Medicine For Treatment Of Effectively Diseases
Parasitical Worms.com The patient was treated with a single malaria drug or a combination of malaria drugs (the dosage of the regimen was calculated according to the weight of the patient) and was monitored clinically and parasites for 28 days or longer (42 days).
During the follow-up, the parasite will reappear and distinguish recurrence from reinfection by using genotypic techniques. Treatment results after adequate observation are categorized as follows:
Early treatment failure (ETF)
There are signs of danger or severe malaria on days 1, 2 or 3 and there are parasites in the blood.
The number of parasites of day 2 is higher than day 0, regardless of armpit temperature
And the parasite on day 3 with armpit temperature> 37.5◦C.
Number of parasites of day 3 ≥ 25% of day 0
Late treatment failure (LTF)
Late clinical failure (LCF)
There are signs of danger or severe malaria and also parasites on any day from the 4th to the 28th (or the 42nd), which did not previously have the standards of early failure treatment
There is a parasite on any day from the 4th to the 28th and the armpit temperature is> 37.5◦C (or a history of fever), which did not previously have the standards of early failure treatment.
Late parasitological failure (LPF): there is a parasite on any day from the 7th to the 28th and the armpit temperature is <37.5◦C, which previously did not have the standard of treatment. treat early failure or treat late failure. Adequate clinical and parasitological response (ACPR): Clean the parasite by day 28, regardless of armpit temperature, which did not previously meet the criteria for early, failed treatment. Late clinical and late parasite failure
There are also in vitro techniques using radioisotopes, ELISA techniques with anti-lactate dehydrogenase (LDH) antibodies or histidin - rich protein (HPR2) of the parasite, or techniques using fluorescent dyes. Photosynthesis attaches to the DNA of the parasite.
In vitro tests help monitor the evolution of resistance of malaria parasites over time, as shown by IC50 and IC90 values (inhibition concentration of 50%, 90% of parasite growth) , and MIC (minimum inhibitory concentration).
Detect molecular markers related to drug resistance
Currently with PCR, it is possible to detect drug-resistant malaria strains without [I culture parasites as in vitro technique
As if you want to know if the Plasmodium falciparum parasite is resistant to pyrimethamine or sulfadoxine, the PCR technique will look for mutations of the genes that produce DHFR (Pfdhfr), DHPS (Pfdhps) in some codons.
For example, if resistant to pyrimethamine, the codon at position 108 of the Pfdhfr gene with the amino acid Serine is replaced by Asparagine; or if sulfadoxine resistance, codon at position 437 of the gene Pfdhps with amino acid Alanine is replaced by Glycine ... If you want to know if Plasmodium falciparum parasite is resistant to chloroquine, you will find out if there is a mutation of the gene that makes protein transported via the intestinal vacuole membrane of the parasite (Pfcrt gene) or not. If the codon at position 76 of this gene has Lysine replaced by Threonine, the parasite will be resistant to chloroquine.
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