adjuvant CPG 7909. Participants were healthy adults 18-45 years old living in the village of Donegubougou, Mali. A total of 24 participants received 2 doses one month apart of either 80 mu g AMA1-C1 /Alhydrogel(R) or 80 mu g AMA1-C1/Alhydrogel(R) + 564 mu g CPG 7909. The study started in October 2007 and completed follow up in May 2008. Both vaccines were well tolerated, with only mild local adverse events and no systemic adverse events judged related to vaccination. The difference in antibody responses were over 2-fold higher in the group receiving CPG 7909 for all time points after second vaccination and the differences are statistically significant (all p &lt; 0.05). This is the first use of the novel adjuvant CPG 7909 in a malaria-exposed population. (C) 2009 Elsevier Ltd. All rights reserved.</p

    A randomized controlled phase 2 trial of the blood stage AMA1-C1/Alhydrogel malaria vaccine in children in Mali

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    A double blind, randomized, controlled Phase 2 clinical trial was conducted to assess the safety, immunogenicity, and biologic impact of the vaccine candidate Apical Membrane Antigen 1-Combination 1 (AMA1-C1), adjuvanted with Alhydrogel (R) Participants were healthy children 2-3 years old living in or near the village of Bancoumana. Mali. A total of 300 children received either the study vaccine or the comparator. No impact of vaccination was seen on the primary endpoint, the frequency of parasitemia measured as episodes &gt;3000/mu L/day at risk. There was a negative impact of vaccination on the hemoglobin level during clinical malaria, and mean incidence of hemoglobi

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    DAILY PALO ALTO TIMES, THURSDAY, MAIU'H ... ux* , FULLER & CO. N Fancy a^a Phone Main 51 RPDWOOD CITY IvOCALS.- tXJNTKST FOB CONTROL OF MILLIONAIRE EKTATK P. PatroBl. A. F. Gaoops snd August Crete* I* were admitted to eiti- teniblp during the wsok by Judge Buck. Applicant! for cUitesifalp under the new federal law now bare to paat a rigid examination. Since tbe new law weat Into effect mtny ippllcenla hsve been denied cltlxen- thlp. The Frank Tanning Compear la making preparations for a buay season. Extensive Improvements and alterations ars being msds In tbe company's yards, tnd a number or new vstt ars being built. Jobn Cordy. grand tecretary oli ,1th. Foresters of America, win visit '" G* i' | Court Mad rone tblt (Thurtdty > Ydf* f*Yl&& evening. At the conclusion of the ♦ meeting t Ueaqoet will be served. Emit Llmpke and Oeorge Llmpke, who were found guilty of burglaris- teg 'a butcbershop In South Ssn Franciaco, wart isntenced latt 'Thursday by Judge Buck to aerve ons year each to Ssa Qutntla. Exteatlvt ttreet Improvements tre being mads lo Wtllstlsy Park. During ths week Clark Rice was awarded a contract to lay 16.000 lineal feet of curbing. Mr. Riot alto has . tbs contrtct to Ity ths cement tide- *** I walkt in tbe park. FROM TTO DAILT PALO ALTO., The member* of Court Msdroos, ■■ ■■ *•— j Forstters of America, art rontsm- (Continued from psgs S) pitting the erection or a new hall on ________ f tbelr lot asar Phelpa atreet. Tbe and Pslo Alio. Pwcantlon. sr. t* !""!."* *"„ '""'."'T*."' "'" "* ISC .xereUed snd th. d.v.lopm.nl ln "" "•'-J-""0"- »' ■'•••»_■ *y •*»* + **♦■* Henry of tb* dieses b It clostty watched.,. Dr. laowbu conferred with u*ny\[°™Z ^iVL^t. ot the ttudenti wbo live In Ban Jote, aad haa adrtaed them la regard to their situation. So far oo official action has been taken In regard to 1 ttudenti wbo lire on the University Ctmput. Dr. vy. F. Snow, chairman of the Public Health Committee of the' University, makes the following announcement ln regard to she smallpox outbrttk: "Editpr 'Dtlly Palo Alto*: " .ft ."PPly. to yoor request for a statement concerning the danger of a' tmall por outbreak here, I would thy that up to the present time no itnsllpox cases bare developed on the Ctmput or In Palo Alto. Tha boat* of atadenta living la San Joss and other towns la tbs valley have been under the bbtervttlon of ths local htalth officer*. Thtre are SS etaden. commuters, but it hit not 'DR. LKONHARD TO UK-TURK. Famous JariM Will Speak la C«s_psl Friday at 11:10 on, Qennaa Legiilstlan. Dr. Rudolph Leonhird, the famous Qermaa Jurltt tad author, will deliver aa address la tht University Cbapel, Friday morning at 11:16. He will tpesk on "The Social T*n- dtaclet Iq Present German Legislation." and all exercises in tbe Law, Economics, snd Hlttory department* ■ win be tntptnded for the hour to enable ttudtntt In thete departmeatt to atttnd the lecture. Dr. Leoohard Is one ot the fore- moat authorltlet on legal subject* la Oermaay. baring been the Deaa of ths Law School of ths UnlvsrillY Of Brstlau, sad being the sulhor of many standard works on the Isw. For the past year he hat been lecturing at Columbia University ss ths Kelter Wllbetm Professor to tbe United States. V. W. C. A, At th* regular weekly meeting of the Young Women's Christian Asao* elation, htld Tuesday afternoon In tbt Unlveralty Chapel, tht officers for the emulag yssr Were elected. They will assume ths dulls* ot tbslr of- lest tblt month tad will continue la offlcs until next March. Tht offl- etrs are aa follows: Mis* A. K. flhtnn, 'OS, prstldsat; Mist L. C. Howell, '08, rioe-presldent; Mitt R. f. Lewlt. *0S, treasurer; Mlts M. T. Howell, '10, recording secretary; Mitt H. Stolle, '08. oor responding tscretsry. P. K. Toot, '08, of California bit given up track work by order of hit physician. Yost took tscond plic* la the half mile 1b laat years tereollegtate mast Com per. of Oakland, a City boy, visited friends her* Sunday. He It now engaged In the plumbing builnea*. being tstootatsd with tbs, Carl Diell Company Bsysr A Krohn have disposed of their bakery to George Baldwin, proprietor of tbe I>t Monte and Bridge-street bakeries Mr. Bald- sin will hereafter conduct the Bridgc-ttreet bakery only as a wholestle ttors. Doctor Mtttbewt. presiding elder of the Ssn Franciaco dtttrict of the Methodist Church, occupied tbe pulpit of the local Methodist Church list Sunday. William Jamleaon thlt week pur chased the plumbing business Benson A Wystt. Mr. Jamleaon wflt-j were Introduced, but all conduct the pew shop ln connection with hit present establishment. Holt of .<%. A. folium Vena* Lorea. i'.it.iirit la Heard Before tbe Hnpi-rtor Coart. Tbe guardanshlp toll of A. A. Co- burn vi'i-aus 1-oren Coburn, which It vtrtuilly s contest for the control or tb* estate of the Ls Hands million- sire. Lores Coburn. came up for hearing again In the asperior court A. Co- bum, tbe plaintiff, a nepfaew or tbe aged capitalist, doea not aeek the appointment or himself, but asks tht tppolntment of tome one to look after hit unci** affairs, alleging that the latter 1* untbls to do so himself. Tbe property Interests Involved sre vest, consisting of valuable land situated In San Mateo county and the San Joaquin valley. At the partial bearing Saturday many witnesses were exsmlnsd to throw light on tbe defendant's mental capacity and ability to take charge of his own fortune Co* burn's attorney!. Archer Klorald of Redwood City, end A. J. Treat, called upon their client to give a history of hit life. This the defendant did. relating bow be cams bete In the esrly day* with W. Clark, with whom he gained control of t Sptnlth grant, the found it Ion of hla fortune. Throughout the examination Coburn showed that hi* every tense wat alert, answering all questions quickly sad Intslllgeotly. Regarding the charge thst Co» h'irn htd ttgned deedi to land which he did not own. the defendant testified that st bit Interest! were vsst It hsd been necessary for blm to gtv* s power or attorney to hit ntphew, Carl J. Coburtr; a former supervisor of ths fifth district Defendant testified that be had accordingly signed mtny paper* which Carl htnded blm, trusting In the younger man's Integrity. The plaintiff's sttorneyi submitted Coburn to t rigid cross-examination. Deeds with Coburo'a name on them thst the millionaire would admit wat thtt the signatures looked like bit. "Guilty." saya Ruef. "Not guilty." overrule! the Supreme Court. We have. 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STANFORD PHARMACY Ooeaer Circle. see* ******** s »* s **»«■*■*»«* » Circus Day at Palo Alto SATURDAY MARCH 21 Performances at 2 and 8 p HI'IMKi: ART IKMll.s AMI , akttqv-b X r.MVKIlNITV IIAZAAR * SOS Inlvrr-liy Avense X Pslo Aim. 0*1. ; •tsttttttttsitisit-itsttti _ THK PLACE FOB AMUSE- S PALO ALTO BOWLINO ALLEY AND POO-BOOM 5 High Strsst. VETERAN A RAMOS. j Ike Remington ust the best typewriter that money can buy. Remington Typewriter Company (loeorpor—ted) 1015 Golden Cat. Art. SAN FIANCISCO 2g 100-CircOT Champions md Citehritiw-lOO 33 Famous .Equestrians ttl Carina Aarls-Ha-a tO HiUlm pptmwA 7 Russian Coaaacka £ Arabian Tumblerg Of courst a man who bestow* money for public benefit at freely aa Mr. Rockereller doe* would not rare for a little matter of I It.000.000. It mutt be the principle of tbe thing that _ ht considers. —Washington Don't cough your heed off wn*n yon caa get a guaranteed remedy In Beet Laxative Cough Syrup. It la eapecially recommended tor children ss It tt pleasant to take, M a testis laxative thai expelling the phlegm from tbe tymtem- For cough t. coldt, croup, wbooplngcough, boarte- nses and bronchial trouble. Guaranteed. Sold by Welngartner A Co. O Senea .-o-_al -Equilibrists 90 Astonishing Acrobats " 0 Comp#a*» Jtapmnttm OAwtm Superb Gotland In,tree Soor«a af Trained Wild Benata §Jtm.i-ifJM ___F __^__p__Stf^ss_----i -TJ-Bj-S-k-S-st-i Camel,, Llamas aod Bos lndlcu. Sduostsd Sssls snd Sss Lions Hl4£he«t Jumptniz Hcrse. Taaadarlaf Roman Chariot Rncc* Tralss. Ia,*rlse -rsbiaa SIslll**, Oaly Lady Japaaass Artists la America fSS t*Banns' /»o_y BaHmt •Cake lA/alklns Horses Marvelous Picards _^_' &~? SUrk (lOJFamily ____ Le FlOUr Trcup. Pretty Edna Maretla Grtid Street Pirtdt.: mwwHmniiiiimwn * RRD STAR LACNDRT KlKl-.Il (X)MfiTOCK, Ageat. Office: McKlnuey's htraeei J abop. 171 I'nlvertlty arsaue. s Pbons It lack _«7. ^brtrkt-rkkMkkk^Skbbbbbbb S*»»»SMM|>I *****»»»! 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Lace Curtains s apsclslty. Cars*. ful atteattoa given to atsa'a Sae linen, Atree.. Pale AM*. ELITE MARKET t It. FlOt'R, Proprietor. * SIS t-altt-t-.ii> Aveaae. j The best of Inspected Meats Personally Selected" HAMS Ajxn BACON OF THE IW»T UK , MIS. P06JLTBT AKD j GAME IK SK.ASO-. PUSH PIKI1 U.K1' FIUDAT. .* Till , WATK1NK * Ml-BltAT 161486 Emsrsoa StrMt- Itl—rkunltlilBc Rabbsr Ttrs Ssltlna . Spsclalty. G. H. ALLEN OIL CO. W. have lake, (bs __-*T 8sr CURIIXYn HOT BLAST OIL BIRNin. sss-dallT a-sfWd for Cook Sums. ---.„ sad he. aacss. Call al oar sdkss sad ss. ssa bs .a■ alius SS* aUwb -a IT
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